Salivary Gland Disorders

ENT doctor checking patient's neck

What are salivary gland disorders?

There are 2 main paired salivary glands within the human body – the parotid gland and the submandibular gland. Salivary gland disorders can range from inflammatory conditions to tumors. Symptoms may include: enlargement or discomfort within the associated salivary gland, dry mouth, bad breath or a foul taste in the mouth. Inflammatory conditions are typically secondary to blockages within the salivary gland itself, leading to decreased salivary flow and swelling of the gland and potential bacterial infections. A common cause of obstruction is salivary stones. Furthermore, salivary masses/tumors can also grow within the glands, with the majority being benign conditions but it is important to seek evaluation, as not all masses are benign.

How are salivary gland disorders treated?

Diagnosis begins with an office visit for a history and physical exam to determine the most likely source of symptoms. Further work-up may include radiographic imaging and needle biopsy. Treatment depends on the underlying cause with conservative managements including use of warm compresses, massages of the affected gland and sialagogues (i.e. chewing gum, sour items, etc.). If infected, oral antibiotics and corticosteroids may sometimes be necessary. More severe cases or tumors/masses may involve surgical management of the obstruction or removal of the mass/gland.

Thyroid Nodules

What are thyroid nodules?

Thyroid nodules are discrete growths within the thyroid gland that are common findings in adults, particularly in women and older individuals. The vast majority of nodules are benign, but a small percentage may represent thyroid cancer, making proper evaluation essential. Thyroid nodules typically present without symptoms, that may be incidentally noted routine physical exam and imaging. Rarely nodules result in overproduction of thyroid hormone that may lead to symptoms of hyperthyroidism. While symptoms are uncommon, they may include: neck fullness, difficulty swallowing, discomfort/pain, lymph node swelling and potentially voice changes/hoarseness.

How are thyroid nodules treated?

Proper evaluation of the thyroid nodules begins with the clinical history and then likely involves an ultrasound evaluation. If there is concern, a needle biopsy is performed. Otherwise, recommendation may be to monitor with repeat ultrasounds to ensure no change. Sometimes, surgical management with removal of portions of the thyroid or the gland in its entirety may be warranted.

Neck Masses

What are neck masses?

Neck masses can occur in both adults and pediatric patients. The majority of neck masses tend to be benign and can be the result of a variety of conditions including congenital (since birth), inflammatory, infectious and neoplastic (both benign and malignant tumors). Clinical history and evaluation is the first step, potentially followed by lab work or imaging studies.

How are neck masses treated?

Typically work-up will include imaging to better characterize the mass. A fine-needle biopsy may be indicated to better identify the source of neck mass. Depending on the cause of the neck mass, treatment may range from supportive care and observation, to use of antibiotics or surgical removal.