Sialoadenitis
Information on the causes, symptoms, and treatments of salivary gland inflammation.
Symptoms and Causes
Sialoadenitis is the inflammation of the salivary glands, which are located under the tongue (sublingual), under the jaw (submandibular), and near the ears (parotid). Although it can occur in all of these glands, it is most frequent in the parotid glands.
Depending on the disease course, it can be classified into two types:
- Acute sialoadenitis: inflammation appears suddenly.
- Chronic sialoadenitis: persistent or recurrent inflammation occurs.
The prognosis of sialoadenitis is favorable, as most patients fully recover if appropriate treatment is initiated in a timely manner. Individuals with underlying conditions such as diabetes, HIV, or malnutrition have an increased risk of complications.
Symptoms
Symptoms of sialoadenitis vary depending on the underlying cause. The most prominent are:
- Pain when chewing or swallowing.
- Swelling of the affected salivary gland.
- Redness of the skin over the affected gland.
- Difficulty opening the mouth or moving the jaw.
- Fever.
- Bad taste in the mouth.
- Presence of pus in the saliva.
Causes
Sialoadenitis can arise from various causes, divided into two main types:
- Obstructive sialoadenitis: the salivary gland is blocked, preventing proper saliva flow and promoting infection. Causes may include:
- Sialoliths: stones in the salivary ducts.
- Tumors.
- Mucous plugs.
- Scarring.
- Trauma.
- Non-obstructive sialoadenitis: inflammation is not due to gland obstruction.
- Infections:
- Bacterial: Staphylococcus, Streptococcus.
- Viral: influenza, paramyxovirus.
- Autoimmune diseases, most notably Sjögren’s syndrome.
- Radiotherapy of the head or neck, especially radioiodine therapy.
- Certain medications, particularly those that reduce saliva flow.
Risk Factors
The main risk factors for sialoadenitis are:
- Age: more frequent between 60 and 70 years. It also occurs in children aged 2 to 6 years, usually secondary to mumps (parotitis).
- Xerostomia: dry mouth.
- Diseases that promote salivary gland inflammation: Sjögren’s syndrome, HIV, tuberculosis, diabetes.
- Dehydration (low fluid intake).
- Malnutrition, undernutrition, or eating disorders (reduce saliva production).
- Poor oral hygiene.
- Tobacco use.
Complications
Untreated sialoadenitis or cases not responding adequately to treatment may lead to:
- Abscesses: accumulation of pus within the salivary gland.
- Infection of adjacent tissues.
- Ludwig’s angina: infection of the floor of the mouth and neck.
- Permanent damage to the salivary glands.
- Rarely, systemic infection, i.e., spreading throughout the body.
- Very rarely, reduced saliva production.
Prevention
It is possible to reduce the risk of sialoadenitis by following these recommendations:
- Maintain proper oral hygiene.
- Stay adequately hydrated.
- Follow a balanced diet with all essential nutrients.
- Avoid consuming spicy, acidic, or excessively salty foods.
- Attend regular dental check-ups.
Which Specialist Treats Sialoadenitis?
Sialoadenitis is diagnosed and managed within the Otorhinolaryngology specialty.
Diagnosis
Sialoadenitis is diagnosed using a combination of medical assessments:
- Medical history: evaluates the patient’s medical background and reported symptoms.
- Physical examination: inspects the oral cavity and palpates both sides of the face and neck to detect signs of inflammation and tenderness.
- Blood tests: help identify signs of infection and inflammation.
- Culture if pus is present.
- Imaging studies: ultrasound, magnetic resonance imaging (MRI), or computed tomography (CT) provide detailed images of the salivary glands, allowing detection of inflammation and underlying causes (tumors, malformations, scar tissue).
- Sialography, in cases of chronic obstructive sialoadenitis.
Treatment
Treatment of sialoadenitis focuses on addressing the underlying cause, as inflammation resolves accordingly:
- Antibiotics: treat bacterial infections.
- Specific medications for autoimmune diseases.
- Sialoendoscopy: a minimally invasive procedure in which the obstruction is removed by inserting an endoscope into the salivary duct.
- Abscess drainage.
- Gland surgery: in severe chronic cases.
