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Parotid sialometry: A standard technique in the diagnosis of parotid sialadenosis

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Abstract

Background

Sialadenosis is a clinical condition characterized by bilateral, painless, diffuse and recurrent parotid gland swelling. Histologically, the only feature of note is acinar cell hypertrophy, with no apparent change in the duct structure or cellular infiltrate. The functional changes in the parotid parenchyma in this condition are ill understood. The association between malnutrition and parotid gland swelling was first reported in Egypt. The pathogenesis of the condition remains unclear. The aim of this study is to explain the development of parotomegaly by analysing the parotid secretory pattern in parotomegaly patients

Subjects and Methods

Patients with malnutrition were studied at Ain Shams University Hospitals. 47 patients, 19 male patients and 28 female patients, were studied, of these eight patients (three male patients and five female patients) suffered parotomegaly. Thirty-one patients with morbid obesity were recruited. 23 patients were female and eight were male. Six patients in this group had parotomegaly. Results were compared with those of 30 healthy volunteers recruited from medical and nursing staff, medical students and patients attending the ENT clinic for minor procedures. Parotid saliva was collected by the standard technique

Results

The results of salivary analysis in 47 patients suggested a pattern of inhibitory proteodyschylia, with increased salivary flow rate and reduced total protein level and amylase activity compared with 30 healthy volunteers. This inhibitory proteodyschylia pattern is identical to the secretory pattern induced experimentally by blocking B-adrenergic receptors in the parotid

Conclusion

A possible explanation for the development of parotomegaly in malnutrition is a degenerative neuropathy affecting the B-adrenergic innervation of the parotid that cause acinar cell congestion by zymogen granules, which is manifested clinically as parotomegaly.

References

  1. Kenaway MR. Endemic enlargement of parotid gland in Egypt. Trans R Soc Trop Med Hyg 1937; 31: 339–344.

    Article  Google Scholar 

  2. Du Plessis DJ. Parotid enlargement in malnutrition. S Afr Med J 1956; 30:700–704.

    Google Scholar 

  3. Sandstead HR, Kohen CJ, Sessians SM. Enlargement of parotid gland in malnutrition. Am J Clin Nutr 1955; 3: 198–203.

    Article  CAS  Google Scholar 

  4. Riad MA, Barton JR, Wilson JW, Maran AGD. Parotid salivary secretory pattern in bulimia nervosa. Acta Otolaryngol 1991; 111: 925–928.

    Article  Google Scholar 

  5. Barton R, Riad MA, Gaze M, Maran AGD. Mucosal immunodeficiency in smokers and in patients with epithelial head and neck tumours. Gut 1990; 31: 181–186.

    Article  Google Scholar 

  6. Squires BT. Human salivary amylase secretion in relation to diet. J Physiol 1953; 119: 153–157.

    Article  CAS  Google Scholar 

  7. Reddy N, Raghvramulu N, Bhaskaram M. Secretory IgA in protein calorie malnutrition. Arch Dis Child 1976; 51: 82.

    Article  Google Scholar 

  8. Arglebe C, Eysholdt V, Chilla R. Pharmacological inhibition of salivary glands. Effect of experimentally induced B-receptor block on the rat parotid gland. ORL J Otorhinolaryngol Relat Spec 1976; 38: 218–229.

    Article  CAS  Google Scholar 

  9. Mignogna MD, Fedele S, Lo Russo L. Anorexia/bulimia-related sialadenosis of palatal minor salivary glands. J Oral Pathol Med 2004; 33: 441–442.

    Article  CAS  Google Scholar 

  10. Chilla R. Sialadenosis of the salivary glands of the head. Studies on the physiology and pathophysiology of parotid secretion. Adv Otorhinolaryngol 1981; 26:1–38.

    PubMed  CAS  Google Scholar 

  11. Satoh M, Yoshihara T. Clinical and ultracytochemical investigation of sialadenosis. Acta Otolaryngol Suppl 2004; 553:122–127.

    Article  CAS  Google Scholar 

  12. Mehler PS, Wallace JA. Sialadenosis in bulimia: a new treatment. Arch Otolaryngol Head Neck Surg 1993; 119:787–788.

    Article  CAS  Google Scholar 

Download references

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Correspondence to Magdy A. Riad.

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Riad, M.A., Salma, H.T., Sabra, R.M.I. et al. Parotid sialometry: A standard technique in the diagnosis of parotid sialadenosis. Egypt J Otolaryngol 30, 138–141 (2014). https://doi.org/10.4103/1012-5574.133217

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  • DOI: https://doi.org/10.4103/1012-5574.133217

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