Salivary Gland Disorder Treatment in Corpus Christi, TX
The salivary glands are exocrine glands that produce saliva, which is essential for lubrication during chewing and swallowing, initiation of starch digestion, and maintenance of oral mucosal health. There are three paired major salivary glands the parotid glands (located in front of and below each ear), the submandibular glands (beneath the jaw), and the sublingual glands (under the tongue) as well as hundreds of minor salivary glands distributed throughout the oral mucosa. Disorders of the salivary glands range from common, easily treated conditions such as salivary stones to inflammatory conditions and neoplasms requiring comprehensive evaluation. At Corpus Christi ENT Sinus & Allergy, Dr. Todd M. Weiss provides expert diagnosis and management of the full spectrum of salivary gland disorders.
Common Salivary Gland Disorders
Sialolithiasis (Salivary Gland Stones)
Sialolithiasis refers to the formation of calcified deposits (sialoliths or salivary stones) within the salivary duct system. The submandibular gland is the most frequently affected (approximately 80 to 90 percent of cases) due to its relatively alkaline secretions, high mucin content, and upward-draining duct against gravity. Salivary stones cause intermittent swelling and pain of the affected gland characteristically worsening during meals when salivary flow is stimulated and may predispose to ascending bacterial infection (sialadenitis).
Acute Sialadenitis (Salivary Gland Infection)
Acute bacterial sialadenitis is an infection of a salivary gland, most commonly caused by Staphylococcus aureus. It typically occurs in the setting of ductal obstruction from a stone, in elderly or dehydrated patients with reduced salivary flow, or in patients who are immunocompromised. Clinically, it presents with rapid onset of painful, tender gland swelling, fever, and purulent discharge from the duct opening into the mouth.
Chronic Sialadenitis
Chronic sialadenitis is recurrent or persistent salivary gland inflammation, often resulting from chronic ductal obstruction, repeated episodes of acute infection, or autoimmune conditions. Over time, recurrent inflammation results in progressive fibrosis and loss of glandular function.
Viral Parotitis (Mumps)
Viral parotitis caused by the mumps paramyxovirus produces bilateral parotid gland swelling in unvaccinated or incompletely vaccinated individuals. Other viral causes of parotitis include Epstein-Barr virus, cytomegalovirus, and HIV.
Sjogren's Syndrome
Sjogren’s syndrome is an autoimmune condition in which the immune system targets exocrine glands primarily the salivary and lacrimal glands. It produces the characteristic triad of xerostomia (dry mouth), xerophthalmia (dry eyes), and bilateral parotid gland enlargement. Sjogren’s syndrome may be primary (occurring alone) or secondary (in association with other autoimmune diseases such as rheumatoid arthritis or systemic lupus erythematosus).
Salivary Gland Tumors
Salivary gland neoplasms are relatively uncommon but important to recognize and evaluate promptly. Approximately 80 percent of salivary gland tumors arise in the parotid gland; of these, roughly 80 percent are benign, with pleomorphic adenoma (mixed tumor) being the most common. Warthin’s tumor is the second most common benign parotid neoplasm. Malignant tumors including mucoepidermoid carcinoma, adenoid cystic carcinoma, and acinic cell carcinoma account for approximately 20 percent of parotid tumors and a higher proportion of submandibular and minor salivary gland tumors. Any new or enlarging salivary gland mass warrants prompt evaluation.
Symptoms Warranting Evaluation
- A persistent or growing mass within or adjacent to a salivary gland
- Recurrent or predictable swelling of the cheek or jaw during or after meals
- Pain or tenderness localized to a salivary gland
- Reduced or absent saliva flow from the affected gland
- Purulent or foul-tasting discharge from the mouth
- Dry mouth or dry eyes (suggesting autoimmune disease)
- Facial nerve weakness on the affected side a red flag requiring urgent evaluation to exclude malignancy
Diagnosis
Evaluation includes a thorough history and physical examination with bimanual palpation of the salivary glands and ducts, assessment of duct openings, and examination for lymphadenopathy. Imaging studies may include ultrasound (first-line for salivary stone detection and gland characterization), CT or MRI of the neck (for tumor staging or complex infections), and sialendoscopy (minimally invasive endoscopic evaluation and treatment of the salivary ducts). Fine-needle aspiration cytology is performed for salivary gland masses to characterize the nature of the tissue.
Treatment
- Acute bacterial sialadenitis: oral or intravenous antibiotics, adequate hydration, gland massage, and treatment of the underlying ductal obstruction
- Benign salivary gland tumors: surgical excision with preservation of the facial nerve in the case of parotid tumors (superficial parotidectomy)
- Malignant salivary gland tumors: surgical resection; multidisciplinary oncologic management including radiation therapy as indicated
- Chronic sialadenitis: sialendoscopy-guided duct dilation and irrigation; gland excision for end-stage fibrotic glands
- Salivary stones: hydration, gland massage, sialagogues (agents that stimulate saliva production), and sialendoscopy for duct stone retrieval; surgical removal for large or refractory stones
Schedule an Appointment Today
If you have salivary gland swelling, pain, stones, or a lump, an evaluation can identify the cause and the right treatment. Call us at (361) 320-6130 or connect with us online to schedule a consultation.