Implantología dental avanzada y estética facial. Advanced implantology & facial aesthetics. Dr. Pablo Furelos.
Salivary glands are divided into major (parotid, submandibular – or submadibulars- and sublingual) and minor (submucus, distributed in the oral area and the upper aerodigestive tract).
Their function is to secrete saliva to humidify the mucus, the digestion of the bolus and the defense against germs (due to its contents in lysozyme and immunoglobulin A).
The most frequent pathology of the salivary glands is submaxilitis severe that is an inflammation of the submandibular gland represented by a lump under the jaw which is painful in some occasions and is normally associated to food or appears after having eaten. This pathology appears as a consequence of the obstruction of the duct where the gland drains when there is a calculus. This provokes an accumulation of saliva in the inner gland, creating inflammation and major predisposition to infestation. In the beginning the treatment is pharmacological and if it doesn´t disappear, surgical treatment removing the gland.
Other pathologies of the glands are the uni and bilateral inflammation of the parotid –parotiditis-( when it is caused by a virus it is commonly called “mumps” and they are typical from childhood) and the obstruction of the minor salivary glands that provokes the so called mucocele (an accumulation of saliva in the mucus where the affected minor gland drains).
Salivary glands can also undergo tumoral pathologies, both benignant and malignant. Benignant tumor are more frequent in the major salivary glands ( the most common tumor there is pleomorphic adenoma or mixed tumor of parotid and the second most frequent is Warthin tumor or adenolymphoma of the parotid). On the contrary, most of the tumors in the minor salivary glands are malignant.
Major salivary glands surgery deserves special attention as they have an important topographic anatomy. The parotid gland is surgically divided into two lobes, superficial and deep, through which the VII Cranial Nerve (facial nerve) goes, it is fundamental for the motor and sensitive innervation of the face. That is why parotids surgery must be done with great care in order not to damage the nerve. On the other hand the submandibular gland is anatomically related to the nerves: lingual (which also goes near the sublingual gland; it is responsible for the sensitivity of the tongue), hypoglossal (innerves the muscle of the tongue) and the marginal branch of the facial nerve (in charge of the sensitivity of the lower lip). That is why it is so important to be careful in the surgical act not to damage at those levels.