Submandibular Sialadenitis/Sialadenosis Follow-up

  • Author: Adi Yoskovitch, MD, MSc; Chief Editor: Arlen D Meyers, MD, MBA   more...
 
Updated: Sep 27, 2011
 

Further Inpatient Care

  • Patients requiring inpatient management should be monitored on a daily basis and preferably twice daily.
  • In order to ascertain the progression or improvement of acute sialadenitis, serial CT scanning may be warranted.
  • Patients with sialolithiasis should be treated conservatively during the acute exacerbation stage and should be monitored after discharge for definitive surgical intervention.
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Further Outpatient Care

  • For patients with acute sialadenitis not requiring admission, follow-up visit should be 3 days from the first visit and then 1 week later (with improvement).
  • Patients with chronic sialadenitis/sialolithiasis and autoimmune sialadenitis or sialadenosis should be seen on a regular basis and if acute exacerbation of the problem occurs.
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Inpatient & Outpatient Medications

  • In addition to the antibiotics, patients may be treated with any form of nonsteroidal anti-inflammatory medications. Narcotics may be needed in severe cases, and increasing pain refractory to medications is often an indication for admission for further evaluation.
  • In addition, medications predisposing to xerostomia should be avoided where possible. These include antiparkinsonian, antiemetics, antinauseants, over-the-counter and prescription cold medications, antidepressants, antihypertensive agents, diuretics, anticholinergics, antianxiety agents, and decongestants.
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Complications

  • The most serious complication of acute sialadenitis is the formation of an abscess. Management is described above.
  • Complications of chronic sialadenitis and autoimmune sialadenitis are most often dental in nature because of the decreased function of the gland and the protective effect provided against caries.
  • Chronic inflammation of the gland with or without calculi often renders the gland difficult to excise because of the loss of normal tissue planes.
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Prognosis

  • The prognosis of acute sialadenitis is very good. Most cases are easily treated with conservative medical management, and admission is the exception, not the rule. Acute symptoms resolve within 1 week; however, edema in the area may last several weeks.
  • Postsurgery, patients are often already admitted with appropriate intravenous antibiotics. These patients have a similar prognosis.
  • Patients with chronic sialadenitis often have a relapsing and remitting course. Prognosis is dependent on the etiology.
  • Patients with sialolithiasis require definitive surgical treatment in most cases, which results in an excellent prognosis.
  • Patients with Sjögren or other autoimmune diseases are likely to have a protracted course related to systemic involvement.
  • Patients with sialadenosis have a good prognosis, if their underlying problem is adequately controlled. Even if control is attained, bilateral swelling may be persistent.
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Patient Education

  • Patients with any form of sialadenitis should be educated as to the value of hydration and excellent oral hygiene. This lessens the severity of the attacks and prevents dental complications. Patients with sialadenosis should be educated regarding the mechanism of their underlying pathology and methods of maintaining control over them.
  • For excellent patient education resources, visit eMedicine's Teeth and Mouth Center.
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Contributor Information and Disclosures
Author

Adi Yoskovitch, MD, MSc  Chief, Department of Otolaryngology - Head and Neck Surgery, Fleury Hospital, Canada

Adi Yoskovitch, MD, MSc is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, Canadian Academy of Facial Plastic and Reconstructive Surgery, and Royal College of Physicians and Surgeons of Canada

Disclosure: Nothing to disclose.

Specialty Editor Board

Richard V Smith, MD  Director of Clinical Affairs, Associate Professor, Department of Otolaryngology, Division of Head and Neck Surgery, Einstein College of Medicine, Montefiore Medical Center

Richard V Smith, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Head and Neck Society, American Laryngological Rhinological and Otological Society, American Medical Association, American Medical Student Association/Foundation, Medical Society of the District of Columbia, New York Academy of Medicine, and Vermont State Medical Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Dominique Dorion, MD, MSc, FRCSC, FACS  Vice Dean and Associate Dean of Resources, Professor of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Sherbrooke Faculty of Medicine, Canada

Disclosure: Nothing to disclose.

Christopher L Slack, MD  Private Practice in Otolaryngology and Facial Plastic Surgery, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders

Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA  Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society

Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation Unrestricted gift Unknown; Axis Three Corporation Ownership interest Consulting; Omni Biosciences Ownership interest Consulting; Sentegra Ownership interest Board membership; Syndicom Ownership interest Consulting; Oxlo Consulting; Medvoy Ownership interest Management position; Cerescan Imaging Honoraria Consulting; GYRUS ACMI Honoraria Consulting

References

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Submandibular calculus.
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