Salivary Gland Disorders in Children and Adolescents: A 15-year Experience

Abstract Introduction Diseases of the salivary glands are rare in children and adolescents, with the exception of viral-induced infections. Objective To determine the clinical course of the disease, the diagnostic procedures, the treatment and the outcome of all children and adolescents affected with salivary gland diseases at our clinic over a period of 15 years. Methods A retrospective chart review including a long-term follow-up was conducted among 146 children and adolescents treated for salivary gland disorders from 2002 to 2016. Results Diagnosing acute sialadenitis was easily managed by all doctors regardless of their specialty. The diagnosis of sialolithiasis was rapidly made only by otorhinolar- yngologists, whereas diagnosing juvenile recurrent parotitis imposed difficulties to doctors of all specialties - resulting in a significant delay between the first occurrence of symptoms and the correct diagnosis. The severity-adjusted treatment yielded improve- ments in all cases, and a full recovery of 75% of the cases of sialolithiasis, 73% of the cases of juvenile recurrent parotitis, and 100% of the cases of acute sialadenitis. Conclusions Due to their low prevalence and the lack of pathognomonic symptoms, salivary gland diseases in children and adolescents are often misdiagnosed, resulting in an unneces- sarily long period of suffering despite a favorable outcome following the correct treatment.

Doenças de glândulas salivares: estudo epidemiológico em um serviço de Estomatologia do sul do Brasil / Salivary gland diseases: epidemiological study in a Stomatology service in southern Brazil

Objetivo: realizar um levantamento epidemiológico das doenças de glândulas salivares por meio de análise de prontuários registrados em um serviço de Estomatologia do sul do Brasil. Métodos: a amostra foi composta por aproximadamente 24.000 prontuários de pacientes do Serviço de Estomatologia do Hospital São Lucas, atendidos no período de 1977 a 2017. Foram selecionados os prontuários que apresentassem as seguintes enfermidades de glândulas salivares: mucocele, rânula, sialolitíase, sialoadenite infecciosa, síndrome de Sjögren, sialometaplasia necrosante e neoplasias benignas ou malignas. Os dados coletados foram analisados por meio de estatística descritiva e inferencial, utilizando o teste Qui-Quadrado. Resultados: das 817 enfermidades encontradas, 56,2% eram mucoceles, 11,1% sialoadenites infecciosas, 10,3% rânulas, 10,1% sialolitíases, 5,5% neoplasias benignas, 4,3% síndrome de Sjögren, 2,1% neoplasias malignas e 0,4% sialometaplasias necrosantes. O mucocele apresentou predileção pelo sexo masculino, enquanto a rânula e a síndrome de Sjögren foram mais associadas ao sexo feminino. As demais enfermidades não apresentaram predileção por sexo. A localização das lesões, as características clínicas e a idade dos pacientes acometidos foram também avaliadas. Conclusão: as doenças das glândulas salivares merecem destaque entre as enfermidades do sistema estomatognático devido à complexa anatomia dessas estruturas, à importância da saliva na homeostase bucal e ao comportamento clínico indolente das neoplasias malignas que acometem essas glândulas.(AU)

Objective: to perform an epidemiological survey of salivary gland diseases by analyzing medical records from a Stomatology Service in southern Brazil. Methods: the sample consisted of approximately 24,000 medical records of patients assisted at the Stomatology Service of the São Lucas Hospital between 1977 and 2017. The following salivary gland disorders were selected: mucocele, ranula, sialolithiasis, infectious sialadenitis, Sjögren's syndrome, necrotizing sialometaplasia, and benign or malignant neoplasms. The data collected were analyzed by descriptive and inferential statistics using the chi-squared test. Results: from the 817 disorders found, 56.2% were mucocele, 11.1% sialadenitis, 10.3% ranula, 10.1% sialolithiasis, 5.5% benign neoplasms, 4.3% Sjögren's syndrome, 2.1% malignant neoplasms, and 0.4% necrotizing sialometaplasia. Mucocele was more prevalent in men, while ranula and Sjögren's syndrome were more associated with women. The other diseases did not present gender preference. The location of the lesions, clinical characteristics, and age of the patients affected were also assessed. Conclusion: salivary gland diseases deserve special attention among stomatognathic system disorders due to the complex anatomy of such structures, the importance of saliva in the oral homeostasis, and the indolent clinical behavior of the malignant neoplasms affecting these glands.(AU)

