Sialolitiasis, sialoadenitis y sialoadenosis. Revisión de literatura y reporte de un caso clínico / Sialolithiasis, sialadenitis and sialadenosis. Review of literature and report of a clinical case

Introducción: la formación de sialolitos se considera la alteración más común en las glándulas salivales. Su origen aún no es claro en cuanto a qué provoca la obstrucción parcial o total del sistema de conductos salivales, con una predilección significativa en las glán - dulas submandibulares, lo que permite un desplazamiento retrógrado de bacterias a través del conducto salival hacia la glándula afectada, el cual se traducirá clínicamente como inflamación unilateral o bila - teral. El tratamiento para la sialolitiasis y sialoadenitis puede variar desde un manejo conservador hasta tratamientos que implican la remoción de la glándula salival afectada. La sialoadenosis difiere de las anteriores en su origen, ya que ésta no se considera inflamatoria ni neoplásica y no afecta la función glandular de excretar saliva. Presentación de caso clínico: se trata de paciente masculino con diagnósticos presuntivos de sialoadenitis y sialolitiasis, al cual se le realizó biopsia escisional de la glándula afectada, su estudio histo- patológico corroboró los diagnósticos mencionados anteriormente que además confirmó un diagnóstico de sialoadenosis. Conclusio- nes: la escisión de la glándula salival involucrada se realizará en casos diagnosticados de sialoadenitis y sialolitiasis con sialolitos de gran tamaño y procesos supurativos crónicos que no resuelven con antibioticoterapia (AU)

Management Options for Sialadenosis.

Sialadenosis (sialosis) is a chronic, noninflammatory, nonneoplastic, bilateral, often painless enlargement of the salivary glands, most frequently affecting the parotid glands. Approximately 50% of cases are associated with an underlying disease process. The pathogenesis of sialadenosis is unknown but likely results from an autonomic neuropathy. The key to management is diagnosis and management of any poorly controlled underlying medical process.

[Assessment of the efficiency of sialosis treatment in patients with type 2 diabetes mellitus]. / Otsenka effektivnosti lecheniya bol'nykh s sialozom na fone sakharnogo diabeta 2-go tipa.

THE AIM OF THE STUDY: Was to determine changes in the levels of cytokines in the oral fluid in patients with type 2 diabetes and sialosis, depending on the level of glycemia and the duration of type 2 diabetes, as well as in the dynamics of basic and complex treatment. MATERIALS AND METHODS: Forty patients with type 2 diabetes were enrolled in the study and divided into two groups according to disease duration: group 1 comprised 15 patients having diabetes for ≤5 years, group 2 - 25 suffering for more than 5 years. RESULTS: The study revealed changes in pancreatic cancer immunological parameters in patients with sialosis and type 2 diabetes. Long course of diabetes led to an increase in the level of IL-2 and a decrease in IFN-γ in oral fluid. The level of IL-1ß was the highest in the group of patients with a duration of diabetes ≤5 years. According to the data presented, the content of IL-1ß, IL-2 in patients with diabetes is higher, and INF-γ is lower than in healthy individuals. In patients with sialosis on the background of type 2 diabetes before treatment there is a decrease in the level of IFN-γ in the oral fluid and its increase to 7.3±0.2 pg/ml after treatment. At the same time, when enzyme therapy was included in the treatment regimen, the increase in the level of IFN-γ in the main group was more pronounced and averaged 8.3±0.1 pg/ml, which was 1.2 times higher than the initial level (p<0,05). CONCLUSION: The inclusion of enzyme therapy in the complex therapy of patients with sialosis against the background of diabets, unlike traditional methods of therapy, made it possible to provide faster positive clinical dynamics, namely, under the influence of this drug, the pain stopped in a short time, salivation increased and the feeling of dryness disappeared. Along with a faster relief of clinical symptoms, normalization of the levels of IL-1ß, IL-2 and an increase in IFN-γ by the end of treatment were noted.

Quantitative Analysis of Parotid Gland Secretion Function in Sjögren's Syndrome Patients with Dynamic Magnetic Resonance Sialography.

