Sialoadenitis

Background

• Occurs from outflow obstruction by a stone or calculus in the salivary gland or duct
• Submandibular location most commonly
  • More viscous secretions and runs an uphill course

Clinical Features

• Xerostomia (dry mouth) along
• Increasing swelling and pain during mealtime

Differential Diagnosis

Facial Swelling

• Buccal space infections
• Dental problems
• Canine space infection
• Facial cellulitis
• Herpes zoster
• Masticator space infections
• Maxillofacial trauma
• Neoplasm
• Parapharyngeal space infection
• Salivary gland diagnoses
  • Parotitis
    • Bilateral parotitis
    • Suppurative parotitis
    • Viral parotitis (Mumps)
  • Ranula
  • Sialoadenitis
  • Sialolithiasis
• Superior vena cava syndrome

Management

• Pass spontaneously
• Start on sialogogues (e.g., sour lozenges, lemon juice), which stimulate salivary secretions and help expel the stone
• Palpable stones may also be “milked” from the duct
  • Stroking in a posterior to anterior direction.
• If infected, consider Amoxicillin/Clavulanate or Clindamycin

Disposition

• Outpatient

Also See

• Parotitis
• Dental problems

References

• Knoop The Atlas of Emergency Medicine, pg 124