Epidemiological survey of mucus extravasation phenomenon at an oral pathology referral center during a 43 year period / Levantamento epidemiológico de fenômeno de extravasamento de muco de um centro de referência em patologia oral por um período de 43 anos

ABSTRACT INTRODUCTION: Mucoceles are common benign pseudocystic lesions of the oral cavity; their main etiological factors are trauma and ductal obstruction. Two histological patterns are found: mucus retention phenomenon (MRP) and mucus extravasation phenomenon (MEP). Mucus extravasation phenomenon is the more common histological subtype and it mainly affects the lower lip. The knowledge of its main clinical features and management is important to assist health professionals in clinical practice. OBJECTIVE: This study aimed to determine the relative frequency and distribution of oral mucoceles in an oral pathology reference center. METHODS: Cross-sectional historical study that analyzed all cases pathologically diagnosed as mucus extravasation phenomenon by the department of anatomic pathology of an oral pathology referral center from June of 1970 to May of 2014, considering the clinical characteristics of the lesion and those relating to the patient. SPSS v. 20.0 software for Windows was used for descriptive analysis. RESULTS: During 43 years, 719 cases of mucus extravasation phenomenon (54.7% men and 45.3% women) were registered, with the lower lip as the most commonly affected site (n = 484; 67.3%). The average age of patients was 20.8 years (SD ± 14.4) with a peak occurrence in the second decade of life. Most professionals had oral mucocele/ranula (n = 606; 84.3%) as the initial clinical impression. CONCLUSION: Mucus extravasation phenomenon is a lesion that primarily affects young patients, affecting mainly the lower lip, and is commonly found in oral diagnostic services.

Resumo Introdução: Mucoceles são lesões pseudocísticas benignas comuns da cavidade oral, que possuem como principais fatores etiológicos trauma ou obstrução ductal. Dois padrões histopatológicos são encontrados: fenômeno de retenção de muco (FRM) e fenômeno de extravasamento de muco (FEM). O FEM é o subtipo histológico mais comum e tem como principal local de acometimento o lábio inferior. O conhecimento acerca de suas principais características clínicas e formas de tratamento se faz importante para auxiliar profissionais da saúde na prática clínica. Objetivo: Este trabalho objetivou determinar a frequência relativa e a distribuição das mucoceles orais em um centro de referência em patologia oral. Método: Estudo transversal de caráter histórico, no qual foram analisados os casos diagnosticados histopatologicamente como FEM pelo serviço de anatomia patológica de um centro de referência em patologia oral no período de junho de 1970 a maio de 2014, considerando-se variáveis clínicas da lesão e relativas ao paciente. O programa estatístico SPSS 20.0 for Windows foi utilizado para a análise descritiva dos dados. Resultados: Durante 43 anos foram observados 719 casos de FEM (54,7% homens e 45,3% mulheres), sendo o lábio inferior (n = 484; 67,3%) o local de principal acometimento. A média de idade dos pacientes foi de 20,8 anos (DP ± 14,4), com pico de ocorrência na segunda década de vida. A maioria dos profissionais teve mucocele oral/rânula (n = 606; 84,3%) como primeira hipótese clínica. Conclusão: O FEM é uma lesão que afeta principalmente pacientes jovens, acometendo preferencialmente o lábio inferior, sendo comumente encontrada nos serviços de diagnóstico oral.

Incidencia de patología salival sintomática aleada en pacientes tratados con yodo radioactivo por cáncer diferenciado de tiroides / Incidence of sympthomatic salivary disease in patients with differentiated thyroid cancer treated with radioactive iodine

Background: The radioactive iodine therapy for differentiated thyroid cancer can produce severe and frequent salivary symptoms, during the treatment or later. Aim: To analyze the incidence, severity and charactheristics of the salivary signs and symptoms in these patients. Patients and Method: Retrospective and descriptive analisis of 106 patients with confirmed diagnosis of differentiated thyroid cancer, treated with surgery and radioactive iodine, that completed a telephonic survey for the evaluation of salivary symptoms. Results: 26 (24.52 percent) patients presented with salivary symptoms or signs after the radioactive iodine therapy (mean 5 months). The average doses of I 131 was 128,5 mCi. Xerostomy, pain, xeroftalmy, inflammation, sialoadenitis and dysgeusia, were the most frequent clinical symptoms. Conclusions: After radioactive iodine therapy the salivary symptoms and signs incidence is high. We conclude that the indication for this treatment must be selective, but in accordance with the oncological risk of each patient.

