Salivary gland diseases

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Salivary gland diseases

• Dr .Khurram Zafar

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Salivary glands

• An introduction to there anatomy and physiology

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Introduction

• Salivary glands are exocrine gland ( they have
  duct system to flow there secretions)
• The saliva that is produced by these glands is
  brought to the oral cavity.
• The main function of the saliva is the
  lubrication of the food that is being chewed and
  assisting in deglutition
• Saliva also performs digestion of the
  carbohydrates by the enzyme it has

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• Major salivary gland
• parotid glands
• submandibular glands
• sublingual glands
• Minor salivary glands
• Labial buccal glands
• Glossopalatine glands
• Palatine glands
• Lingual glands

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Major salivary glands
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Major salivary glands
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Parotid gland

• It is enclosed in a well defined connective
  tissue capsule with its superficial part lying in
  front of the ear and the deeper part lying in the
  retromandibular fossa.
• Its secretory duct is the stansons duct which
  opens in the buccal mucosa oppsite to the 2nd
  maxillary molar
• Its a pure serous gland
• All the five terminal branches of the facial
  nerve pass through the parotid gland .

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Parotid gland
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Parotid gland
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Submandibular gland

• This gland is also enveloped by a well developed
  capsule.
• It is located in the submandibular triangle
  behind and below the free border of the
  mylohyoid muscle with its small extension lying
  above the mylohyoid.
• Its has a whartons duct, which opens at the
  lingual freenum on the floor of the mouth.
• It has a mixed secretion both serous and mucous

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Submandibular gland
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Sublingual gland

• It lies in between the floor of the mouth and the
  mylohyoid muscle,it is composed of large main
  part and small numerous glands.
• Its duct is the Bartholins duct which opens with
  in or adjacent to the whartons duct.
• Iis a mixed gland too.

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Minor salivary glands

• LABIAL BUCCAL GLANDS
• These are present on the lips and the cheeks
  and are of the mixed type.
• GLOSSOPALATINE GLANDS
• They are pure mucous glands, there location is
  the isthmus of the glossopalatine fold

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Minor salivary glands

• PALATINE GLANDS
• they are also pure mucous in variety,they
  consist of hundreds of glandular aggregations in
  the lamina propria of the postro-lateral region
  of the hard palate and in the submucosa of the
  soft palate and the uvula.

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Minor salivary glands

• LINGUAL GLANDS
• They can be divided into several groups.
• the anterior group is near the apex of the
  tongue and are of the mucous character.
• and the posterior group is of the mixed type.
• There ducts open on the ventral surface of the
  tongue near the lingual frenum.

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Physiology of salivary glands

• Salivary glands produce serous sections and
  mucous secretions or mixed secretions.
• SEROUS SERETIONS
• There are serous cells which specialized for the
  synthesis, storage and secretions of the
  proteins.
• The typical serous cell is pyramidical in shape
  with its broad base resting on the basal lamina
  and its narrow apex broadening on the lumen.
• The prominent feature of the serous cells ia the
  accumlation of the secretery granules in the
  apical cytoplasm.

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Mucous cells

• These cells are also specialized for the
  synthesis, storage and secretion of secretory
  product.
• The apex of these cells appear empty except for
  some thin strands of cytoplasm
• forming trabacular network.
• The nucleus and some cytoplasm is pushed towards
  the base of the cell.

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Mucous cells

• The secretory product of the mucous cells differ
  from the serous cells in two important respect.
• 1. they have little or no enzymatic
• activity and only serve the purpose of
• lubrication.
• 2. the ratio of carbohydrate is greater to
• that of the protein with large amount of
  
• sialac acid.

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Myoepithelial cells

• These cells are closely related to the secretory
  and the intercalated duct system.
• The body of the cell is small filled with a
  flattened nucleus and numerous branching
  cytoplasmic processes.
• These cells are considered to have a contractile
  function helping to expel secretions from the
  lumina of the secretory units and the ducts.

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Classification

• Of salivary glands

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Reactive lesions

• Mucocele
• Mucus retention cysts
• Sialolitiasis
• Chronic sclerosing sialadenitis
• Necrotizing sialometaplasia

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Salivary infections

• Acute parotitis
• Viral endemic parotitis(Mumps)
• Bacterial sialadenitis

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Immune related diseases

• Lymphoepithelial sialadenitis
• Sjogren Syndrome.

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Salivary gland tumors

• BENIGN
• Pleomorphic adenoma
• Monomorphic adenoma
• Papillary cystadenoma
• Oncocytoma
• Other adenomas

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Salivary gland tumors

• MALIGNANT
• Mucoepidermoid carcinoma.
• Adenoid cystic carcinoma
• Acinic cell carcinoma
• Polymorphous low grade adenocarcinoma
• Other adenocarcinomas