Information on the following diseases can be found in the Related Disorders section of this report:

• Mikulicz Syndrome
• Sjogren Syndrome
• Mixed Tumor of the Salivary Gland
• Periodic Sialadenosis

Symptoms of sialadenitis include enlargement, tenderness, and redness of one or more salivary glands. These are the glands in the mouth, located near the ear (parotid), under the tongue (sublingual), and under the jaw bone (submaxillary), plus numerous small glands in the tongue, lips, cheeks and palate. Salivary stones (calculi) may block secretions from any of these glands. The gland may sometimes become infected, leading to fever and other complications.

Decreased salivary flow is a hallmark of both the acute and chronic forms of sialadenitis. The pain is more obvious while eating, and more than three-quarters of patients complain of dry mouth (xerostomia).

The exact cause of sialadenitis is unknown. In some cases, the condition may be associated with the formation of salivary gland stones (sialolithiasis).

Sialadenitis affects males and females in equal numbers. It shows no racial biases.

Mikulicz Syndrome is a benign chronic lymphocytic infiltration and enlargement of the tonsils and salivary glands near the ear (parotid gland), beneath the upper jaw bone (submaxillary), tear (lacrimal) and other glands. This condition causes excessive dryness of the mouth and eyes and is often related to Sjogren's Syndrome. (For more information on this disorder, choose "Mikulicz" as your search term in the Rare Disease Database.)

Sjogren Syndrome is a degeneration of the tear and salivary glands that may be associated with arthritis. Patients often complain of a gritty, burning sensation in their eyes due to loss of lubrication. When their mouths become dry, chewing and swallowing food is difficult. The lack of saliva causes particles of food to stick to the cheeks, gums, and throat. Other symptoms may include a weak voice, dental decay, dryness of the nose, skin and vagina. (For more information on this disorder, choose "Sjogren" as your search term in the Rare Disease Database.)

Mixed Tumor of the Salivary Gland (Pleomorphic Adenoma of the Salivary Gland) is a slowly growing, benign tumor of unknown origin. It is usually located in the parotid salivary glands. Onset of the disorder is slow, but later the tumor tends to grow rapidly. Paralysis of the facial muscles is a rare complication. Sometimes pain occurs in conjunction with the tumor. This disorder tends to be familial and can occur in multiple family members.

Periodic Sialadenosis (Periodic Sialorrhea, or Recurring Salivary Adenitis) is a disorder of unknown cause, possibly of autosomal dominant inheritance. It is characterized by sudden discomfort in the region of the salivary glands near the ear and jaws. An unusually large flow of saliva may occur. The outer ear sometimes appears distorted.

Diagnosis
The disorder is often diagnosed by means of a thorough patient history and physical examination. Recent advances in endoscopic equipment make the diagnosis somewhat easier.

Treatment
Initial treatment of sialadenitis involves antibiotic therapy and rehydration of the patient. Patients are referred to specialists (otolaryngologists) if any signs of facial nerve involvement are present or if drainage of the swelling is contemplated. If a stone is present, gentle massage may help move it out of the gland. Otherwise, surgery may be indicated.

Information on current clinical trials is posted on the Internet at www.clinicaltrials.gov. All studies receiving U.S. government funding, and some supported by private industry, are posted on this government web site.

For information about clinical trials being conducted at the NIH Clinical Center in Bethesda, MD, contact the NIH Patient Recruitment Office:

Tollfree: (800) 411-1222
TTY: (866) 411-1010
Email: prpl@cc.nih.gov

For information about clinical trials sponsored by private sources, contact:
www.centerwatch.com

A clinical trial on the treatment of chronic sialadenitis with intraductal penicillin or saline produced promising results. Additional study of this treatment method is needed.

Other experimental investigations deal with improved endoscopic techniques for the imaging and detection of chronic sialadenitis.

TEXTBOOKS
Ballenger JJ, ed. Diseases of the Nose, Throat, Ear, Head and Neck. 14th ed. Lea & Febiger, Malvern, PA; 1991:300-301.

JOURNAL ARTICLES
Morimoto Y, Tanaka T, Tominaga K, et al. Clinical application of magnetic resonance sialographic 3-dimensional reconstruction imaging and magnetic resonance virtual endoscopy for salivary gland duct analysis. J Oral Maxillodac Surg. 2004;62:1237-45.

Zenk J, Koch M, Bozzato A, et al. Sialoscopy – initial experiences with a new endoscope. Br J Oral Maxillofac Surg. 2004;42:293-98.

Antoniades D, Harrison JD, Epivatianos A, et al. Treatment of chronic sialadenitis by intraductal penicillin or saline. J Oral Maxillodac Surg. 2004;62:431-34.

Grotz KA, Wustenberg P, Kohnen R, et al. Prophylaxis of radiogenic sialadenitis and mucositis by coumarin/troxerutine in patients with head and neck cancer – a prospective, randomized, placebo-controlled, double-blind study. Br J Oral Maxillofac Surg. 2001;39:34-39.

FROM THE INTERNET
Sclerosing Sialadenitis. The Doctor’s Doctor. Last Updated 3/27/2003. 11pp.
www.thedoctrosdoctor.com/diseases/sclerosing_sialadenitis.htm

Yoskovitch A. Submandibular Sialadenitis/Sialadenosis. emedicine. Last Updated: November 18, 2003. 15pp.
www.emedicine.com/ent/topic598.htm