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PubMed1990

Salivary gland masses: the diagnostic value of fine-needle aspiration cytology.

A series of 165 needle aspirates (134 from the parotid gland, 26 from the submandibular glands, and nine from the palate) was studied. Seventeen aspirates (12.14%) were inadequate for evaluation; 25 were excluded because they came from branchial cysts. Of the remaining 123 samples from major and minor salivary glands, 107 (76.42%) were negative for malignancy and 16 (11.42%) were positive. Benign, non-neoplastic lesions were diagnosed in 53.27% of the aspirates and benign tumors in 46.72%. The cytodiagnoses were compared with the subsequent histological findings in ten of the 57 non-neoplastic lesions, 16 of the 50 benign neoplasms, and ten of the 16 malignant neoplasms. Despite problems of interpretation, in all cases where comparison was possible, the cytodiagnoses were confirmed by the histologic report. Fine-needle aspiration biopsy is superior to other investigations such as scialography, computed tomography (CT) and CT scialography, commonly used in salivary gland disease. As underlined by the results of this study, aspiration biopsy cytology will identify lesions that are not clinically obvious and provide the surgeon with the required preoperative information.

Biopsy, Needle↗
PubMed1998

Sjögren syndrome: comparison of assessments with MR sialography and conventional sialography.

PURPOSE: To compare the diagnostic accuracy of magnetic resonance (MR) sialography with that of conventional sialography in the assessment of salivary gland disease in Sjögren syndrome. MATERIALS AND METHODS: Thirty-five patients (32 women, three men; age range, 18-69 years) suspected of having Sjögren syndrome were examined with MR sialography and conventional sialography. Gradient and spin-echo MR sialography was performed with a 1.5-T system. MR sialographic findings were compared with conventional sialographic findings. RESULTS: In 31 (89%) patients, the stage of salivary gland disease determined with MR sialography accurately correlated with that determined with conventional sialography. However, the stage at MR sialography was higher in two patients: They had stage I disease but were determined to have stage II disease. In two other patients, the stage at MR sialography was lower: A patient with stage II disease and a patient with stage III disease were determined to have stage I and stage II disease, respectively. The correlation between the stage at conventional sialography and that at MR sialography (P < .001) can be estimated with the following equation: conventional sialographic stage = 0.021 + 0.982 x (MR sialographic stage). Both the sensitivity and the specificity of MR sialography in the diagnosis of Sjögren syndrome were 100%. CONCLUSION: MR sialography is highly accurate in the evaluation of salivary gland disease in Sjögren syndrome.

Adolescent↗
PubMed1999

The detection of Epstein-Barr virus in the lesions of salivary glands.

Epstein-Barr virus (EBV) is known in association with lymphoid and epithelial lesion. Because the salivary gland is an organ close to the oropharynx, it has a higher incidence of EBV infection and is a possible route of EBV infection. Formalin-fixed, paraffin embedded tissue sections of 87 cases of salivary gland diseases were used for the study of EBV with PCR, in situ PCR for EBNA-1 (EBV nuclear antigen-1), and immunohistochemistry for LMP-1 (latent membrane protein-1). EBV was detected in 12 cases (13.8%): 7 of nonspecific chronic sialadenitis (21.2%), 4 of Warthin's tumors (30.8%), and one lymphoepithelial carcinoma. EBNA-1 was negative in all the other lesions. EBV DNA was detected in the nucleus of epithelial cells and the surrounding lymphocytes. LMP-1 positivity was found in the cytoplasm of epithelial cells. The results of the present study showed that EBV is implicated in some of the inflammatory and neoplastic lesions of the salivary gland in which the lymphocytes are abundant. However, the pathogenesis and mechanism of immortalization and tumorigenesis of the epithelial cells in the salivary glands remain to be determined.

Epstein-Barr Virus Nuclear Antigens↗
PubMed2003

HIV/AIDS orofacial lesions in 156 Zimbabwean patients at referral oral and maxillofacial surgical clinics.

OBJECTIVE: To document the prevalence, age and gender distribution and clinical features of HIV/AIDS orofacial lesions in patients referred to the two largest Oral and Maxillofacial specialist centers in Harare, Zimbabwe, and compare the findings with those from other parts of the world. DESIGN: Descriptive study. SETTING: Oral and Maxillofacial Surgical Clinics at specialist referral hospitals; Harare Central Hospital and Parirenyatwa Government Hospital, Harare, Zimbabwe. SUBJECTS: A total of 7800 consecutive patients referred for various orofacial conditions were examined. From this group, 156 patients with orofacial lesions of or suggestive of HIV/AIDS were further interviewed and examined by the oral and maxillofacial surgeon in charge of the clinics. METHODS: Head, neck and oral examinations were carried out. Oral examination was carried out using mouth mirror and dental light in a dental chair. HIV/AIDS orofacial lesions were recorded and diagnosed using the EC Clearing House Criteria on Oral Problems related to HIV Infection (1993). RESULTS: There were 79 males and 77 females. Male:female ratio 1:1; age range 1-56 years; candidiasis (55.1%) was the most common lesion with the pseudomembranous type (55.8%) predominating. High prevalences of Kaposi's sarcoma (18.6%), salivary gland disease (12.2%) and cancrum oris (3.8%) were noted. Heterosexual contact and mother to child transmissions appear to be the mode of transmission. CONCLUSION: The spectrum of orofacial lesions is similar to that in other countries. This study shows a high prevalence of candidiasis, Kaposi's sarcoma, salivary gland disease, non-Hodgkin's lymphoma, cancrum oris and rampant caries.

