Chronic Sialadenitis

For patients with chronic sialadenitis, removal of the submandibular glands is associated with high morbidity and financial cost. Many submandibular glands that have been removed because sialadenitis are normal histologically, and it has been shown that glands have the ability to recover functionally or be free of symptoms after removal of obstruction. A study by Antoniades, et al evaluated the treatment of chronic sialadenitis with intraductal penicillin or saline. The study involved 55 patients with chronic submandibular sialadenitis aged 12 to 65 years, and 27 patients with chronic parotitis aged 8 to 65 years. The patients were treated by intraductal instillation of penicillin or saline. The study found that of those patients with submandibular sialadenitis, 44 patients treated with penicillin and 11 treated with saline became symptom free. There was recurrence of symptoms in 3 patients who were treated with penicillin, and 2 of these patients became free of symptoms after additional instillations, and 1 patient became free of symptoms after removal of a sialolith at the ductal orifice. Of the patients with parotitis, 18 patients who were treated with penicillin became free of symptoms; 8 treated with saline became symptom free; and 1 treated with both modalities became symptom free. The study concludes that the intraductal instillation of penicillin or saline is a simple and successful technique for treating chronic sia-ladenitis.


(Source: Journal of Oral and Maxillofacial Surgery, Vol. 62, No. 4)