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PubMed1976

The diagnostic value of sialography and scintigraphy in salivary gland diseases.

The diagnostic value of sialographic and scintigraphic investigations was compared in 169 patients. In this group were 75 inflammatory diseases and 49 benign and malignant tumours. Sialograms and scintigrams were examined by different physicians who had no knowledge of the clinical data of the patients. The scintigraphic diagnosis was considered correct if any abnormal finding was noted. The sialographic diagnosis was considered correct if the actual disease was diagnosed. In spite of the less stringent requirements for a correct scintigraphic diagnosis the sialographic technique was found to be superior. Radioactivity uptake curves over the salivary glands did not improve the scintigraphic diagnostic accuracy.

Humans↗
PubMed1989

Clinical assessment and diagnosis of immunologically mediated salivary gland disease in Sjögren's syndrome.

Because salivary gland function and morphology can be changed by a variety of diseases and drugs, the process of clinically assessing and diagnosing salivary gland changes in patients suspected of having Sjögren's syndrome (SS) must include not just clinical recognition of the problem and assessment of its nature and severity, but identification of the cause. Determining the presence of the salivary component of SS in a patient suspected of having the disease involves three types of observations: (1) eliciting symptoms and observing signs suggesting decreased salivary function (xerostomia) during the examination, (2) objectively assessing functional or anatomical salivary changes with different types of clinical procedures that are not necessarily disease-specific, and (3) applying the most disease-specific procedures as diagnostic criteria to determine the cause of the problem. Currently used diagnostic criteria for the salivary component of SS are reviewed and compared. Alternative diagnostic criteria should be avoided if they substitute non-specific tests for more disease-specific tests. There is as yet no perfect diagnostic criterion for the salivary component of SS, but significant focal sialadenitis in a labial salivary gland biopsy is the best in terms of its disease specificity, convenience, availability and low risk.

Autoimmune Diseases↗
PubMed2000

[Salivary gland diseases].

After more than 25 years of activity in the field of salivary gland surgery, especially parotid gland surgery, the following statements can be made. 1. Salivary gland diseases are extremely variable and their treatment requires vast clinical experience. 2. The judgement of salivary gland diseases requires highly competent pathologic assistance and a specialized laboratory in this respect. In the field of salivary gland pathology--like in many other specialized subdivisions in pathology--the need of a second opinion in order to increase the reliability of the original diagnosis has to be claimed once more. 3. A certain change has taken place in the diagnostic means. Modern techniques of visualization show a shift toward noninvasive sonography, but also toward computed tomography with or without contrast agents, and there is a steadily increasing shift toward magnetic resonance tomography as well. 4. The literature about salivary gland diseases and their therapy can no longer be overlooked and is unfortunately characterized by very different aspects of judgement, which in many cases hardly allow a comparative discussion of certain clinical and therapeutic questions. 5. Parotid gland surgery requires a clear concept concerning the different diseases, especially of the different oncologic entities. Surgical preparation of the facial nerve has to be mastered equally from the central and the peripheral course of the nerve.

Adolescent↗
PubMed1993

Salivary autoantibodies in HIV-associated salivary gland disease.

A subset of HIV-positive patients develops salivary gland disease (HIV-SGD), characterized by salivary gland enlargement and/or decreased salivary flow. While clinical symptoms are similar to Sjögren's syndrome (SS), patients with HIV-SGD lack circulating anti-SS-A/Ro and anti-SS-B/La. Occasionally, SS patients lacking circulating anti-SS-A/Ro and anti-SS-B/La have these antibodies in their saliva. Salivas from 11 patients with HIV-SGD, 13 HIV+ patients without HIV-SGD, 14 HIV-negative men controls, and 11 patients with SS were screened for autoantibodies. Five HIV-SGD salivas had antibodies recognizing the cytoplasm of a salivary cell line. No HIV+ controls showed reactivity. Ten of 11 SS patients had salivary autoantibodies, and one HIV-negative control was positive for them. Salivary anti-SS-A/Ro was present in 8/11 SS patients, and 7 also contained anti-SS-B/La. No HIV-SGD salivary samples had these specific autoantibodies. These findings suggest that while glandular polyclonal expansion occurs in both HIV-SGD and SS, different autoantibodies are produced.

Autoantibodies↗
PubMed1984

Salivary phosphohexoseisomerase activity in health and salivary gland diseases.

