Salivary Gland Enlargement

The majority of causes of salivary gland enlargement do not require emergency intervention. However, the patient should be instructed to seek appropriate follow-up for definitive diagnosis and treatment.

Salivary gland enlargement can result from a large number of conditions. (See T§b!e.232-1.) HIV may cause painless gradual enlargement.17 Other infectious diseases, such as sarcoidosis, cat-scratch disease, tuberculosis, atypical mycobacterial infections, and actinomycoses may present as a chronic form of sialoadenitis.1 ,19

Neoplastic lesions may present with enlarged salivary glands. Less than 3 percent of all head and neck tumors are found in the salivary glands. 17 Although about 70 to 80 percent of salivary tumors arise in the parotid, 75 to 90 percent are benign. 1720

ED disposition and outpatient follow-up should be based upon the suspected underlying cause of salivary gland enlargement. CHAPTER REFERENCES

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14. Mandel L: Submasseteric abscess caused by a dentigerous cyst mimicking a parotitis: Report of two cases (Review). J Oral Maxillofac Surg 55:996, 1997.

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17. Krause GE, Meyers AD: Management of parotid swelling. Comp Ther 22:256, 1996.

18. Peter JR, Haney HM: Infections of the oral cavity. Pediatr Ann 25:572, 1996.

19. Johnson A: Inflammatory conditions of the major salivary glands. ENT J 68:94, 1989.

20. Langlais RP, Benson BW, Barnett DA: Salivary gland dysfunction: Infections, sialoliths, and tumors. ENT J 68:758, 1989.

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