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Cited by 59Salivary Gland Disorders and FunctionsSalivary Gland Tumors Diagnosis and TreatmentHIV/AIDS oral health manifestations

The DOI matches its DataCite record; 238 of the 240 references it cites were found in a registry or an index.

Salivary gland diseases in children

Open access
Iro, Heinrich, Zenk, Johannes·2014·German Medical Science GMS Publishing House
DOI 10.3205/cto000109PMC PMC4273167
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Abstract

Salivary gland diseases in children are rare, apart from viral-induced diseases. Nevertheless, it is essential for the otolaryngologist to recognize these uncommon findings in children and adolescents and to diagnose and initiate the proper treatment. The present work provides an overview of the entire spectrum of congenital and acquired diseases of the salivary glands in childhood and adolescence. The current literature was reviewed and the results discussed and summarized. Besides congenital diseases of the salivary glands in children, the main etiologies of viral and bacterial infections, autoimmune diseases and tumors of the salivary glands were considered. In addition to the known facts, new developments in diagnostics, imaging and therapy, including sialendoscopy in obstructive diseases and chronic recurrent juvenile sialadenitis were taken into account. In addition, systemic causes of salivary gland swelling and the treatment of sialorrhoea were discussed. Although salivary gland diseases in children are usually included in the pathology of the adult, they differ in their incidence and some­times in their symptoms. Clinical diagnostics and especially the surgical treatment are influenced by a stringent indications and a less invasive strategy. Due to the rarity of tumors of the salivary glands in children, it is recommended to treat them in a specialized center with greater surgical experience. Altogether the knowledge of the differential diagnoses in salivary gland diseases in children is important for otolaryngologists, to indicate the proper therapeutic approach.