Introducción: El tratamiento con yodo radioactivo en el tratamiento del cáncer diferenciado de tiroides puede originar síntomas alejados de origen salival. Éstos pueden llegar a ser intensos y frecuentes. Objetivo: Conocer la incidencia, características e intensidad de dichos síntomas. Material y Método: Revisión retrospectiva y análisis descriptivo de 106 pacientes con diagnóstico definitivo y anatomopatológico de cáncer diferenciado de tiroides, tratados con yodo radioactivo, que contestaron una encuesta telefónica especialmente diseñada para evaluación de patología salival. Resultados: Veintiséis (24,52 por ciento) pacientes presentaron y consultaron por síntomas y/o signos alejados (promedio 5 meses) de la terapia ablativa, de origen salival. La dosis promedio fue de 128,5 mCi de I 131. Los síntomas más frecuentes fueron xerostomía, dolor, xeroftalmia, inflamación, sialoadenitis y alteración del gusto. Discusión: La incidencia de signos y síntomas salivales alejados en pacientes tratados con I 131 es alta y justificaría a nuestro juicio su indicación selectiva, de acuerdo a los riesgos de recurrencia tumoral de cada paciente.

Lesiones intraorales de glándulas salivales menores / Intraoral lesions of minor salivary glands: analysis of 59 patients

Background: Most salivary gland lesions are benign. Tumors are uncommon. Pleomorphic adenoma and cystic adenoid carcinoma are the most common benign and malignant lesions. Aim: To assess the incidence management and evolution of intraoral lesions among patients consulting in a head and neck surgical service. Material and Methods: Retrospective review of medical records of patients consulting for intraoral lesions of minor salivary glands between 1975 and 2009 in a head and neck surgical service. Results: Thirty five females and 24 males are reported. Forty eight (81 percent) had benign lesions. Of these, 35 (73 percent). were non neoplastic lesions. Eleven patients had malignant lesions. Of these, four (36 percent) had a mucoepidermoid carcinoma, two (18 percent) had an adenoid-cystic carcinoma, two (18 percent) had an acinous cell carcinoma and one patient each had an undifferentiated carcinoma, an adenocarcinoma and an epidermoid carcinoma. Conclusions: In this series of patients, benign lesions predominated. Benign lesions were excised and the management of malignant lesions depended on the type of tumor.

Introducción: Las lesiones de glándulas salivales menores son en su mayoría benignas. Los tumores son infrecuentes y conforman un grupo heterogéneo, siendo el adenoma pleomorfo la neoplasia benigna más frecuente y el carcinoma adenoideo-quístico el tumor maligno más encontrado. Objetivos: El propósito de este estudio es evaluar la incidencia, manejo y evolución de las lesiones intraorales de glándulas salivales menores en el Servicio de Cirugía de Cabeza y Cuello del Hospital Barros Luco-Trudeau. Material y Método: Se presenta estudio retrospectivo de 59 casos tratados entre 1975 y 2009 en dicho hospital. Resultados: Encontramos 35 mujeres y 24 hombres. En 48 pacientes (81,3 por ciento) se encontró lesiones benignas, de las cuales 35 (73 por ciento) correspondieron a lesiones no neoplásicas y 13 (27 por ciento) a neoplasias. Las neoplasias malignas fueron 11 (18,6 por ciento del total), 4 (36,3 por ciento) con Ca mucoepidermoide, 2 (18 por ciento) con Ca adenoideo-quístico, 2 (18 por ciento) con Ca de células acinosas, 1 (9 por ciento) con Ca indiferenciado, 1 (9 por ciento) con adenocarcinoma y 1 (9 por ciento) con Ca epidermoide. Conclusiones: Las lesiones de glándulas salivales menores en nuestro hospital se caracterizan por ser predominantemente benignas. Se encontró similar frecuencia de tumores benignos y malignos. Predominó el adenoma pleomorfo entre los primeros y el carcinoma mucoepidermoide entre los segundos. Los tumores benignos, luego de su extirpación, se manejaron con cierre del lecho tumoral mediante rotación de colgajos locales de mucosa oral para cobertura y, en algunos casos, cierre por segunda intención. La evolución fue en general excelente. En el caso de los tumores malignos, el manejo dependió de Ia histología.

