Chapter 10. Diseases and Injuries of Salivary Glands (V.V. Afanasyev)
9 topics with a brief review: definitions, key facts, and classroom questions.
This chapter is dedicated to one of the most complex topics in oral and maxillofacial surgery — salivary gland pathologies. Here, we will sequentially analyze all the material: from basic anatomy, physiology, and modern examination methods to the clinical presentation of specific nosologies. The section details acute and chronic sialadenitis, sialolithiasis, cysts, tumors, as well as injuries, fistulas, and systemic disorders such as Sjögren's syndrome and sialosis.
During practical classes and exams, instructors evaluate knowledge of differential diagnosis most strictly. You will be expected to clearly distinguish between an exacerbation of chronic sialadenitis and a primary acute process, interpret sialograms in sialolithiasis, and understand the clinical difference between cysts and true tumors of the glands.
Pay special attention during your study to the technique of duct probing, contrast radiography, and surgical tactics for stone removal. This is not just theory, but the foundation of your confident work at the patient's chair.
Where does the excretory duct of the parotid salivary gland open?
The orifice of the parotid duct opens into the vestibule of the oral cavity on a specific papilla located at the level of the upper molars.
How long does sialometry take?
Secretion collection for quantitative evaluation lasts strictly 20 minutes.
What is the difference between sialadenosis and sialadenitis?
Sialadenosis is a reactive-dystrophic process without a pronounced inflammatory component, occurring against the background of other diseases. Sialadenitis is true inflammation of the salivary gland.
Why do teeth rapidly break down in Sjögren's syndrome?
Due to a critical decrease in saliva production, debilitating dryness (xerostomia) and dysbiosis of the oral mucosa develop, which deprives the teeth of natural protection and leads to rapidly progressive caries.
In which salivary gland do stones most commonly form?
In 90–95% of cases, sialolithiasis affects the submandibular salivary glands.
Why is the parotid salivary gland rarely affected by stones?
The parotid gland secretion contains the statherin protein, which acts as a potent inhibitor of calcium phosphate precipitation from saliva.
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