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Sialolithiasis accounts for about 50% of all disease occurring in major salivary glands, and for about 66% of all obstructive salivary gland diseases. Salivary gland stones are twice as common in males as in females. The most common age range in which they occur is between 30 and 60, and they are uncommon in children. [2]
The two parotid glands are major salivary glands wrapped around the mandibular ramus in humans. [6] These are largest of the salivary glands, secreting saliva to facilitate mastication and swallowing, and amylase to begin the digestion of starches. [7] It is the serous type of gland which secretes alpha-amylase (also known as ptyalin). [8]
A salivary diverticulum (plural diverticuli) is a small pouch or out-pocketing of the duct system of a major salivary gland. [16] Such diverticuli typically cause pooling of saliva and recurrent sialadenitis , [ 17 ] especially parotitis . [ 18 ]
Sialadenitis (sialoadenitis) is inflammation of salivary glands, usually the major ones, the most common being the parotid gland, followed by submandibular and sublingual glands. [1] It should not be confused with sialadenosis (sialosis) which is a non-inflammatory enlargement of the major salivary glands. [2]
Strictures are the second most common cause of chronic obstructive sialadenitis, after salivary stones. [1] In line with this, strictures may give rise to the "meal time syndrome", [1] where there is pain and swelling of the involved salivary gland upon salivary stimulation with the sight, smell and taste of food.
Stones may be removed by manipulation in the doctor's office, or, in the worst cases, by surgery. Lithotripsy, also known as "shock wave" treatment, is best known for its use breaking up kidney stones. Lithotripsy can now be used on salivary stones as well. Ultrasound waves break up the stones, and the fragments flush out of the salivary duct. [7]
Mucoepidermoid carcinoma is a common malignant tumour of the salivary glands and has a low incidence of 4–13%. [13] Adenoid cystic carcinoma is also a common malignant salivary gland lesion and has an incidence of 4–8%. This carcinoma tends to invade nerves and can re-occur post-treatment.
This occurs because of a ruptured salivary gland duct usually caused by local trauma (damage) in the case of mucous extravasation phenomenon and an obstructed or ruptured salivary duct in the case of a mucus retention cyst. The mucocele has a bluish, translucent color, and is more commonly found in children and young adults.