head and neck. swellings in parotid region acute: acute: sc tissue abcess sc tissue abcess parotid...

Head And NeckHead And Neck

Swellings In Parotid RegionSwellings In Parotid Region

Acute:Acute:

SC tissue abcessSC tissue abcess

Parotid Mumps, septic parotitisParotid Mumps, septic parotitis

Bone OstemyelitisBone Ostemyelitis Chronic:Chronic:

Salivary Gland originSalivary Gland origin

Extrasalivary Gland originExtrasalivary Gland origin

Salivary Gland originSalivary Gland origin

Unilateral (suspect Tumor):Unilateral (suspect Tumor): Cystic AdenolymphomaCystic Adenolymphoma Solid Tumor (B or M)Solid Tumor (B or M)Bilateral (mostly Benign):Bilateral (mostly Benign): Inflammatory (chronic Parotitis)Inflammatory (chronic Parotitis) SialactaisisSialactaisis Endemic (Nutrirional) parotitisEndemic (Nutrirional) parotitis Mikulicz Syndrome,Sjogren’sMikulicz Syndrome,Sjogren’s Tumor (10% Adenolymphoma)Tumor (10% Adenolymphoma) OthersOthers

Extra-salivary GlandExtra-salivary Gland

Skin Skin SubcutaneousSubcutaneous Lymph NodeLymph Node Facial Nerve NeuromaFacial Nerve Neuroma Masseter MuscleMasseter Muscle

Idiopathic Hypertrophy, FibrosarcomaIdiopathic Hypertrophy, Fibrosarcoma MandibuleMandibule

AdamantimomaAdamantimoma

Acute parotitis (Parotid Acute parotitis (Parotid Abscess)Abscess) Aetiology:Aetiology:

Organism: StaphaureusOrganism: Staphaureus Route: mouth rare BloodRoute: mouth rare Blood Predisposed: Dehydration,Bad Predisposed: Dehydration,Bad

hygienehygiene Clinical PictureClinical Picture General: ToxaemiaGeneral: Toxaemia Local: Swelling, oedema, Throbbing Local: Swelling, oedema, Throbbing

pain, Tender gland, oral cavity pus on pain, Tender gland, oral cavity pus on pressure on the gland, Cervical LNpressure on the gland, Cervical LN

TreatmentTreatment Incision and DrainageIncision and Drainage

Acute parotitis (Parotid Acute parotitis (Parotid Abscess)Abscess)

Chronic Parotitis (Recurrent Chronic Parotitis (Recurrent Parotitis)Parotitis)

Adulthood:Adulthood:

Obstruction by stone or stenosisObstruction by stone or stenosis

Autoimmune (Bilateral) Autoimmune (Bilateral)

Sjogren’s Syndrme Sjogren’s Syndrme

Childhood (Sialectasis):Childhood (Sialectasis):

CongenitalCongenital

Autoimmune ( 3m-10y )remit at 15yAutoimmune ( 3m-10y )remit at 15y

Chronic Parotitis due to Chronic Parotitis due to obstruction by stoneobstruction by stone

Chronic Parotitis due to Chronic Parotitis due to Sjogren’s SyndromeSjogren’s Syndrome

Keratoconjuntivitis SiccaKeratoconjuntivitis Sicca

XerostomiaXerostomia

Rhematoid ArthritisRhematoid Arthritis

Cavitary sialectasis with Cavitary sialectasis with Sjogren’s SyndromeSjogren’s Syndrome

Mikulicz syndromeMikulicz syndrome

Sialectasis (snow storm Sialectasis (snow storm apperance in sialogram)apperance in sialogram)

Salivary Gland CalculiSalivary Gland Calculi

50 times more common in 50 times more common in submandibular gland !submandibular gland !

Clinically Clinically recurrent inflammation,recurrent inflammation, pain increase with meals,pain increase with meals, stone may felt in mouth floorstone may felt in mouth floor

Diagnosis : Plain x ray or SialogramDiagnosis : Plain x ray or Sialogram

Submandibular stoneSubmandibular stone

Submandibular stoneSubmandibular stone

Parotid stoneParotid stone

Treatment of salivary Gland Treatment of salivary Gland CalculiCalculi

ParotidParotid Gland single direct extractionGland single direct extraction multiple superficial multiple superficial

parotidectomyparotidectomy Duct extractionDuct extraction in front of masseter transoralin front of masseter transoral over the masseter parotid incisionover the masseter parotid incision SubmandibularSubmandibular Gland ExcisionGland Excision Duct stone extraction from mouthDuct stone extraction from mouth

Submandibular excisionSubmandibular excision