Sialadenose

Sialadenose

Physicians understand sialadenosis to be a disease of the glandular tissue (glandular parenchyma) in the salivary glands. However, this disease, which is due to a secretion disorder of the salivary gland, is not based on inflammation. Occasionally, sialadenosis is also referred to as sialose. In professional circles, however, this designation is considered outdated.

What is sialadenosis?

professor dr In 1976, Seifert from the University of Hamburg defined sialadenosis as a non-inflammatory, parenchymatous (affecting the tissue) disease of the salivary glands, which is based on metabolic and secretion disorders in the glandular tissue (glandular parenchyma). In most cases, this leads to a dough-like swelling of the parotid gland (glandula parotidea). For pandas in dictionary, please visit dictionaryforall.com.

Occasionally, other major salivary glands are also affected by the disease. Malfunctions of the vegetative nervous system are named as causes. Painful symptoms do not necessarily occur in the affected regions. The disease is often noticed late or not at all and is not clearly diagnosed even by specialists.

Unlike sialadenitis, neither inflammation nor tumor-like phenomena are the cause of the disease. A side effect of sialadenosis is an expansion of the tissue caused by cell enlargement or an increase in cell volume ( hypertrophy ). The International Statistical Classification of Diseases and Related Health Problems (ICD) classifies sialadenosis under “Other diseases of the salivary gland” (K11.8).

Causes

The most common causes of sialadenosis are nutritional and metabolic diseases as well as impairments of the glands that release their products directly into the blood. Liver diseases and neurogenic disorders can also be the cause. In some cases, incorrect drug treatment can also lead to a disease.

In addition, a whole range of other factors can be taken into account, all of which can lead to a disturbance in the secretion of saliva from the salivary glands. Alcoholism, especially in connection with liver cirrhosis, can be just as causal as chronic vitamin or protein deficiency. Malnutrition with nervous-related loss of appetite can also cause the disease.

People who suffer from diabetes or inflammation of the pancreas are also particularly at risk. Less common, but not to be underestimated, are diseases of the adrenal glands and a hormonal change – such as during menopause – to be named as the cause. Some medications can also impair the secretion of saliva in the oral cavity, which can lead to a build-up of saliva that is disease-promoting.

This can cause swelling in the salivary glands. These drugs primarily include so-called anticholinergics, the antibiotic ethambutol, which is used to treat tuberculosis, and phenothiazines, which are often used to treat mental illnesses.

Symptoms, Ailments & Signs

Sialadenosis leads to a mostly painless swelling of both parotid glands. It is usually bilateral and symmetrical. Impaired gland functions can also lead to dry mouth (xerostomia).

However, there is no direct connection between the swelling and food intake. In rarer cases, other salivary glands are also thickened. In contrast to swelling caused by bacteria or inflammation, in most cases there is at best a slight tension pain.

The volume of the gland cells, doctors speak of acinus cells, can swell up to three times the normal level. Women are more frequently affected by the disease than men, especially after puberty, pregnancy or menopause.

Diagnosis & course of disease

In many cases, sialadenosis can be diagnosed without much technical effort based on the typical swelling of the glands. Magnetic resonance imaging, also commonly known as “nuclear spin tomography”, provides security. However, this is usually only necessary to distinguish it from other diseases after the “exclusion process”.

These include bacterial inflammation (sialadenitis), salivary gland stones ( sialolithiasis ), mumps (parotitis epidemica), tumor-like disease of the glands or an enlargement of the tissue due to overuse (hypertrophy). These diseases have similar symptoms but are to be distinguished from sialadenosis. Occasionally, taking tissue samples from the swollen organ can also provide information about the disease.

Complications

Sialadenosis can lead to various symptoms. First and foremost, this leads to severe swelling of the salivary glands in the ears. Although these swellings are not always visible, they can lead to aesthetic complaints and thus to reduced self-esteem or inferiority complexes.

Dry mouth is also very common with this disease, and the dryness cannot usually be compensated for with the help of liquid intake. Pain can also occur in the face or ears. If the pain also occurs at night, this can lead to sleep disorders and thus to irritability of the person concerned.