The attitude of phosphohexoseisomerase (PHI), a glycolytic enzyme, in parotid and submandibular saliva of healthy human control subjects of different sex and age was studied flow rate dependent. The results obtained from this group were compared to the PHI activity measured in the saliva of patients suffering from salivary gland diseases. Significantly elevated salivary PHI levels were found in chronic sialadenitis, while in sialadenosis, parotid gland infarction and parotid cysts the enzyme activity was within the normal range. Single patients suffering from parotid gland tumors showed elevated PHI values. A possible role of salivary PHI activity for the differential diagnosis of salivary gland diseases is discussed.

Female↗
PubMed1992

HIV-associated salivary gland disease: a review.

Human immunodeficiency virus-associated salivary gland disease (HIV-SGD) is defined as the presence of xerostomia and/or swelling of the major salivary glands. It is common among children but uncommon among adults. HIV-SGD includes lymphoepithelial lesions and cysts involving the salivary gland tissue and/or intraglandular lymph nodes, and Sjögren's syndrome-like conditions, diffuse interstitial lymphocytosis syndrome, and other reported lesions of the major salivary glands. This article reviews the terminology, prevalence, symptoms, clinical features, diagnostic procedures, histopathology, serology, natural history, treatment, and pathogenesis of HIV-SGD.

Adult↗
PubMed2004

Modern management of obstructive salivary gland disease.

AIMS: To investigate the results of a minimally invasive approach to the management of obstructive salivary gland disease. MATERIALS AND METHODS: Five hundred and thirty-seven patients with symptomatic obstructive salivary gland disease (455 calculi, 82 strictures) consisting of 330 submandibular and 207 parotid cases were treated using minimally invasive techniques. Extra-corporeal shock wave lithotripsy (ECSWL), fluoroscopically guided basket retrieval, or intra-oral stone removal under general anaesthesia, were used for salivary calculi, either alone or in combination. Strictures were treated using fluoroscopically guided balloon dilatation. RESULTS: ECSWL achieved complete success (stone and symptom free) in 87/221 (39%) of cases (84/218 primary, 3/3 secondary) of which submandibular 43/131, parotid 44/90. Basket retrieval cured 124/166 (75%) cases (103/136 primary, 21/30 secondary) of which submandibular 80/109, parotid 44/57. Intra-oral surgical removal provided a cure in a further 137/143 (96%) submandibular cases (99/101 primary, 36/38 secondary and 2/4 tertiary). The overall success rate for the three techniques was 348/455 (76%). Balloon dilatation resulted in complete elimination of the stricture in 44/82 (54%) and a reduction in the stricture in 32/82 (39%) and no improvement in 6/82 (7%). Review at six months showed resolution 14/32 (44%), improvement 16/32 (50%) and no change 2/32 (6%) of symptoms. CONCLUSIONS: A minimally invasive approach to the management of obstructive salivary gland disease is to be encouraged. All four techniques described have a low morbidity and afford the possibility of retaining a functional gland.

Humans↗
PubMed1978

[Diagnostic possibilities in salivary gland diseases (author's transl)].

A survey about different diagnostic parameters in salivary gland diseases is given. History, inspection, palpation, radiologic examinations by sialography and szintigraphy as well as sialometric and sialochemic findings are compared for their diagnostic value. Thereby by sialochemie and sialometrie a differentiation between sialadenitis and sialadenoses is possible in nearly all cases. Also in the differential diagnosis between benign and malignant tumors sialochemic findings are helpful.

Chemistry, Clinical↗
PubMed1998

[Diagnostic pitfalls in benign and malignant salivary gland diseases. Their significance for prognosis and therapy].

Diagnostic pitfalls exist when benign salivary gland diseases are mistakenly classified as malignant, with consequences for treatment and prognosis. Examples are necrotizing sialometaplasia, metaplastic Warthin tumour and sclerosing polycystic sialadenopathy. The proper diagnosis is of eminent importance to distinguish cases of primary tumours that have developed in salivary glands or their lymph nodes from cases of extraglandular tumours with metastases in these glands or their nodes. In these cases clinical data and additional immunocytochemical methods are necessary to clarify the exact diagnosis, especially when the primary salivary gland tumours have a structure largely identical to the metastases (e.g. squamous cell carcinoma). Nasopharyngeal or cervical chordomas can be mistaken for pleomorphic adenoma or mucinous adenocarcinoma. The initial stage of malignant MALT lymphomas in association with Sjögren's syndrome demands identification of clonal rearrangement for therapeutic implication. The diagnostic criteria for proper classification are analysed in detail.

Diagnosis, Differential↗