| Abstract: |
Background: Human salivary glands are of two types, major (paired parotid, submandibular and sublingual) and minor (more than 600 hundreds), all are responsible for production of saliva which is important for speech, digestion, taste sensation and immunity of the oral cavity. The inflammatory salivary glands disorders include acute, subacute and chronic sialadenitis which all may be caused by viral or bacterial infection with risk factors like tobacco smoking, bad oral hygiene and immunodeficiency. However, chronic sialadenitis may be caused by an autoimmune disease (like Sjoِgren’s syndrome) or by a granulomatous disease (like tuberculosis). The non inflammatory salivary glands disorders include sialolithiasis, cysts, sialadenosis and necrotizing sialometaplasia which all can cause salivary gland enlargement with or without pain associated with decrease in the production of saliva and subsequent oral dryness and injury manifestations. Concerning the neoplastic salivary glands disorders, it divides into benign and malignant tumors. The benign tumors are the most common to occur and are characterized by slowly painless growth to the affected part or gland without affection to the related lymph nodes and with no spread of the tumor cells. This type usually occurs in the forth to sixth decades. However, the malignant tumors have the lesser percentage to occur and are characterized by painful slowly or rapidely growing swelling with affection to the nearby structues such as nerves, blood vessels and lymphatic system with also the ability of the tumor cells to spread causing secondary malignant foci else where in the body. Most patients who present with an acute swelling irrespective of age are considered to have an inflammatory or infectious course. Such patients need culture and sensitivity if suffer from discharge. In the resolved acute clinical presentation, investigations, if facilities are available, would be ultrasound (US), followed by sialendoscopy. In the acute Unresolved cases (after about 2 weeks of treatment), a magnetic resonance image (MRI), or plain computed tomographic (CT) image would be appropriate. In the chronic or neoplastic situation, a plain (CT or MRI) image, ultrasound (US)-guided fine-needle aspiration cytology (FNAC) or sialogram is mandatory. In the child or infant in an acute situation, the most frequent diagnosis is viral infection. As the child will be toxic and pyrexial and suffers pain, antibiotics, analgesics, and hydration are recommended. In the recurrent acute situation occurring at frequent intervals, anti-inflammatory with analgesia treatment should be given but its effectiveness in preventing recurrence is much debated and frequently does not shorten or prevent further episodes. In adults, the acute situation is most usually associated with a bacterial infection. They require hydration, antibiotics, anti-inflammatories, and analgesia. In the chronic situation, the patient should be treated according to the result of the previous investigations described above, including the results of a culture if performed. In the benign neoplastic disorders, patients require complete surgical removal of the tumor with follow up for fear that the tumor may reoccur or may turn malignant. However, in the malignant tumors, the treatment is radical surgical excision accompanied with neck dissection in some aggressive cases. The chemotherapy and radiotherapy can be used in certain cases as adjuvant or very rarely alternative to surgery.Objectives: The aim of this work is the fulfillment of the major and minor salivary glands disorders and their management.
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