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Figures

Figure 1 a) Three-year-old boy with a painful red swelling of the right cheek since 3 days. b) No improvement on antibiotics. Axial ultrasound scan shows a hypoechoic, poorly demarcated, inhomogeneous lesion, measuring 21 mm x 16 mm (+…+), in the parotid gland, consistent with the diagnosis of an abscess. c) Treatment of choice was drainage of the abscess under general anaesthetic, with irrigation and insertion of a wick. Blue line: the mandible.
Figure 1 a) Three-year-old boy with a painful red swelling of the right cheek since 3 days. b) No improvement on antibiotics. Axial ultrasound scan shows a hypoechoic, poorly demarcated, inhomogeneous lesion, measuring 21 mm x 16 mm (+…+), in the parotid gland, consistent with the diagnosis of an abscess. c) Treatment of choice was drainage of the abscess under general anaesthetic, with irrigation and insertion of a wick. Blue line: the mandible.CC BY-NC-ND · PubMed Central
Figure 2 Sialendoscopy performed on a 13-year-old girl to detect a stone in the hilum of the right submandibular gland (see screen) that could not be clearly demonstrated with ultrasound scanning.
Figure 2 Sialendoscopy performed on a 13-year-old girl to detect a stone in the hilum of the right submandibular gland (see screen) that could not be clearly demonstrated with ultrasound scanning.CC BY-NC-ND · PubMed Central
Figure 3 a) Ultrasound scan showing two hilar stones, measuring 4.4 mm and 4.7 mm, in the left submandibular gland of 14-year-old girl, before treatment. The hypoechoic changes in the parenchyma of the gland are regarded as the expression of chronic obstruction. b) Transoral stone extraction with marsupialisation of the duct under local anaesthetic in the same patient. c) Four months after the stone extraction, the patient is free of symptoms and has no new stones. The ultrasound scan shows a normal gland parenchyma (MMH: mylohyoid muscle, GSM LI: left submandibular gland). d) A neo-ostium with no signs of inflammation can be seen in the left posterior floor of the mouth.
Figure 3 a) Ultrasound scan showing two hilar stones, measuring 4.4 mm and 4.7 mm, in the left submandibular gland of 14-year-old girl, before treatment. The hypoechoic changes in the parenchyma of the gland are regarded as the expression of chronic obstruction. b) Transoral stone extraction with marsupialisation of the duct under local anaesthetic in the same patient. c) Four months after the stone extraction, the patient is free of symptoms and has no new stones. The ultrasound scan shows a normal gland parenchyma (MMH: mylohyoid muscle, GSM LI: left submandibular gland). d) A neo-ostium with no signs of inflammation can be seen in the left posterior floor of the mouth.CC BY-NC-ND · PubMed Central
Figure 4 a) Pre-operative ultrasound scan of a 5-year-old girl with a stone measuring almost 9 mm (+…+) in the right parotid gland (DS: Stensen’s duct; GP: parotid gland; UK: lower jaw; MM: masseter muscle). b) Extracorporeal shockwave therapy under general anaesthetic. c) No stones or symptoms one year after the intervention, with an unremarkable ultrasound appearance of the right parotid gland. d) A 3-year-old boy after lithotripsy of a stone in the left parotid, showing petechial haemorrhages into the skin as a typical adverse effect of lithotripsy. These will be resorbed within a few days.
Figure 4 a) Pre-operative ultrasound scan of a 5-year-old girl with a stone measuring almost 9 mm (+…+) in the right parotid gland (DS: Stensen’s duct; GP: parotid gland; UK: lower jaw; MM: masseter muscle). b) Extracorporeal shockwave therapy under general anaesthetic. c) No stones or symptoms one year after the intervention, with an unremarkable ultrasound appearance of the right parotid gland. d) A 3-year-old boy after lithotripsy of a stone in the left parotid, showing petechial haemorrhages into the skin as a typical adverse effect of lithotripsy. These will be resorbed within a few days.CC BY-NC-ND · PubMed Central
Figure 5 Sonographic imaging in an 11-year-old boy with recurrent pneumoparotitis after blowing up balloons with mobile hyperechoic reflections with acoustic shadowing (LUFT=AIR), which correspond to air inclusions in the duct system (MM: masseter muscle, UK: lower jaw, GP: parotid gland).
Figure 5 Sonographic imaging in an 11-year-old boy with recurrent pneumoparotitis after blowing up balloons with mobile hyperechoic reflections with acoustic shadowing (LUFT=AIR), which correspond to air inclusions in the duct system (MM: masseter muscle, UK: lower jaw, GP: parotid gland).CC BY-NC-ND · PubMed Central
Figure 6 Ultrasound scan of an atypical mycobacterial infection in the inferior pole of the left parotid gland (RF +…+), prior to surgical excision, in a 2-year-old girl (MSCM: sternocleidomastoid muscle; GLP: parotid gland).
Figure 6 Ultrasound scan of an atypical mycobacterial infection in the inferior pole of the left parotid gland (RF +…+), prior to surgical excision, in a 2-year-old girl (MSCM: sternocleidomastoid muscle; GLP: parotid gland).CC BY-NC-ND · PubMed Central
Figure 7 Typical ‘cloud-like’ appearance of the gland in the ultrasound scans of a 22-month-old girl (a) and an 8-year-old girl (b) with recurrent swelling of the right and left parotid glands, respectively (GLP: parotid gland; VRM: retromandibular vein; UK: lower jaw, MD: digastric muscle, posterior belly).
