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

1. Rapaport MJ, Vinnik C, Zarem H: Injectable silicone: Cause of facial nodules, cellulitis, ulceration, and migration. Aesthet Plast Surg 20:267, 1996.

2. Fairbanks DN: Antimicrobial Therapy in Otolaryngology—Head and Neck Surgery, 8th ed. American Academy of Otolaryngology—Head and Neck Surgery Foundation, 1996.

3. Middleton DB, Ferrante JA: Periorbital and facial cellulitis. Am Fam Physician 21:98, 1980.

4. Biederman GR, Dodson TB: Epidemiologic review of facial infections in hospitalized pediatric patients. J Oral Maxillofac Surg 52:1042, 1994.

5. Marbach JJ: Temporomandibular pain and dysfunction syndrome: History, physical examination, and treatment. Rheum Dis Clin North Am 22:477, 1996.

6. Talley RL, Murphy GJ, Smith SD, et al: Standards for the history, examination, diagnosis, and treatment of temporomandibular disorders (TMD): A position paper: American Academy of Head, Neck, and Facial Pain. Craniology 8:60, 1990.

7. Mitchell RJ: Etiology of temporomandibular disorders. Curr Opin Dentistry 1:471, 1991.

8. Westesson PL: Reliability and validity of imaging diagnosis of temporomandibular joint disorder. Adv Dent Res 7:137, 1993.

9. Tarro AW: The treatment of TMJ disorders: A current update. J Mass Dent Soc 40:125, 1991.

10. Totten VY, Zambito RF: Propofol bolus facilitates reduction of luxed temporomandibular joints. J Emerg Med 16:467, 1998.

11. Undt G, Kermer C, Piehslinger E, Rasse M: Treatment of recurrent mandibular dislocation, part I: Leclerc blocking procedure. Int J Oral Maxillofac Surg 26:92, 1997.

12. Luyk NH, Larsen PE: The diagnosis and treatment of the dislocated mandible. Am J Emerg Med 7:329, 1989.

13. Peterson LJ: Odontogenic infections, in Cummings CW (ed): Otolaryngology—Head and Neck Surgery, 2d ed. St. Louis: Mosby-Year Book, pp 1199-1215.

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.

15. Doxey GP, Harnsberger HR, Hardin CW, Davis RK: The masticator space: The influence of CT scanning on therapy. Laryngoscope 95:1444, 1985.

16. Baker AS, Montgomery WW: Oropharyngeal space infections. Curr Clin Top Infect Dis 8:227, 1987.

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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