Medical Coding Institute in Trivandrum
K11.23
Chronic Sclerosing Sialadenitis
Sialadenitis is an inflammation of a salivary gland. Salivary glands are the glands that make saliva, which helps with swallowing and digestion and protects your teeth from bacteria. There are three main salivary glands:
- Parotid glands in front of the ear in the cheeks
- Submandibular glands under the chin
- Sublingual glands under the tongue
Sialadenitis mostly affects the parotid and submandibular glands.
It can be an acute (sudden), chronic (long term), or recurrent condition. It is a rare condition. Sialadenitis is most common among elderly adults with salivary gland stones, calcified structures that can form inside a salivary gland and block the flow of saliva into the mouth. Sialadenitis can also occur in other age groups, including infants during the first few weeks of life.
Sialadenitis affects men and women of all races equally.It often happens in people who are sick or recovering from surgery, or people who are dehydrated, malnourished, or immunosuppressed (when your body can’t fight disease).
Symptoms of sialadenitis include:
- Enlargement, tenderness, and redness of one or more salivary glands
- Fever (when the inflammation leads to infection)
- Decreased saliva (a symptom of both acute and chronic sialadenitis)
- Pain while eating
- Dry mouth (xerostomia)
- Reddened skin
- Swelling in the cheek and neck region
If you notice any of these symptoms you should seek medical advice from your doctor. He or she may refer you to an otolaryngologist.A series of patients with unilateral, hard, tumour-like masses of the submandibular gland were diagnosed with chronic sclerosing sialadenitis by Küttner in 1896 . This disease is clinically similar to salivary gland neoplasms and is classified as a tumour-like lesion of the salivary glands by the World Health Organization .Chronic sclerosing sialadenitis is clinically characterised by a firm, relatively painful swelling of one of the submandibular glands. This disorder is characterised by plasmocytic and lymphocytic periductal infiltrate eventually leading to encasement of ducts with thick fibrous tissue .
Decreased salivary flow with stasis is a key factor in chronic sialadenitis. Like acute sialadenitis, this condition is more common in the parotid gland. Its development is often associated with a previous episode of acute suppurative inflammation with subsequent glandular destruction. Another possibility is the recurrent parotitis of childhood which has continued into adulthood.With the onset of the chronic inflammatory process, alterations in salivary chemistry and enzyme and immunoglobulin content take place.
Sialectasis, ductal ectasia, and acinar atrophy occur, accompanied by a lymphocytic infiltrate.Symptoms include recurrent mildly painful swelling of the parotid which often accompany eating. Approximately 80% of patients experience permanent xerostomia.Treatment is initially conservative with acute exacerbations treated similarly to acute sialadenitis.
A thorough search is made for treatable predisposing factors such as a calculus or stricture. If conservative measures fail, ductal dilatation, ligation of the duct, tympanic neurectomy, irradiation of the gland, or excision of the gland may be performed. Only the last of these has been predictably effective.
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