Head And Neck

Swellings In Parotid Region Acute: Acute: SC tissue abcess SC tissue abcess Parotid Mumps, septic parotitis Parotid Mumps, septic parotitis Bone Ostemyelitis Bone Ostemyelitis Chronic: Chronic: Salivary Gland origin Salivary Gland origin Extrasalivary Gland origin Extrasalivary Gland origin

Salivary Gland origin Unilateral (suspect Tumor): Cystic Adenolymphoma Cystic Adenolymphoma Solid Tumor (B or M) Solid Tumor (B or M) Bilateral (mostly Benign): Inflammatory (chronic Parotitis) Inflammatory (chronic Parotitis) Sialactaisis Sialactaisis Endemic (Nutrirional) parotitis Endemic (Nutrirional) parotitis Mikulicz Syndrome,Sjogren’s Mikulicz Syndrome,Sjogren’s Tumor (10% Adenolymphoma) Tumor (10% Adenolymphoma) Others Others

Extra-salivary Gland Skin Skin Subcutaneous Subcutaneous Lymph Node Lymph Node Facial Nerve Neuroma Facial Nerve Neuroma Masseter Muscle Masseter Muscle Idiopathic Hypertrophy, Fibrosarcoma Idiopathic Hypertrophy, Fibrosarcoma Mandibule Mandibule Adamantimoma Adamantimoma

Acute parotitis (Parotid Abscess) Aetiology: Aetiology: Organism: Staphaureus Organism: Staphaureus Route: mouth rare Blood Route: mouth rare Blood Predisposed: Dehydration,Bad hygiene Predisposed: Dehydration,Bad hygiene Clinical Picture Clinical Picture General: Toxaemia General: Toxaemia Local: Swelling, oedema, Throbbing pain, Tender gland, oral cavity pus on pressure on the gland, Cervical LN Local: Swelling, oedema, Throbbing pain, Tender gland, oral cavity pus on pressure on the gland, Cervical LN Treatment Treatment Incision and Drainage Incision and Drainage

Acute parotitis (Parotid Abscess)

Chronic Parotitis (Recurrent Parotitis) Adulthood: Adulthood: Obstruction by stone or stenosis Obstruction by stone or stenosis Autoimmune (Bilateral) Autoimmune (Bilateral) Sjogren’s Syndrme Sjogren’s Syndrme Childhood (Sialectasis): Childhood (Sialectasis): Congenital Congenital Autoimmune ( 3m-10y )remit at 15y Autoimmune ( 3m-10y )remit at 15y

Chronic Parotitis due to obstruction by stone

Chronic Parotitis due to Sjogren’s Syndrome Keratoconjuntivitis Sicca Xerostomia Rhematoid Arthritis

Cavitary sialectasis with Sjogren’s Syndrome

Mikulicz syndrome

Sialectasis (snow storm apperance in sialogram)

Salivary Gland Calculi 50 times more common in submandibular gland ! 50 times more common in submandibular gland ! Clinically Clinically recurrent inflammation, recurrent inflammation, pain increase with meals, pain increase with meals, stone may felt in mouth floor stone may felt in mouth floor Diagnosis : Plain x ray or Sialogram Diagnosis : Plain x ray or Sialogram

Submandibular stone

Parotid stone

Treatment of salivary Gland Calculi Parotid Parotid Gland single direct extraction Gland single direct extraction multiple superficial parotidectomy multiple superficial parotidectomy Duct extraction Duct extraction in front of masseter transoral in front of masseter transoral over the masseter parotid incision over the masseter parotid incision Submandibular Submandibular Gland Excision Gland Excision Duct stone extraction from mouth Duct stone extraction from mouth

Submandibular excision