Encyclopedia of Health and Medicine

50 The Ear, Nose, Mouth and Throat
nasal button, that fits into the perforation to create
a temporary closure. Untreated septal perforation
results in frequent infections and continued
erosion of the nasal lining as well as CARTILAGE.
See also FOREIGN OBJECTS IN THE EAR OR NOSE;
OCCUPATIONAL HEALTH AND SAFETY; RHINORRHEA; SUR-
GERY BENEFIT AND RISK ASSESSMENT.
sialadenitis INFLAMMATION and swelling of a salivary
gland, usually a submandibular or parotid
gland. Common causes include
• SIALOLITHIASIS, in which a small “stone” or mineral
calculus blocks the flow of saliva and irritates
the tissues of the involved salivary gland
• bacterial INFECTION, which can develop when
the blockage persists because the MOUTH contains
an abundance of BACTERIA
• viral infection with various viruses, including
MUMPS, coxsackie, INFLUENZA, herpes, and
human immunodeficiency virus (HIV)
• AUTOIMMUNE DISORDERS such as SJÖGREN’S SYN-
DROME and SYSTEMIC LUPUS ERYTHEMATOSUS (SLE)
Diagnosis arises mostly through physical
examination and other clinical indicators, though
sometimes the doctor will order X-rays or other
imaging procedures to help distinguish the cause
or to determine whether an ABSCESS (pocket of
infection) is present. Treatment focuses on the
underlying cause of the inflammation. Bacterial
sialadenitis requires treatment with ANTIBIOTIC
MEDICATIONS. Antibiotics are not helpful for viral
sialadenitis, which typically improves in 10 to 14
days. Regardless of cause, drinking plenty of fluids,
frequently rinsing the mouth with warm saltwater
or applying warm compresses (moist heat)
to the outside of the face over the affected area,
and taking a nonsteroidal anti-inflammatory drug
(NSAID) such as ibuprofen can help relieve discomfort.
See also BACTERIA; HIV/AIDS; NONSTEROIDAL ANTI-
INFLAMMATORY DRUGS (NSAIDS); VIRUS; X-RAY.
sialolithiasis The formation of a crystallized
mineral deposit, called a salivary calculus
(“stone”), in a salivary gland. Sialolithiasis most
commonly involves the submandibular and
parotid SALIVARY GLANDS. Its primary symptoms are
PAIN and swelling when it blocks the flow of saliva
from the gland. Sometimes the calculus remains
symptomless and undetected until it shows up on
an X-RAY done for other reasons such as a routine
dental exam. Doctors sometimes use COMPUTED
TOMOGRAPHY (CT) SCAN, ULTRASOUND, or sialography
to confirm the diagnosis. A small calculus may
pass from the gland on its own. Because the risk
of INFECTION is high, however, doctors prefer to
surgically remove salivary calculi. The OPERATION
involves making a small incision into the salivary
gland and extracting the calculus. Recovery is usually
complete, though some people have recurrent
episodes or experience narrowing (stricture) of the
affected salivary duct. Researchers do not know
what causes salivary calculi to develop.
See also SIALADENITIS; SURGERY BENEFIT AND RISK
ASSESSMENT.
sialorrhea Excessive saliva production that may
result in drooling or choking if there are impairments
to swallowing. Sialorrhea often accompanies
neurologic disorders and BRAIN injuries that
affect the parasympathetic NERVOUS SYSTEM, which
regulates the functions of most of the body’s
glands. People who have sialorrhea are at risk for
ASPIRATION (inhaling excessive saliva into the airways
and LUNGS), choking, INFECTION, and irritation
of the SKIN around the face and neck. Sialorrhea
also presents significant hygienic concerns and
often is embarrassing to the person who has it.
Anticholinergic medications, which “dry out”
the body, curtail sialorrhea in many people. These
medications also affect neurotransmitters in the
brain, however, which can have unintended detrimental
effects on motor function. Some people
benefit from botulinum toxin A injections (BOTU-
LINUM THERAPY) into the tissues surrounding the
salivary glands, which temporarily paralyzes the
muscles that release saliva. Other treatment
approaches include surgery to remove or obstruct
portions of the submandibular salivary glands,
which produce about 80 percent of the saliva, and
therapy to improve muscle control and swallowing
ability. Treatment success depends on the
underlying causes.
See also NEUROTRANSMITTER; SIALADENITIS;
SIALOLITHIASIS.