By Dr. Sumit Mrig, Director & Unit Head, ENT, Max Smart Super Speciality Hospital, Saket, New Delhi
Many patients frequently complain of pain and recurring swelling at the jaw/ear region when they eat or drink anything. Most of these patients don’t realize that these symptoms come from salivary gland infections or Sialadenitis. The positive aspect of Sialadenitis is that, if diagnosed in time and treated correctly, most patients can achieve permanent relief and still protect the health of their natural glands.
Salivary Glands are responsible for producing Saliva, which is critical for chewing, swallowing, digesting food and keeping the mouth free of bacteria. The most often infected glands are:
- Submandibular Gland – below the lower jaw
- Parotid Gland – in front of the ear (near the angle of the jaw)
When the flow of saliva is inhibited or stopped (by stones, thick secretions or the narrowing of ducts), bacteria will proliferate and result in infection/inflammation of the salivary glands.
Submandibular Sialadenitis is the most common, and it typically occurs due to salivary stones. Most patients will describe swelling beneath the jaw bone that becomes increasingly painful to the touch or when they eat/drink. This is due to a lack of saliva that can freely pass into the mouth. Patients may also report dryness of the mouth, tenderness of the affected area and occasionally fever/pus discharging from the duct.
The parotid gland can become infected (parotid sialadenitis) with either an acute or chronic infection. Symptoms include swelling and tenderness in front of the ear as well as tenderness when chewing; fever; redness of the affected area; and sometimes a foul-tasting discharge from pus draining into the mouth. Those who are elderly, dehydrated, or have poor oral hygiene are at increased risk for developing this condition.
What is Sialendoscopy?
Sialendoscopy is a new option for treating salivary glands that offers a less invasive, gland-preserving approach than other types of surgery. This process involves the use of a very small, thin camera that enables us to view the salivary duct from inside without performing any incisions externally. Using this technology, we can remove stones or mucus plugs, clear out debris from narrowed ducts, or perform a thorough flushing of the glands.
The Importance of Sialendoscopy
The most significant benefit of sialendoscopy from an ENT perspective is that it allows for preservation of the natural salivary gland, as opposed to the need for major surgical procedures which carry with them all of the associated risks. Healing occurs relatively quickly with very little pain involved, and long-term relief from repeated episodes of swelling and infection is excellent.
How Do You Know When Treatment is Adequate?
Conservative treatment (good hydration, warm compresses, gentle massage of the gland, use of sour foods to stimulate saliva production) can often cure early stages or mild cases of infection. Antibiotics and analgesics will be prescribed to help reduce pain and fever while controlling the infection.
Recurrent or persistent cases often have a recurrence of their symptoms because the underlying blockage has not been treated.
Conclusion
Repeated swelling of the salivary glands should never be disregarded, as we now have safe and effective options such as sialendoscopy. These advancements provide patients with the means to receive care without having to endure complications while enhancing their quality of life.