A survey of oral and maxillofacial biopsies in children: a single-center retrospective study of 20 years in Pelotas-Brazil

Despite the large number of published cases about oral and maxillofacial pediatric lesions, the literature is scarce on epidemiological studies regarding the prevalence of these entities. This study retrieved oral and maxillofacial pediatric lesions from the Center of Diagnosis of Oral Diseases (CDDB) at the Dental School of the Federal University of Pelotas (UFPEL), comprising a 20-year period (1983-2002). From the total of 9,465 biopsies received in this period, 625 (6.6%) were from children aged 0 to 14 years. Regardless of the histopathological diagnosis, patient data referring to lesion location, sex and age were collected. Diagnoses were grouped in 13 categories. As much as 89 percent of the cases occurred in patients aged 7 to 14 years (53% in females and 47 percent in males). Mucocele (17.2%) was the most common type of lesion, followed by dentigerous cyst (8.6%). In the category of odontogenic tumors, odontoma was the most frequent lesion (64.2%). Malignant lesions were observed in a small section of the sample (1.2%). Generally, the results of the present study are in line with those reported in the literature concerning the most prevalent lesions in the pediatric population. Most lesions were benign, and malignant lesions were diagnosed in a very small part of the sample.

Compromiso de las glándulas salivales en la enfermedad HIV/Sida / Salivary glands involvement in HIV/AIDS disease

La enfermedad de las glándulas salivales asociada al HIV es definida como la presencia de aumento del tamaño de la glándula asociado o no a xerostomía. Esta patología es más habitual en niños que en adultos. La enfermedad de las glándulas salivales asociada al HIV incluye lesiones linfoepiteliales y quistes que comprometen el tejido glandulas y/o los ganglios linfáticos, síndrome símil-Sjogren, síndrome de linfocitosis T CD8 difuso y neoplasias. Este artículo incluye una revisión de la epidemiología, la fisiopatología, las manifestaciones clínicas, la metodololgía diagnóstica y los diagnósticos diferenciales de la enfermedad de las glándulas salivales asociada al HIV

Inflamación de glándulas salivales, revisión bibliográfica / Salivary glands inflammation: a review of the literature

Las glándulas salivales son estructuras pares, simétricas y localizadas junto a la rama y el cuerpo de la mandíbula, involucran glándulas parótida (saliva serosa), submaxilar (predominantemente serosa) y sublingual (predominantemente mucosa). Además existen numerosas glándulas salivales menores en la superficie de la mucosa bucal, yugal, palatina y sublingual de la cavidad bucal (300-400 aproximadamente) que producen saliva mucosa. El objetivo de esta revisión bibliográfica es hacer una reseña sobre los diversos proceos infecciosos que afectan las glándulas salivales, los diferentes enfoques diagnósticos y pautas de tratamiento. Los trastornos infecciosos de las glándulas salivares entran en el área de responsabilidad de la odontología, todo facultativo debe estar familiarizado con estos tratornos, las técnicas de diagnóstico aplicables y estar en capacidad de referir aquellos casos que son competencia de los especialistas.

Afecciones quirúrgicas de glándulas salivales mayores que requieren tratamiento: estudio de 7 años / Surgical affections of major salivary glands requiring treatment: a 7-year study

Se realizó un estudio descriptivo de 205 pacientes que fueron intervenidos quirúrgicamente de afecciones en glándulas salivales mayores durante un período de 7 años en el servicio de Cirugía Maxilofacial del Hospital Universitario "Arnaldo Milián Castro" de Villa Clara, con el propósito de describir su frecuencia según edad y sexo, comportamiento biológico, localización anatómica, resultado citológico y corroboración hística; asimismo, se describió el procedimiento quirúrgico empleado por excelencia: la parotidectomía subtotal y las secuelas posoperatorias más frecuentes, donde sobresale la parálisis temporal del nervio facial. Se demostró que la biopsia por aspiración es un procedimiento de certeza diagnóstica en entidades benignas. Hubo predominio de las condiciones neoplásicas en la parótida, mientras que en la submandibular se manifestaron con mayor frecuencia los procesos inflamatorios crónicos. El adenoma pleomorfo fue el tumor más frecuente entre las neoplasias benignas y el carcinoma mucoepidermoide, el más común de las malignas

