Salivary Gland (Human Anatomy): Image, Functions, Diseases, and Treatments

The saliva produced by the salivary glands helps break down food, maintains a moist mouth, and helps keep your teeth in good condition. There are three sets of salivary glands in your mouth: the parotid, the sublingual, and the submandibular. Your lips, the interior of your cheeks, and the lining of your mouth and throat all contain several small salivary glands.

• Sublingual glands: You'll find them underneath the floor of your mouth, on each side of your tongue.
• Submandibular glands: The submandibular salivary glands are located in the lower region of your jaw and divided into the superficial and deep lobes. Saliva from the submandibular glands also enters the mouth sublingually.
• Parotid glands: In front of each ear is a pair of glands called the parotids. Your parotid glands have a superficial and deep portion, much like your submandibular glands. Small ducts close to your upper molars carry the saliva from your parotid glands into your mouth.

• Saliva production is the primary role of the salivary glands. The health of your mouth and body are both supported by your saliva. Saliva, for instance, lubricates and relaxes the oral and pharyngeal regions.
• Makes food more manageable by making it more semi-solid.
• Amylase is an enzyme that aids in the digestion of carbohydrates.
• Helps maintain a clean tongue.
• Helpful in lowering the probability of tooth decay and gum disease.
• Maintains the ideal level of saliva in the mouth.

• Sialolithiasis: In this disease, calcium-based stones form in the salivary glands. If these stones obstruct the glands, the salivary flow may become partially or entirely ineffective.
• Sialadenitis: Sialadenitis is a term for an infection of the salivary glands (sometimes known as sialadenitis). When the gland is congested with stones, it frequently occurs. Bacteria like staph or strep may bring on this infection. The disease is more likely to harm elderly adults and neonates.
• Sjögren's syndrome: Sjögren's syndrome is another typical salivary gland disorder. White blood cells assault healthy cells in glands that secrete moisture, such as oil, sweat, and salivary glands, to cause this condition. Most commonly, this issue affects women who have autoimmune disorders like lupus.
• Cancerous tumours: Salivary gland cancerous tumours are pretty uncommon. According to Cedars-Sinai, they typically affect people between 50 and 60 when they occur.
• Non-cancerous tumours: The parotid glands can be impacted by pleomorphic adenomas and Warthin's tumours, two non-cancerous tumours. Additionally, benign pleomorphic adenomas can infrequently form in the submandibular gland and minor salivary glands.
• Salivary glands cyst: When the normal flow of saliva into the mouth cavity is blocked, a hole filled with fluid called a sialocele, also known as a salivary gland cyst, forms. Trauma to the salivary system can reduce normal flow and cause saliva to build up in a big salivary gland or nearby tissues.
• Dry mouth: When the salivary glands in your mouth cannot produce enough saliva to keep your mouth moist, the condition known as dry mouth, or xerostomia, develops. An unfavourable drug reaction, aging-related diseases, or radiation therapy for cancer are major causes of dry mouth. A less common cause of dry mouth is a condition that directly affects the salivary glands.
• Salivary duct stones: Stones in the salivary gland or the draining tubes (ducts) are referred to as salivary gland stones. They create a barrier that hinders the flow of saliva. Stones in the salivary glands are the most common cause of inflammatory salivary gland disease.
• Pleomorphic adenomas: Pleomorphic adenomas are the most common parotid tumours. It is benign and develops gradually. The first symptom of a pleomorphic adenoma is a painless lump towards the back of the jaw, directly below the earlobe. They are more prevalent in women.
• Benign pleomorphic adenomas: Although less frequent than in the parotid, benign pleomorphic adenomas can also develop in the submandibular gland and minor salivary glands.
• Warthin's tumour: The second most frequent benign parotid gland tumour is Warthin's tumour. Older guys are more likely to have it.
• Viral Infections: Salivary gland enlargement can be brought on by viral illnesses like the flu, mumps, and other similar conditions. Parotid glands swell on both sides of the face, producing the impression of 'chipmunk cheeks.'
• Bacterial infection: Typically, bacterial infections result in unilateral salivary gland enlargement. The swelling will be accompanied by additional symptoms, including fever and soreness. The bacteria are typically staph bacteria as well as those that are typically present in the mouth. The parotid gland is commonly affected by these illnesses.
• Salivary stones, or sialoliths: Salivary stones are accumulations of crystallised saliva deposits and are the most frequent cause of enlarged salivary glands. Salivary stones can occasionally stop the flow of saliva. Saliva backs up into the gland when the ducts are blocked, resulting in discomfort and swelling. Pain is typically intermittent, localised to one gland, and worsens over time. The gland is likely to get an infection if the blockage is not removed.
• Parotid fistula: An epithelialized passageway between the skin or mucosa and the parotid duct or gland, where saliva is secreted, is known as a parotid fistula. The retro auricular area, skin across the cheek, or oral mucosa can be the fistula's entrance location.
• Perineural invasion: Perineural invasion, or PNI for short, is the invasion of cancer into the area close to a nerve. It frequently occurs in colorectal, prostate, and head and neck cancer cases.
• Ranula: Under the tongue is a spit-filled cyst known as a ranula. The cause can be a plugged salivary gland. Saliva leaks into the nearby tissues, causing a cyst or 'bubble' to form there instead of pouring from the gland and into your mouth. Typically painless and insignificant, ranulas do not cause any problems.
• Plunging ranula: When mucus from the sublingual gland escapes and herniates into the submandibular region, and beyond through the mylohyoid muscle, a non-epithelial-lined salivary gland cyst is known as a 'plunging ranula' (PR), also referred to as a 'cervical ranula.'
• FREY'S SYNDROME: Surgery in the area near the parotid glands frequently leads to Frey syndrome, a rare illness. Frey syndrome's primary signs and symptoms include unwanted sweating and flushing after eating particular meals, especially those that produce a substantial salivary reaction, which happens on the cheek, temple (temporal region), or behind the ears (retro-auricular region).

