最新Salivary Glands Disorders - Shanyar：唾液腺疾病的shanyar教学讲义ppt课件.ppt

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1、SalivaryGlandsDisorders-Shanyar：唾液腺疾病的shanyarAnatomicalConsiderationsTwosubmandibularTwoParotidTwosublingual>400minorsalivaryglandsMinorsalivaryglandsTheseliejustundermucosa.Distributedoverlips,cheeks,palate,floorofmouth&retro-molararea.Alsoappearinupper

2、aerodigestivetractContribute10%oftotalsalivaryvolume.Stensen’sduct…1.5cminferiortotheZygomaticarch.superficialtothemassetermuscle,thenturnsmedially90degreestopiercetheBuccinatormuscleatthelevelofthesecondmaxillarymolarwhereitopensintotheoralcavity.Functi

3、ons1500mlofsaliva/day;Fromtheparotidgland:thin,wateryfluid,SublingualandSubmandibularglands:muchthickerItfacilitatesswallowingItkeepsthemouthmoist&aidsspeechItservesasasolventformoleculeswhichstimulatethetastebudsItcleansthemouth,gum,&teeth.Itcontainsenz

4、ymesDiagnosticApproachesEvaluationofdrymouthPast&presentmedicalhistoryClinicalexaminationSalivacollectionSalivaryglandimagingSalivaryglandbiopsy&FNASerologicevaluationClinicalHistoryHistoryofswellings/changeovertime?Trismus?Pain?Variationwithmeals?Bilate

5、ral?Drymouth?dryeyes?Recentexposuretosickcontacts(mumps)?Radiationhistory?Currentmedications?DiagnosticapproachClinicalexaminationExtra-Oralexamination:PalpatecervicallymphnodesPalpatethegland-Slightlyrubbery-Painlessunlessinfected/inflammedCheckmotorfun

6、ctionoffacialnervePlain-filmradiographySialographyUltrasonographyRadionuclideimagingComputedtomography(CT)Magneticresonance(MRI)Specificdiseases&disordersDevelopmentalabnormalitiesMucoceles&RanulaInflammatory&ReactivelesionsSialolithiasisImmuneconditions

7、GranulomatousconditionsSalivaryglandtumoursDevelopmentalabnormalitiesAbsenceofsalivaryglandRareAssociatedwithotherdevelopmentaldefectsAccessorysalivaryductDiverticuli(pouchintheductwall)SialadenitisAcuteinfectionBacterial:AcuteChronicRecurrentparotitisVi

8、ral:MumpsCytomegalovirusSialadenitisAcuteinfectionAllergicsialadenitisPost-irradiationSarcoidosisSialadenitisofminorglandsBacterialsialadenitisSusceptibleindividuals:glandhypo-functionAgeextremesPoororalhygieneParotidgland