AIDS-Related Opportunistic Infections↗
PubMed1999

Chronic inflammatory disorders of the salivary glands.

When dealing with salivary gland disease, the otolaryngologist must be familiar with the various chronic inflammatory disorders that patients may be inflicted with. Physicians may have to treat such disorders as chronic sialadenitis, tuberculosis, sarcoidosis, animal scratch disease, actinomycosis, and Sjögren's syndrome. Symptoms, causes, and treatments of these chronic inflammatory disorders are discussed in this article.

Chronic Disease↗
PubMed1985

High-resolution computed tomography of the major salivary glands: current status.

At our institution, computed tomography is the procedure of choice for evaluation of suspected mass lesions of the major salivary glands. It affords exact anatomic localization of a mass and allows simultaneous examination of the contralateral gland and other regional structures of importance in salivary gland disease. Intravenous contrast medium enhancement is always utilized; however, concomitant sialography has never been necessary. Regional anatomy of the salivary glands with respect to computed tomography imaging and clinical material demonstrating its efficacy are presented. The neoplastic and nonneoplastic diseases affecting the salivary glands are reviewed.

Adolescent↗
PubMedDate not supplied

Sialosis of unknown origin.

Sialosis (sialadenosis) is defined as an asymptomatic, non-inflammatory, non-neoplastic parenchymal salivary gland disease accompanied by a persistent painless bilateral swelling of the salivary glands, most commonly involving the parotid glands. There is no sex predilection, and the peak age incidence is between 30 and 70 years of age. Sialosis occurs in three different groups of patients: alcoholics, diabetics and the malnourished. An autonomic neuropathy, seen as a demyelinating polyneuropathy, seems to be the common underlying basis for this seemingly disparate group of patients with sialosis.

Biopsy, Needle↗
PubMed1990

[Clinico-pathological study of oral mucoceles].

We present a clinical and histopathological study of 25 mucoceles of the oral cavity. Incidence was found to be greatest between age 10 and 20 (12 cases), with no significant differences in terms of sex. The lower lip was most frequently affected (17 cases), other locations being much less common. In 72% of cases there were etiological antecedents of traumatism. Mucocele size varied from 3 to 13 mm. although a great many of them were between 10 and 13 mm. Evolution period was 1-16 months, incidence being highest between 1 and 4 months. Finally, histology showed 95% to be due extravasation, the remaining 5% being the result of retention. Among the extravasation mucoceles, 11.7% were in the initial phase, another 11.7% in the reabsorption stage, and 76.4% in the final phase.

Adolescent↗
PubMed2006

Application of magnetic resonance virtual endoscopy as a presurgical procedure before sialoendoscopy.

OBJECTIVES: The objectives of this study were to investigate the feasibility of clinical application of magnetic resonance (MR) virtual endoscopy as a presurgical procedure before sialoendoscopy and to evaluate its value in the diagnosis of obstructive salivary gland diseases and preoperative visualization of endoluminal views. STUDY DESIGN: This study presents our initial experience to use MR virtual endoscopy for the presurgical visualization of salivary duct lumen and ductal pathologies in comparison to the sialoendoscopy findings in a feasibility study. METHODS: Six consecutive patients with suspected obstructive salivary gland diseases underwent MR sialography with a three-dimensional fast imaging using steady-state acquisition. The three-dimensional MR data were transferred to an independent workstation and were postprocessed with navigator software to generate three-dimensional reconstruction and virtual endoscopic images. The fly-through mode was used to imitate the sialoendoscopic exploratory procedure. Then the patients underwent sialoendoscopy and the endoscopic findings were compared with the preoperative virtual endoscopic images. RESULTS: The MR data acquisition and postprocessing protocol were feasible. The virtual endoscopy created clear endoluminal views of salivary duct and the ductal pathologies. The diagnoses were all confirmed by surgical sialoendoscopy. The virtual endoscopic images showed close resemblance to the sialoendoscopic findings. CONCLUSIONS: MR virtual endoscopy is an effective and noninvasive diagnostic method for evaluating the endoluminal anatomy and pathologies of the salivary duct. The clinical application of MR virtual endoscopy as a presurgical procedure before sialoendoscopy is a valuable and promising approach, which can provide surgeons useful morphologic and pathologic information.

Adult↗