OBJECTIVE: To evaluate the secretory function of parotid glands by dynamic magnetic resonance (MR) sialography and determine the clinical performance of this technique in diagnosing and evaluating Sjögren's syndrome (SS) patients. MATERIALS AND METHODS: This study enrolled 29 healthy volunteers (25 women and 4 men; mean age, 34.8 ± 6.3 years; age range, 26-47 years) and 25 primary SS (pSS) patients (23 women and 2 men; mean age, 37.7 ± 7.9 years; age range, 25-50 years) with decreased secretory function. The volume of the parotid gland ducts was precisely measured for both groups at single pre- and 6 post-gustatory-stimulated phases. Time-dependent volume change ratio curves were generated, four parameters were derived from the curves: the slope of the increase in the first post-stimulation phase (slope1st), the peak value, the time-to-peak, the total saliva secretion post-stimulation. All values were used to quantitatively evaluate the secretory function of the parotid gland. The repeated measurement analysis, Mann-Whitney U test and receiver operating characteristic curve were applied. RESULTS: Time-dependent volume change ratio curves demonstrated that there is a statistically significant difference between the two groups (F = 8.750; p = 0.005). A quickly increasing curve was shown in the volunteer group, whereas a slowly increasing curve was shown in the pSS patient group. The slope1st, peak value and total saliva secretion post-stimulation of the patient group were significantly lower than those of the volunteer group (p = 0.005, p = 0.003, and p = 0.002, respectively). The time-to-peak between the two groups was not significantly different (p = 0.383). The slope1st can be used as a discriminator to diagnose SS patients (p = 0.015; odds ratio = 4.234; area under the curve = 0.726). CONCLUSION: Dynamic MR sialography is proven to be an effective method in evaluating salivary gland function and has a great potential in diagnosing and evaluating pSS patients.

Quantitative Analysis of Parotid Gland Secretion Function in Sjögren's Syndrome Patients with Dynamic Magnetic Resonance Sialography

OBJECTIVE: To evaluate the secretory function of parotid glands by dynamic magnetic resonance (MR) sialography and determine the clinical performance of this technique in diagnosing and evaluating Sjögren's syndrome (SS) patients. MATERIALS AND METHODS: This study enrolled 29 healthy volunteers (25 women and 4 men; mean age, 34.8 ± 6.3 years; age range, 26–47 years) and 25 primary SS (pSS) patients (23 women and 2 men; mean age, 37.7 ± 7.9 years; age range, 25–50 years) with decreased secretory function. The volume of the parotid gland ducts was precisely measured for both groups at single pre- and 6 post-gustatory-stimulated phases. Time-dependent volume change ratio curves were generated, four parameters were derived from the curves: the slope of the increase in the first post-stimulation phase (slope(1st)), the peak value, the time-to-peak, the total saliva secretion post-stimulation. All values were used to quantitatively evaluate the secretory function of the parotid gland. The repeated measurement analysis, Mann-Whitney U test and receiver operating characteristic curve were applied. RESULTS: Time-dependent volume change ratio curves demonstrated that there is a statistically significant difference between the two groups (F = 8.750; p = 0.005). A quickly increasing curve was shown in the volunteer group, whereas a slowly increasing curve was shown in the pSS patient group. The slope(1st), peak value and total saliva secretion post-stimulation of the patient group were significantly lower than those of the volunteer group (p = 0.005, p = 0.003, and p = 0.002, respectively). The time-to-peak between the two groups was not significantly different (p = 0.383). The slope(1st) can be used as a discriminator to diagnose SS patients (p = 0.015; odds ratio = 4.234; area under the curve = 0.726). CONCLUSION: Dynamic MR sialography is proven to be an effective method in evaluating salivary gland function and has a great potential in diagnosing and evaluating pSS patients.

Sonographic and CT findings of sialadenosis in a child with leukemia.

Sialadenosis is characterized by asymptomatic bilateral enlargement of the parotid glands. It is uncommon, especially in children. Diagnosis and analysis of sialadenosis based on imaging modalities have been rarely reported. Here, we report a case of sialadenosis in a child with leukemia, in which the diagnosis was made based on sonography and CT findings.

Sonographic and CT Findings of Sialadenosis in a Child with Leukemia

Sialadenosis is characterized by asymptomatic bilateral enlargement of the parotid glands. It is uncommon, especially in children. Diagnosis and analysis of sialadenosis based on imaging modalities have been rarely reported. Here, we report a case of sialadenosis in a child with leukemia, in which the diagnosis was made based on sonography and CT findings.

Sialadenosis in patients with advanced liver disease.

Sialadenosis (sialosis) has been associated most often with alcoholic liver disease and alcoholic cirrhosis, but a number of nutritional deficiencies, diabetes, and bulimia have also been reported to result in sialadenosis. The aim of this study was to determine the prevalence of sialadenosis in patients with advanced liver disease. Patients in the study group consisted of 300 candidates for liver transplantation. Types of liver disease in subjects with clinical evidence of sialadenosis were compared with diagnoses in cases who had no manifestations of sialadenosis. The data were analyzed for significant association. Sialadenosis was found in 28 of the 300 subjects (9.3%). Among these 28 cases, 11 (39.3%) had alcoholic cirrhosis. The remaining 17 (60.7%) had eight other types of liver disease. There was no significant association between sialadenosis and alcoholic cirrhosis (P = 0.389). These findings suggest that both alcoholic and non-alcoholic cirrhosis may lead to the development of sialadenosis. Advanced liver disease is accompanied by multiple nutritional deficiencies which may be exacerbated by alcohol. Similar metabolic abnormalities may occur in patients with diabetes or bulimia. Malnutrition has been associated with autonomic neuropathy, the pathogenic mechanism that has been proposed for sialadenosis.