The salivary glands

Xerostomia

Xerostomia means dryness of the mouth. Causes include:
• Psychogenic-anxiety
• Pyrexia
• Drugs-anticholinergics, antihistamines, and tricyclic and related antidepressants
• Sjogren’s syndrome
• Diabetic ketoacidosis and dehydration The sensation of excess salivation (ptyalism) is chiefly psychogenic. It occurs before vomiting and with lesions of the mouth.

Bacterial and viral infections

These can affect any of the salivary glands, the commonest condition being acute parotitis due to the mumps virus. Acute parotitis due to an ascending infection with staphylococci or streptococci occurs in alcohol-dependent patients and in elderly patients, usually associated with dehydration and poor oral hygiene. Treatment consists of antibiotic and drainage of any abscess that is demonstrated.

Sarcoidosis

This can produce parotid gland enlargement. When combined with lacrimal gland enlargement it is known as Mikulicz syndrome. Salivary duct obstruction due to calculus Obstruction due to calculus usually involves the submandibular gland. There is painful swelling of the gland after eating. The stones can sometimes be felt in the floor of the mouth and their removal is usually followed by complete relief of symptoms.

Tumours

Salivarygland turnours are usually of a mixed type. They may involve any of the salivary glands but usually affect the parotid. The gland becomes swollen but not tender and treatment is by removal, although local recurrences occur.

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