Salivary gland lesions: a Jamaican perspective

A retrospective analysis of the spectrum and relative frequency of salivary gland lesions diagnosed in the Department of Pathology, University of the West Indies, Kingston, Jamaica, between 1965 and 1994, is reported. Four hundred and sixty-four salivary gland biopsies were received. Of these 99 (21.3) were non-neoplastic and the remaining 365 (78.7) were neoplasms: 261 (71.5) were benign and 104 (28.5) malignant. Benign mixed tumour (BMT)/pleomorphic adenoma (PA) was the most common neoplasm (63.3) while mucoepidermoid carcinoma (MEC) was the most common malignant neoplasm (9.6), followed by adenoid cystic carcinoma (ACC) (7.4). The increased frequency of MEC over ACC is at variance with other reported series but the preponderance of pleomorphic adenoma is consistent. In the major salivary glands, benign neoplasms predominate at a ratio of 3:1, while a higher proportion of minor salivary gland neoplasms was malignant, ratio 1.2:1 (p = 0.003). These data represent the first attempt to document the spectrum of disease related to oral and maxillofacial pathology in Jamaica.

Estudio histopatológico de glándulas salivales menores en alcohólicos / Histopathological study of minor salivary glands in alcoholics

A qualitative and quantitative histological analysis of minor salivary glands was carried out in 60 alcoholics and 20 matched control patients. Minor salivary glands biopsies were obtained and samples were processed for conventional light microscopy. A quantitative morphometrical assessment was carried out by counting the number of acinar cells present in an area by means of a squared grid eye piece. Neither hipertrophic nor atrophic responses were found in the quantitative analysis. Histological changes such as acinar degeneration, hyperemia, mononuclear inflammatory and fat infiltration were found in both experimental and control samples. None of these findings reached statistical significance. Eleven adult alcoholics with liver damage (ASD) presented duct dilatation. On the other hand, only 3 adult alcoholics with liver damage (ACD) developed this response. This difference was statistically significant (p=0.02). Perhaps no difference was found when we compared ASD group with its respective control group (p=0.699). Whe could not differentiate if this change was due to alcoholism or another undeterminated factor. At least under the scope of this study, we may conclude that minor salivary glands are acarcely affected by alcoholism even when liver damage has been established

Estudio comparativo y revisión bibliográfica de los reportes en incidencia y prevalencia de lesiones en cavidad oral / A comparative study and review of the literature of the reports on incidence and prevalence of oral cavity lesions

Se realiza un estudio retrospectivo y comparativo de los 6 estudios más importantes reportados en el país de 1988 a 1991 y que se relacionan con la incidencia y prevalencia de lesiones en cavidad bucal. Además, se establece una comparación con un reporte efectuado en individuos americanos de raza blanca de Estados Unidos, por la cantidad de pacientes involucrados. En términos generales, se destaca la necesidad de llevar un seguimiento tanto longitudinal como transversal de estos estudios, efectuando un análisis comparativo de los hallazgos reportados para cada región que involucre a los estudios correspondientes

Correlación entre sialografía y la ecografía en el estudio de las glándulas salivales / Sialography and ultrasonography in the diagnosis of salivary gland diseases

Se estudiaron 90 pacientes con supuesta patología de las glándulas salivales mediante sialografía y ecografía. El objetivo del estudio fue establecer la capacidad diagnóstica de cada método en particular, en distintas patologías: litiasis extra e intraglandular, afecciones inflamatorias de los conductos excretores y de las glándulas y tumores. Se determinó además la incidencia de la patología por sexo y grupo etario. Se establecieron las indicaciones de cada método cuya eficiencia es semejante en algunos casos y absolutamente complementaria en otros. Ambos no pueden reemplazarse entre sí ni excluyen otros medios de diagnóstico por imágenes a los que se deberá apelar en circunstancias definidas como la TC y la RNM

clinical survey of diseases of the throat in Sudanese patients

A retrospective study was carried out to show the pattern of diseases of the throat and salivary glands in Sudanese patients. Diseases of the throat formed 37% of otorhinolarynological diseases [ORLD] seen in Khartoum. Inflammatory diseases of the tonsils and adenoids were the most frequently encounter. The peak incidence of the disease was between the ages of 6 - 10 years in males and 11 - 20 years in females. Nasopharyngeal carcinoma was the most common cancer in the upper respiratory tract. Foreign bodies form the major group of trauma. Salivary gland calculi were most common in the submandibular duct. Pleomorphic salivary gland tumours were the commonest tumours seen mostly in the parotid gland. Branchial and thyroglossal cysts were the commonest cysts seen in the neck