Figure 7 Typical ‘cloud-like’ appearance of the gland in the ultrasound scans of a 22-month-old girl (a) and an 8-year-old girl (b) with recurrent swelling of the right and left parotid glands, respectively (GLP: parotid gland; VRM: retromandibular vein; UK: lower jaw, MD: digastric muscle, posterior belly).CC BY-NC-ND · PubMed Central
Figure 8 Endoscopy and duct irrigation with normal saline and cortisone. a) Sialendocopy of a right Stensen’s duct in a 4-year-old patient with chronic recurrent juvenile parotitis. The illuminations shows the tip of the endoscope b) Hilum and c) distal duct segment with the typical white changes of the duct wall without any vessels visible.
Figure 8 Endoscopy and duct irrigation with normal saline and cortisone. a) Sialendocopy of a right Stensen’s duct in a 4-year-old patient with chronic recurrent juvenile parotitis. The illuminations shows the tip of the endoscope b) Hilum and c) distal duct segment with the typical white changes of the duct wall without any vessels visible.CC BY-NC-ND · PubMed Central
Figure 9 a) Sjögren’s syndrome in a 10-year-old girl with only the symptoms of non-specific bilateral parotid swellings. Ultrasonography showed typical hypoechoic cloud-like changes in all three major salivary glands. b) Left parotid gland (GP: parotid gland; MM: masseter muscle, UK: lower jaw). c) Left submandibular gland (GSM LI: left submandibular gland; MMH: mylohyoid muscle). d) Left sublingual gland (GSL: sublingual gland; UK: lower jaw; MB: floor of the mouth). In this case, the biopsy to confirm the diagnosis was taken from the sublingual gland. e) Dense lymphocytic infiltration of the sublingual gland parenchyma with the formation of lymphoepithelial lesions (reproduced with the kind permission of Prof. Agaimy, Department of Pathology, and Erlangen, Germany).
Figure 9 a) Sjögren’s syndrome in a 10-year-old girl with only the symptoms of non-specific bilateral parotid swellings. Ultrasonography showed typical hypoechoic cloud-like changes in all three major salivary glands. b) Left parotid gland (GP: parotid gland; MM: masseter muscle, UK: lower jaw). c) Left submandibular gland (GSM LI: left submandibular gland; MMH: mylohyoid muscle). d) Left sublingual gland (GSL: sublingual gland; UK: lower jaw; MB: floor of the mouth). In this case, the biopsy to confirm the diagnosis was taken from the sublingual gland. e) Dense lymphocytic infiltration of the sublingual gland parenchyma with the formation of lymphoepithelial lesions (reproduced with the kind permission of Prof. Agaimy, Department of Pathology, and Erlangen, Germany).CC BY-NC-ND · PubMed Central
Figure 10 a) Unclear findings on ultrasonography of the left parotid gland of a 12-year-old girl. MRI showed a space-occupying lesion with high signal intensity in the T2 weighted scan and (b) a hypointense, inhomogeneous structure taking up contrast medium in an enhanced T1 weighted scan (c). The diagnosis of an atypical pleomorphic adenoma seemed most likely. After extracapsular dissection of the tumour (d), histology showed a cavernous haemangioma with cystic, partially thrombosed vascular clefts with residual acini in between them (e: reproduced with the kind permission of Prof. Agaimy, Department of Pathology, Erlangen, Germany).
Figure 10 a) Unclear findings on ultrasonography of the left parotid gland of a 12-year-old girl. MRI showed a space-occupying lesion with high signal intensity in the T2 weighted scan and (b) a hypointense, inhomogeneous structure taking up contrast medium in an enhanced T1 weighted scan (c). The diagnosis of an atypical pleomorphic adenoma seemed most likely. After extracapsular dissection of the tumour (d), histology showed a cavernous haemangioma with cystic, partially thrombosed vascular clefts with residual acini in between them (e: reproduced with the kind permission of Prof. Agaimy, Department of Pathology, Erlangen, Germany).CC BY-NC-ND · PubMed Central
Figure 11 A 12-year-old boy with a mobile, slowly growing space-occupying lesion in the right parotid gland (arrow). After parotidectomy, histology showed an acinus cell carcinoma (image kindly supplied by Prof. M.B. Gillespie, University of South Carolina, Charleston, USA)
Figure 11 A 12-year-old boy with a mobile, slowly growing space-occupying lesion in the right parotid gland (arrow). After parotidectomy, histology showed an acinus cell carcinoma (image kindly supplied by Prof. M.B. Gillespie, University of South Carolina, Charleston, USA)CC BY-NC-ND · PubMed Central
Figure 12 Boy with persistent drooling despite four sessions of botox therapy in both parotid and submandibular glands and rerouting the submandibular ducts into the tonsillar fossa (a). Clear improvement was seen only after bilateral submandibular gland resection (b).
Figure 12 Boy with persistent drooling despite four sessions of botox therapy in both parotid and submandibular glands and rerouting the submandibular ducts into the tonsillar fossa (a). Clear improvement was seen only after bilateral submandibular gland resection (b).CC BY-NC-ND · PubMed Central
Figure 13 Permanent facial palsy (House-Brackman VI) after resection of a fistula in the right parotid gland, in a one-year-old patient operated on elsewhere. Revision surgery was performed with nerve interposition grafting.
Figure 13 Permanent facial palsy (House-Brackman VI) after resection of a fistula in the right parotid gland, in a one-year-old patient operated on elsewhere. Revision surgery was performed with nerve interposition grafting.CC BY-NC-ND · PubMed Central

