A simple method to estimate the secretion of saliva from minor salivary glands using iodine-starch reaction.

OBJECTIVE/HYPOTHESIS: This study was undertaken to detect the faculty of secretion of saliva from minor salivary glands by analyzing a color reaction on a test tape containing iodine and starch that was applied on the lower lip. STUDY DESIGN: A study involving 63 patients with oral dryness, 7 patients with Sjogren syndrome, and 70 healthy individuals was performed. METHODS: A test tape (1 x 1 cm) containing iodine and starch was set on the mucosal area anterior to the labia frenulum for 30 seconds. Because the number of blue spots was considered to correspond to the number of ostia of the salivary gland on the lower lip that was examined, the number of blue spots occurring as a reaction of iodine and starch on the test tape was counted and was compared among three groups. In addition, the relationship between the histopathological findings and the number of spots was analyzed. RESULTS: The average number of spots in the patients with oral dryness (4.52+/-3.18 [mean +/- SD]) was lower than that in healthy individuals (9.49+/-2.52, P <.01), and that in the patients with Sjögren syndrome (2.14+/-1.35) was the lowest among all groups in the study. Moreover, this reduction in the number of spots in those patients was accompanied by histopathological changes of the minor salivary glands. CONCLUSION: These findings suggest that this simple, noninvasive method can be successfully used for the estimation of the faculty of secretion of saliva from the minor salivary glands.

Kinetics of epidermal growth factor in saliva.

Human epidermal growth factor (hEGF) stimulates the growth and differentiation of various tissues. We measured EGF levels in saliva (n = 128), urine (n = 94), and serum (n = 99) with radioimmunoassay in order to study the kinetics of hEGF in saliva of normal subjects and patients with oral disease. Salivary EGF levels showed an apparent diurnal rhythm related to the taking of meals. Urinary and serum EGF levels showed no obvious diurnal rhythm. There was no significant correlation between salivary and urinary EGF levels, nor between salivary and serum EGF levels. Salivary EGF levels were significantly lower in the younger group (0-9 years old, 3.06 +/- 0.32 ng/ml, p < 0.05) than in the elder group (10-79 years old, 4.78 +/- 3.5 ng/ml), but did not correlate with age in the elder group. There was no significant difference between males and females between EGF levels in saliva, urine or serum. The relative proportion of EGF levels in submandibular gland saliva, parotid saliva, and whole saliva was 1:6:4. The positive rate of immunohistochemical EGF showed no significant differences between submandibular gland, parotid gland, sublingual gland or minor salivary gland. Salivary EGF levels were markedly low in patients with oral inflammations (stomatitis aphthosa, or peritonsillar abscess) or head and neck tumors (squamous cell carcinoma of the tongue, oral cavity, hypopharynx or larynx). These findings may be significant pathophysiologically. Low salivary EGF levels may reduce the capacity of oral mucosal defense mechanisms to fight against injury by physiochemical agents.

Approach to the diagnosis of sialadenosis using sialography.

Since parotid swelling is the most informative symptom of sialadenosis, we examined parotid swelling with sialography as a means of diagnosing sialadenosis. An X-ray was taken from a fixed position relative to the body, using a focus film distance (FFD) of 70 cm. To determine an "index" of parotid swelling, the distance between the submandibular bone ridge and the end of the main duct was measured on X-ray. After examination of 30 normal parotids, abnormal swelling was defined as an "index" exceeding 1.9 cm. Sixteen of 24 patients suspected of having sialadenosis showed swelling exceeding 1.9 cm. Six of 7 patients who were histologically diagnosed with sialadenosis showed swelling in excess of 1.9 cm. Our method is reproducible and recurrence of parotid swelling correlating with sialadenosis can be objectively demonstrated. Furthermore, serum amylase levels in patients who were diagnosed with sialadenosis were measured before and after sialography. After sialography serum amylase levels increased remarkably higher than those of normal subjects. Thus if a patient with underlying diseases has an "index" over 1.9 cm and his serum amylase level after sialography increases remarkably, a diagnosis of sialadenosis is likely.

Congenital absence of lacrimal puncta and of all major salivary glands: case report and literature review.

A 7-year-old girl had dry mouth and recurrent infections of the lacrimal fistulae with decreased lacrimal secretion. All four puncta were absent, and a Schirmer test showed decreased lacrimal secretion. Salivary gland imaging with sodium pertechnetate 99mTcO4 showed absence of all major salivary glands. Lower lip biopsy disclosed normal structure of the salivary gland. No evidence of abnormal inheritance patterns could be demonstrated.

Prognostic determination and submandibular function in Bell's palsy. Dynamic testing with technetium Tc 99m.

In 56 patients with Bell's palsy, a submandibular gland function test employing a dynamic technetium Tc 99m scan was performed, to study the relationship between the test results and the prognosis of paralysis. Patients who had no difference in function on the affected facial side compared with the healthy side during the test (performed within ten days after symptomatic onset) had a high rate of early improvement. Patients who showed no response to the salivary secretory stimulant administered had an incomplete recovery and were all considered for surgery. Prognosis within ten days after onset was possible in as many as 37 of the 56 cases.