Sialosis
(Redirected from Sialadenosis)
Sialosis | |
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Used with permission (Scully et al. 2008)[1] |
- Sialosis (sialadenosis) is a chronic, bilateral, diffuse, non-inflammatory, non-neoplastic swelling of the major salivary glands that primarily affects the parotid glands
Epidemiology[edit | edit source]
- ♀ > ♂
- Peak age of presentation is 30-60 years old
Clinical Features[edit | edit source]
- Bilateral swellings usually of parotid (hamster-like)
- Uncommonly involves submandibular gland and rarely involves minor salivary glands
- Painless
Differential Diagnosis[edit | edit source]
- Inflammatory conditions of salivary glands
- Sialolithiasis and obstructive sialadenitis
- Infective sialadenitis
- Granulomatous disorders
- Sjögren syndrome
- Human immunodeficiency virus (HIV) sialopathy
- Recurrent sialadenitis of childhood
- Radiation-induced sialadenitis
- Sialocele
- Kimura and Kikuchi disease
Aetiology and Pathogenesis[edit | edit source]
Aetiology[edit | edit source]
- Largely Unknown, but may be associated with:
- Diabetes mellitus
- Obesity
- Chronic alcoholism
- Hormonal disturbances
- Ovarian – pregnancy and lactation
- Thyroid – hypothyroidism
- Malnutrition (protein deficiencies/avitaminosis)
- Cirrhosis
- Bulimia nervosa/starvation
- Drugs:
- Antihypertensives/diuretics
- Steroids
- Iodine
- Isoprenaline
Investigations[edit | edit source]
- No investigations are needed if clinical diagnosis is obvious
Imaging[edit | edit source]
- Not usually needed if clinical diagnosis is obvious
- Ultrasound
- Fatty deposition in the parotid glands results in a hyperechoic gland with reduced through transmission of sound waves
- Sialography
- Normal
- MRI
- Enlarged gland
- Varies in echotexture andattenuation depending on histological change
Histopathology[edit | edit source]
- Acinar cell hypertrophy (granular, vacuolated, mixed)
- Compression of striated ducts
- Fatty replacement in long-standing cases
Other investigations[edit | edit source]
- Largely academic:
- Elevated salivary potassium
- Stimulated salivary flow rate is normal
Management[edit | edit source]
- There is no specific treatment for sialosis
- If an underlying cause has been identified then successful treatment of that cause may reduce the swelling of the salivary glands
Prognosis and Complications[edit | edit source]
- There is limited evidence that any particular treatment or whether addressing underlying aetiology is of notable benefit