Disease |
Clinical |
Investigations |
Management |
Xerostomia |
Dry mouth, often due to Sjogren's syndrome, diabetes, medications (antidepressants, antihistamines), anxiety, aging, dehydration, or mouth breathing. Reduces saliva, impairing speech, swallowing, and increasing risk of dental caries. |
- Salivary gland function tests
- Blood tests for autoimmune markers, blood glucose
- Oral examination for dryness and dental caries
|
- Rehydration if needed
- Review and adjust medications
- Encourage regular oral fluids and oral hygiene
|
Parotitis |
Swollen, warm, and tender parotid gland, bad taste, and halitosis. Often seen in children with mumps, or in elderly with bacterial infections (staphylococcal or streptococcal). |
- CBC and inflammatory markers
- Culture of discharge if present
- Ultrasound to confirm infection or abscess
|
- Antibiotics for bacterial infection
- Analgesia for pain relief
- Encourage good oral hygiene
|
Salivary Duct Calculi |
Swelling and pain in the gland, especially before or during meals, as saliva production increases. |
- Ultrasound or CT scan to locate stones
- Sialography if indicated
|
- Stone removal via sialendoscopy
- Hydration and warm compresses
|
Salivary Gland Tumors |
70% benign (pleomorphic adenoma common in parotid). Tumors in smaller glands more likely malignant. Suspect malignancy if facial nerve palsy present with swelling. |
- Ultrasound or MRI to assess tumor
- Fine needle aspiration or biopsy for histology
- CT scan for staging if malignancy suspected
|
- Surgical excision, e.g., parotidectomy
- Postoperative radiation for malignant tumors
- Regular follow-up for recurrence
|
Pleomorphic Adenoma |
Benign tumor, often in parotid gland; slowly enlarging, non-tender mass. |
- Ultrasound or MRI to confirm location and size
- Fine needle aspiration or biopsy for histology
|
- Superficial parotidectomy with preservation of facial nerve
- Follow-up for recurrence
|
Malignant Tumors |
Includes mucoepidermoid carcinoma, adenoid cystic carcinoma, and squamous cell carcinoma; may present with pain, rapid growth, and facial nerve palsy. |
- MRI and/or CT scan for staging
- Fine needle aspiration or biopsy
- Consider PET scan for metastasis
|
- Radical parotidectomy or tumor resection
- Radiation therapy if indicated
- Oncologic follow-up for recurrence/metastasis
|