In most cases, the treatment of sialadenosis is not associated with complications. The symptoms can usually be well limited by taking medication. In some cases, however, surgical interventions are also necessary, which take place due to aesthetic complaints. The life expectancy of those affected is also not negatively affected by the disease. Creams and ointments can also be used to reduce swelling.

When should you go to the doctor?

Since sialadenosis is a serious condition that can lead to serious complications, this condition must always be treated by a medical professional. Further symptoms can only be prevented and limited by early detection and treatment of the disease. This disease cannot heal on its own. A doctor should be consulted for sialadenosis in the first place if the person affected is suffering from severe dryness in the mouth. This does not go away on its own and remains even if the person concerned drinks a lot. Furthermore, strong swellings at the inflamed areas point to the disease.

Sufferers also suffer from swelling that can occur while eating, making it difficult to eat. In many cases, sialadenosis also delays puberty in those affected, so that psychological problems can also occur. These should also be examined and treated by a psychologist . Sialadenosis can be diagnosed by a general practitioner. However, the treatment is carried out by various specialists, and complete healing cannot always be guaranteed. This disease may also reduce the life expectancy of the patient.

Treatment & Therapy

A direct treatment of sialadenosis is not possible. Therefore, the doctor treating you will limit the therapy to investigating the causes and try to counteract them. In almost all cases, the sialadenosis is based on another disease. For example, if it is the result of incorrect medication, an attempt can be made to replace the medication administered with others.

While the doctor can give drugs to increase salivation, at best this can relieve the symptoms and not the condition itself. Sucking on sticks of butter or pilocarpine may also be considered to reduce symptoms. Also, the use of decongestant ointments may only provide temporary relief from symptoms and is not a particularly good treatment.

A blood count can give the doctor information about a possible undersupply in the blood. The doctor can then try to compensate for the deficiency by administering appropriate preparations or prescribing diets. Surgical means are only used in very rare cases.

During these procedures, the surgeon will reduce the affected areas of the salivary glands. Only in very severe and rare cases is the parotid gland removed completely. Surgical interventions take place almost exclusively for cosmetic reasons.

Prevention

A sialadenosis can only be prevented indirectly. Therefore, only the treatment or prevention of the underlying disease can have a preventive effect. It is not uncommon for there to be a connection to diet. It is therefore advisable to check these from time to time and to question them if necessary. The doctor can use a blood count to identify possible risks. A reasonable use of stimulants, especially alcohol, can also reduce the risk of illness.

Aftercare

Follow-up care for sialadenosis depends primarily on the patient’s complaints and symptoms and the causative disease. As a rule, the patient is prescribed a new drug as part of the aftercare, which is intended to replace the triggering drug. It must then be observed over a longer period of time whether the drug achieves the desired effect.

Further follow-up appointments are necessary for this. The time intervals at which these must take place depend on various factors. The patients must primarily follow the instructions of the responsible internist. Should swelling of the parotid glands or other serious complications occur, an operation is usually essential.

After an operation, the patient must be carefully observed. As part of the aftercare, the doctor can give tips on how the patient can treat the swelling independently. In many cases, however, inpatient observation is necessary. Follow-up care is provided by the responsible internist. Depending on whether complications occur or the disease heals well, other specialists must be involved in the treatment. Follow-up care usually takes place a few weeks after the end of therapy.

You can do that yourself

If the sialadenosis is based on a nutritional disorder, the diet must first be adjusted. It is important to compensate for the vitamin and nutrient deficiency and thus eliminate the symptoms. If you have a dry mouth, you should drink plenty of mineral water or tea. Diabetics should consult a nutritionist if their salivary glands become swollen. The nutritional plan must be put together professionally to reduce discomfort and improve long-term well-being.

If the symptoms are triggered by a drug, it must be discontinued. For people who are taking clonidine or furosemide and also have sialadenosis symptoms, it is best to talk to their doctor. The same applies to other antihypertensive drugs, because these drugs can cause swelling of the salivary glands. In severe cases, an operation is necessary. The ear canals must then be protected from cold, moisture and other stresses. In addition, general measures such as rest and bed rest apply. In addition, the doctor should be regularly informed about the course of the disease.

In the case of sialadenosis, regular visits to the doctor at intervals of one to two weeks are indicated. If the symptoms get worse or there are concomitant diseases such as diabetes, further doctor appointments may be necessary.

Sialadenose