Otolaryngology: Sialadenitis
Sialadenitis
Definitions
- Sialolithiasis: Stone Within the Salivary Gland or Duct
- Sialadenitis/Sialoadenitis: Inflammation of the Salivary Gland
Stone Risk Factors
- Stagnant Flow of Saliva
- Inflammation or Injury
- Male Sex
- Hypovolemia or Diuretics
- Anticholinergic Medications
- Tobacco
Most Common Glands
- Submandibular Gland (80-90% – Most Common)
- Longer Duct
- Slow Flow of Saliva Against Gravity
- High Mucin and Calcium Content
- Parotid Gland (6-20%)
- Sublingual Glands (1-2%)
Presentation
- Pain
- Swelling
Diagnosis
- Clinical Diagnosis
- Consider Imaging (US/CT) if Concerned for Malignancy or Abscess
Treatment
- Primary Treatment: Conservative Management
- Good Hydration
- Duct Massage
- Salivation (Hard Candies/Lemon Drops)
- NSAID’s for Pain Control
- If Fails: Minimally Invasive Intervention
- Sialoendoscopy with Stone Removal
- Laser Lithotripsy
- Extracorporeal Lithotripsy
- If Still Fails: Surgical Stone Removal
- ABX if Concerned for Secondary Infection (Fever/Purulence)
Suppurative Parotiditis
Basics
- Definition: Acute Infection of the Parotid Gland
- Most Common Organism: Staphylococcus aureus
Presentation
- Often See 4-12 Days Postoperatively
- Pain & Swelling
- Erythema
- Decreased Saliva
Risk Factors
- Postoperative Elderly Patients with Dehydration – Most Common
- Stagnant Flow of Saliva
- Anticholinergic Medications
- Tobacco
- Malnutrition
- Sialolithiasis
Treatment
- Primary Treatment: Hydration and IV Antibiotics
- Indication for Surgical Drainage: Abscess or Antibiotic Failure After 48 Hours