• Needle biopsy of salivary gland: The skin surrounding the selected salivary gland is first cleaned with rubbing alcohol. After that, a local anaesthetic is administered to treat the pain. The salivary gland is numbed, and a tiny needle is used to carefully insert a small piece of tissue. After being placed on microscope slides, the tissue is sent to a lab for examination.
• X-ray: Dental X-rays assist in identifying problems with your mouth, teeth, gums, and jaw early on. Serious problems can cost you money, pain, and occasionally even your life. Avoiding them can help.
• CT: CT scans offer more accurate views of the body's structures than traditional X-rays, including the bones, muscles, fat, and organs. Internal organs, bones, soft tissue, and blood vessels can all be scanned with a CT scanner, which is more accurate and informative than regular X-ray inspections. While having a CT scan, radiation exposure is minimised. A dye may be injected into a vein or consumed to make the organs or tissues more noticeable.
• MRI: A magnetic resonance imaging scan is sometimes known as an MRI. A non-invasive, radiation-free medical diagnostic procedure is an MRI (X-rays). The MRI machine takes pictures of the inside of your body using a strong magnet and a computer. Each image or 'slice' only shows a few layers of biological tissue simultaneously. The photos can then be examined on a computer screen.
• Ultrasound: For the differential diagnosis of disorders affecting the salivary glands, ultrasonography (US) is helpful. Salivary glands may have several tiny, oval, hypoechoic regions and are enlarged and hypoechoic during acute inflammation.
• Sialography: Sialography is the term used to describe the radiographic evaluation of the salivary glands. Usually, a small amount of contrast material is injected into a single gland's salivary duct, and then ordinary X-ray projections are used to capture the image. The term 'sialogram' refers to an image like this.
• FNAC: In outpatient clinics, fine needle aspiration cytology (FNAC) is frequently used to quickly, simply, and affordably sample superficial masses like those found in the neck. It rarely causes complications and just mildly traumatizes the patient.

• Sublingual gland surgery: Excisional surgery is required to altogether remove the sublingual gland in cases of cancers. The sublingual glands are on either side of your mouth's floor, beneath your tongue. The surgeon will remove the gland and portion of the surrounding tissue through an internal mouth cut (an incision).
• Submandibular Sialadenectomy: The head and neck treatments known as submandibular sialadenectomy are common. The existence of inflammatory illness with or without intraglandular sialolithiasis, benign and malignant tumours, and these conditions are indications. An incision of varying sizes is used in the typical procedure.
• Radiation therapy: Ionizing radiation, often known as radiation therapy or radiotherapy, is a treatment used to regulate or kill cancerous cells in the body. It is typically administered using a linear accelerator and is frequently abbreviated as RT, RTx, or XRT.
• Chemotherapy: Chemotherapy is a pharmacological therapy to eradicate your body's uncontrolled growing cells. Chemotherapy is most frequently used to treat cancer because cancer cells grow and reproduce much faster than most other types of body cells. Chemotherapy medications come in a variety of forms.
• Superficial or lateral or classical parotidectomy: This is done for superficial benign and malignant tumours. Salivary tissue that is next to the facial nerve is removed in this.
• Deep lobe parotidectomy: Salivary tissue close to the facial nerve is removed when a deep lobe benign or malignant tumour is present.
• Total conservative parotidectomy: It is performed for benign and malignant tumours affecting both the superficial and deep lobes. This preserves the facial nerve while removing all salivary tissue.
• Radical parotidectomy: A radical parotidectomy sacrifices the FN and removes all parotid tissue. This is done when a tumour has infiltrated the FN or if preoperative FN function was compromised due to malignant illness.

• Antibiotics for treatment of infection of salivary: The bacterial infection of the salivary glands may be treated with antibiotics such as cephalosporin (cephalothin or cephalexin), dicloxacillin, clindamycin, amoxicillin-clavulanate, or ampicillin.
• Anticholinergics for treating secretary problems of salivary gland: Propantheline, glycopyrrolate, benztropine, and scopolamine are examples of anticholinergic medicines that are often used to treat problems of the salivary glands. The majority of anticholinergic drugs act on muscarinic gland receptors, causing a reduction in the amount of saliva that is produced.
• Nonsteroidal anti-inflammatory medicines for reducing pain: NSAIDS such as metformin, naproxen, indomethacin, and ibuprofen, along with other similar medications, are used to alleviate pain and swelling.
• Salivary Stimulants for dryness in the oral cavity: These are medications that are administered to enhance the amount of saliva that is secreted by the salivary glands. Examples of these medications include cevimeline, evoxac, pilocarpine, and Salagen.