Salivary glands

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Salivary glands

Intro

Saliva is a multifaceted bodily fluid.
Moisturizing the oral cavity, saliva has an essential role in:

  • Initiating the digestion process and acting as a food lubricant to help swallowing
  • Modulates food taste and aromatic sensitivity;
  • Protects against tooth decay;
  • Has antibacterial and antifungal functions, helping to regulate oral flora
  • Important in avoiding bad breath;
  • To moisture those “French Kisses”.

Saliva and salivary glands

Saliva is produced and secreted by the salivary glands. These are classified into major and minor glands.

There are 6 major salivary glands, 3 on each side of the face.
The largest are the parotid glands, located in front of the ears. Their draining ducts open in the buccal mucosa, at the upper first molar level. Then the submandibular glands represent the second largest glands and can be found beneath the floor of the mouth. Anteriorly to them, lie the sublingual glands.

There are around 800 minor salivary glands throughout the aerodigestive track, but most are concentrated in the buccal mucosa (inside of the cheek), lips and tongue.

Saliva is mainly comprised of water, proteins, ions and enzymes.

Mucoceles

Salivary flow can be disrupted and saliva may get retained and collected inside a cyst, creating a mucocele. They usually occur in the minor salivary glands of the lip and cheek mucosa.

It may also leak through the floor mouth tissues, appearing as large translucent swelling, resembling the belly of a frog, therefore called ranulla.

In young ages, mucoceles and ranullas tend to resolve spontaneously. But if they are symptomatic, persistent, and are not self-resolving they can be surgically managed.

Lithiasis (calculus/stone)

Salivary flow can also be interrupted by a stone. Salivary glands can form stones, sharing some similarities to kidney stones.

It usually happens in the submandibular gland, because the highly viscous saliva from this gland, flows against gravity, stagnating more easily and contributing to ion precipitation. It may also occur in the parotid glands or any other salivary gland.

In these cases, the gland size may fluctuate. It rises suddenly during meal times, when there is saliva stimulus, but no drainage due to the mechanical blockade caused by the calculus. Then, in between meal times, the size tends to reduce partially.

Stones may be expelled on their own, but sometimes they need a surgical intervention, either with local or general anesthesia, occasionally using an endoscope, if the calculs location is favourable for that method.

Tumors

Tumors originating from salivary glands are usually benign, presenting more frequently in the parotid gland, as a solid slow growing lump.

Pay attention, do not disregard benign tumors, as some types of benign tumors carry a considerable risk for malignant transformation.
A painful, fast growing lump, neck nodal lump and facial paralysis are some red alert signals pointing toward a possible malignant mass. The smaller the size of the salivary gland, the higher the probability of a malignant tumor.

The usual diagnostic workflow includes imaging exam and a fine-needle aspiration.

Surgery is the mainstay therapy. One of the main concerns, is to preserve the facial nerve structure and function, not only in the submandibular, but in particular in the parotid gland. Because the nerve crosses the gland interior it therefore requires a high level of expertise to remove the tumor, preserving all nerve ramifications as far as possible.

In malignant cases, surgery might have to include the resection of neck lymph nodes. Radiotherapy is an also a main or complementary treatment option.

parotid salivary gland tumor

MD, DSS, Miguel Lopes Oliveira

Maxillofacial Surgeon

At Faces, we offer a wide range of specialized services in facial health. Our highly qualified team is ready to meet your individual needs. In our clinic, you will find a global and comprehensive approach to facial and neck surgery, achieving results beyond restoration.

We provide treatments for conditions such as temporomandibular joint dysfunction, orthognathic surgery, salivary gland problems, neck conditions, snoring and sleep apnea, tear duct and eyelid issues, facial fat grafting, and trauma-related injuries.

Our dedicated team is here to answer all your questions and provide the most suitable treatment for you. Schedule a consultation with us today and discover how we can help you.

Pedro Costelas
Pedro Costelas
2022-12-31
Recentemente fui submetido a uma cirurgia Maxilofacial para retirar um tumor benigno, tendo a mesma sido efetuada pelo Dr. Miguel Oliveira. A cirurgia não podia ter corrido melhor só tendo a agradecer ao Dr Miguel o seu grande profissionalismo e o interesse que demonstrou em resolver o meu problema, que tanto me preocupava. A intervenção correu muito bem, assim como a posterior recuperação. A cicatriz mal se nota pelo excelente trabalho efetuado pelo Dr. Miguel. Mais uma vez o meu Muito Obrigado por tudo!!!
Teresa Canário
Teresa Canário
2022-12-30
Fui intervencionada recentemente a um enorme lipoma pelo Dr. Miguel Oliveira e não quero deixar de destacar o extremo profissionalismo, simpatia, empatia com que conduziu todo o meu processo. De destacar ainda a forma descontraída com que sempre me tratou, o que ajudou em muito a que eu acreditasse que estava realmente nas mãos certas. O resultado foi perfeito, a cicatriz é quase invisível e ninguém acredita que daquele tão pequeno espaço saiu um lipoma tão grande. Quero agradecer profundamente ao Dr. Miguel por todo o seu excelente trabalho!
Tânia Calisto
Tânia Calisto
2022-12-29
O Dr. MIGUEL foi impecável. Super atencioso, simpático e prestável. Foi muito esclarecedor.
Anabela Correia
Anabela Correia
2022-12-29
O Dr. Miguel Oliveira é um profissional de excelência. A cirurgia reconstrutiva q fez ao olho esquerdo do meu pai fIcou PERFEITA. O meu pai tem 82 anos e foi alvo de violência q o deixou com várias lesões no rosto em especial na zona ocular e o Dr. Miguel foi de uma atenção, empatia e perfeccionismo inexcedível. Obgada.
Mariana Rosa
Mariana Rosa
2022-12-22
Excelente médico, sempre disponível fossem que horas fossem. Durante a recuperação ligou várias vezes para acompanhar ao máximo a recuperação apesar de não estar perto. Aconselho!
Mario Reis
Mario Reis
2022-12-18
As consultas e a cirurgia com o Dr. Miguel Oliveira decorreram de forma tranquila, serena, com toda a informação. A intervenção evidenciou elevado nível de competência profissional. Grato pelos serviços profissionais prestados.
maria anjos
maria anjos
2022-11-24
Sempre considerei que profissionalismo e competência é o que devemos valorizar em qualquer área mas sobretudo na saúde. Quando nada o fazia prever foi-me diagnosticado um carcinoma mucoepidermoide. Em boa hora conheci o Dr. Miguel Oliveira e desde o primeiro momento senti uma enorme confiança. Fui operada e até hoje continuo a ser acompanhada por ele. Embora ainda não se possa cantar vitória, o certo é que até agora tem tudo corrido bem. Bem haja Sr. Dr. Miguel Oliveira.
pedro brandao
pedro brandao
2022-10-27
Consulta que demonstrou confiança serenidade e competência no diagnóstico clínico .Fui recebido a horas e decorreu com a urbanidade que esperava.

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