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Citations

Cites

Research works printed but not linked: 8

  1. [4]Seifert G Miehlke A Haubrich J Chilla R Speicheldrüsenkrankheiten. Pathologie, Klinik, Therapie, Fazialischirurgie 1984 Stuttgart Thieme 91 97
  2. [15]Gruber W Congenitaler Mangel beider Glandulae submaxillares bei einem wohlgebildeten, erwachsenen Subjecte Arch Pathol Anat Physiol Klin Med 1885 102 1 9 11 10.1007/BF01932760 Available from: http://dx.doi.org/10.1007/BF01932760 · DOI
  3. [17]Ferreira AP Gomez RS Castro WH Calixto NS Silva RA Aguiar MJ Congenital absence of lacrimal puncta and salivary glands: report of a Brazilian family and review Am J Med Genet 4 9 2000 94 1 32 34 10982479
  4. [18]Wiedemann HR Salivary gland disorders and heredity Am J Med Genet 20 1 1997 68 2 222 224 9028463
  5. [35]Webster RG Granoff A Rima BK Mumps virus Encyclopedia of Virology. Vol 2 1994 New York Academic Press 876 883
  6. [133]Wu AJ Lafrenie RM Park C Apinhasmit W Chen ZJ Birkedal-Hansen H Yamada KM Stetler-Stevenson WG Baum BJ Modulation of MMP-2 (gelatinase A) and MMP-9 (gelatinase B) by interferon-gamma in a human salivary gland cell line J Cell Physiol 5 1997 171 2 117 124 9130458
  7. [141]Iro H Uttenweiler V Zenk J Kopf-Hals-Sonographie. Eine Anleitung zur praxisbezogenen Ultraschalluntersuchung 2000 Berlin Springer 10.1007/978-3-642-57012-4 Available from: http://dx.doi.org/10.1007/978-3-642-57012-4 · DOI
  8. [192]Orvidas LJ Kasperbauer JL Lewis JE Olsen KD Lesnick TG Pediatric parotid masses Arch Otolaryngol Head Neck Surg 2 2000 126 2 177 184 10.1001/archotol.126.2.177 Available from: http://dx.doi.org/10.1001/archotol.126.2.177 10680869 · DOI

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Metadata

Authors
Iro, H., & Zenk, J.
Affiliations
Friedrich-Alexander-Universität Erlangen-Nürnberg (DE)
ORCID
Venue
German Medical Science GMS Publishing House
Publisher
German Medical Science GMS Publishing House
Published
2014
Volume
13
Pages
Doc06-Doc06
DOI
10.3205/cto000109
PMC
PMC4273167
OpenAlex
W38431779
Cited by
54
References
240
Citations by year
2026: 2 · 2025: 6 · 2024: 2 · 2023: 6 · 2022: 4 · 2021: 6 · 2020: 5 · 2019: 7 · 2018: 5 · 2017: 4 · 2016: 7
FWCI
2.44
Type
journal article
Language
en
Open access
Licence
cc-by-nc-nd
Locations
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • German Medical Science (German Research Foundation) (publishedVersion, cc-by-nc-nd)
  • OPUS (Augsburg University) (submittedVersion, cc-by-nc-nd)
  • German Medical Science (German Research Foundation)
Topics
  • Health Sciences › Medicine › Physiology (medical) › Salivary Gland Disorders and Functions
  • Health Sciences › Medicine › Surgery › Salivary Gland Tumors Diagnosis and Treatment
  • Health Sciences › Dentistry › General Dentistry › HIV/AIDS oral health manifestations
Keywords
salivary gland diseases, salivary gland tumors, sialendoscopy, drooling, differential diagnosis, salivary gland surgery, adolescents

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