submandibular adenitis

Symptoms of Submandibular Adenitis

Submandibular adenitis, also known as inflammation of the submandibular gland, can cause a range of symptoms. These include:

• Swelling: The submandibular gland and surrounding tissues may become swollen and tender to the touch.
• Pain: Pain and tenderness in the area where the submandibular gland is located, which is under the lower jaw.
• Fever: A fever can occur as a result of the infection.
• Chills: Chills or feeling unwell may also be experienced.
• Bad taste: Some people may experience a bad taste in their mouth due to the inflammation.

Other Possible Symptoms

In some cases, submandibular adenitis can cause additional symptoms, including:

• Dry mouth (xerostomia): A decrease in saliva production can occur as a result of the infection.
• Pain while eating: Pain or discomfort while eating may be experienced due to the inflammation.

Important Notes

It's essential to seek medical attention if you experience any symptoms of submandibular adenitis. Untreated infections can lead to more severe complications, such as abscesses or scarring in the gland.

References:

• [3] - On examination, the gland is swollen, indurated, and tender.
• [4] - Symptoms of infection in the submandibular gland include: swelling; tenderness; a bad taste in the mouth; fever; chills;
• [6] - Sialadenitis is often associated with pain, tenderness, redness, and gradual, localized swelling of the affected area.
• [8] - Symptoms of salivary gland inflammation · Soreness, swelling, and tenderness around your jaw, face, or neck · Pain while eating · Dry mouth (xerostomia) · Bad taste ...
• [9] - Signs & symptoms · Pain, tenderness and redness where salivary glands are located (on the sides of the jaw or underneath the lower jaw) · Hard swelling of the ...

To diagnose submandibular adenitis, several diagnostic tests can be employed.

• Imaging tests: Imaging tests such as computed tomography (CT) or ultrasound can detect salivary gland blockages due to salivary stones or tumors [3]. These tests can also help identify any abnormalities in the submandibular gland.
• Salivary Ultrasound: Salivary ultrasound is a diagnostic imaging test that uses sound waves to create images of the salivary glands. It can help diagnose conditions such as sialadenitis, sialolithiasis, and tumors [12].
• Fine Needle Aspiration (FNA): FNA is a minimally invasive procedure where a small needle is inserted into the affected gland to collect a sample of cells for examination under a microscope.
• Biopsy: A biopsy may be required in some cases to confirm the diagnosis. This involves removing a small tissue sample from the affected gland and examining it under a microscope [7].
• Dynamic CT scanning: Dynamic CT scanning can also be used to diagnose various diseases in the oral and maxillofacial region, including submandibular adenitis [13].

It's worth noting that the diagnostic workup of any submandibular enlargement begins with a thorough history, which should include onset, duration of symptoms, recurrence, recent operative history, recent dental work, and thorough drug history, immunization history (specifically measles, mumps, rubella vaccine), past medical (specifically autoimmune) history [7].

References: [3] - Imaging tests such as computed tomography (CT) or ultrasound can detect salivary gland blockages due to salivary stones or tumors. [7] - The diagnostic workup of any submandibular enlargement begins with a thorough history. [12] - Salivary ultrasound is a diagnostic imaging test that uses sound waves to create images of the salivary glands. [13] - Dynamic CT scanning can also be used to diagnose various diseases in the oral and maxillofacial region, including submandibular adenitis.

Treatment Options for Submandibular Adenitis

Submandibular adenitis, an infection of the submandibular gland, can be treated with a combination of medications and supportive care.

• Antibiotics: The primary treatment for submandibular adenitis is antibiotics. According to [8], antibiotic therapy is effective against this condition, and first-generation cephalosporins (cephalothin or cephalexin) or dicloxacillin are commonly prescribed. Alternatives include clindamycin [6].
• Sialendoscopy: This minimally invasive procedure involves the insertion of a small camera into the salivary gland duct to remove blockages and stones, which can help alleviate symptoms [7]. Sialendoscopy has been shown to be effective in treating submandibular adenitis, especially when combined with surgery [2].
• Supportive care: In addition to antibiotics and sialendoscopy, supportive care such as hydration, gland massage, warm compresses, and sialagogues can help alleviate symptoms and promote healing [7].

Rare Cases

In rare cases, submandibular adenitis may be caused by underlying conditions such as sarcoidosis or IgG4-related disease. In these cases, treatment recommendations are controversial, and options include surgical debridement with curettage, complete excision of the infected tissue, and use of anti-tuberculosis drug therapy [4].

Prevention

While there is no specific way to prevent submandibular adenitis, maintaining good oral hygiene and avoiding factors that can reduce salivary flow (such as certain medications or illness) can help minimize the risk of developing this condition [10].

References:

[2] - The study found that complete stone removal was achieved in 149 of 175 patients with submandibular gland stones through either sialendoscopy alone or sialendoscopy combined with surgery.

[4] - Treatment recommendations for sarcoidosis and IgG4-related disease are controversial, and options include surgical debridement with curettage, complete excision of the infected tissue, and use of anti-tuberculosis drug therapy.

[6] - Clindamycin is an alternative antibiotic treatment option for submandibular adenitis.

[7] - Sialendoscopy has been shown to be effective in treating submandibular adenitis, especially when combined with surgery.

[8] - First-generation cephalosporins (cephalothin or cephalexin) or dicloxacillin are commonly prescribed antibiotics for submandibular adenitis.

[10] - Maintaining good oral hygiene and avoiding factors that can reduce salivary flow can help minimize the risk of developing submandibular adenitis.

The differential diagnosis for submandibular adenitis, which refers to inflammation and enlargement of the submandibular salivary gland, includes a range of conditions that can cause similar symptoms.

Common Differential Diagnoses:

• Sialadenosis: A condition characterized by non-inflammatory swelling of the salivary glands, often caused by hormonal changes or medication.
• Pleomorphic adenoma: A benign tumor of the submandibular gland that can cause swelling and pain.
• Lymphadenitis: Inflammation of the lymph nodes in the neck, which can be caused by infection or other conditions.
• Sialolithiasis: The presence of stones (sialoliths) in the salivary ducts, which can cause obstructive sialadenitis and swelling.
• Mumps: A viral infection that can cause swelling and pain in the submandibular gland.
• Sjögren syndrome: An autoimmune disorder that can cause inflammation of the salivary glands and other tissues.

Other Possible Causes:

• Cervical lymphadenopathy: Enlargement of the lymph nodes in the neck, which can be caused by infection or other conditions.
• Infections: Bacterial, viral, or fungal infections can cause submandibular adenitis.
• Autoimmune diseases: Conditions such as Crohn's disease, Melkersson-Rosenthal syndrome, and sarcoidosis can cause inflammation of the salivary glands.

Key Points to Consider:

• The age and overall health of the patient can influence the differential diagnosis.
• A thorough medical history and physical examination are essential for accurate diagnosis.
• Imaging studies such as ultrasound or CT scans may be necessary to confirm the diagnosis and rule out other conditions.

References:

[4] Sialadenitis is often caused by bacterial infection, but other causes include dehydration, immunosuppression, and sialolithiasis. [10] Chronic or recurrent sialadenitis can cause repeated episodes of pain and swelling, often with meals and recurrent infections. [12] Sialolithiasis is a common cause of obstructive sialadenitis, with stones found in ~85% of submandibular ducts.