The initial step in the examination of the salivary glands should consits of face-to-face observation. Through this observation any
signs of facial asymmetry, discoloration, visible pulsation or discharging sinuses can be observed.
The initial step in the examination of the salivary glands should consits of face-to-face observation. Through this observation any
signs of facial asymmetry, discoloration, visible pulsation or discharging sinuses can be observed. Figures 1 to 3 show the general anatomy of the major salivary glands.
Examination Of Parotid Gland
- Parotid enlargement: Enlargement of the parotid gland usually appears as a diffuse swelling, which when seen from the front, may left the lobule of the ear. The enlargement is more easily observed when it is unilaterally.
This is accomplished using the finger tips with a circular firm, but delicate, pressure over the gland (Fig 1). Any well defined nodule or diffuse swelling within the substance of the gland can be felt.
- Intraoral examination: Occasionally
parotid tumors may grow in a parapharyngeal direction to occupy the lateral pharyngeal space. In such cases the tumor may be represented as a mass in the retromolar fossa.
- Parotid Duct (Stenson's duct): Using a lacrimal probe passed
through the duct any obstruction or stricture can be detected.
- Nature of the flow: The gland is milked using extraoral pressure of the gland while observing the opening of the duct. Normally the gland excrete watery clear saliva. Diseased
gland may excrete saliva containing purulent material, debris or thick mucous.
Examination Of Submandibular Gland
- Enlargement: Submandibular gland
swelling may be diffuse or nodular. Swelling appears extraoral in the submandibular region. Diffuse swelling of the submandibular gland simply add fullness to the submandibular region.
- Palpation: Palpation of the submandibular gland
is performed bimanually by placing the finger of one hand intraorally on the floor of the mouth and the fingers of the other hand are placed extraoral at the submandibular region and the gland is palpated between the two hands. (Fig. 4)
of submandibular duct (Warton's duct): The orifice of the duct can be locatd, at the floor of the mouth near the midline, by expressing saliva from the gland. A thin lacrimal probe is then inserted and advanced along the duct to detect any obstruction or stricture.
- Nature of salivary flow: The gland can be milked by gentle firm pressure with one or two fingers placed just medial to the angle of the mandible and advanced forward. Normally the saliva should be viscous and clear.
Examination Of Sublingual Gland
Enlargement of the sublingual gland appears as an elevation in the floor of the mouth. The gland is palpated bimanually with one finger exerts
pressure at the submental region and the other is placed intraorally.
Examination Of Minor Salivary Glands
Enlargement of minor salivary glands appears as discrete nodules
within the substance of the submuscoa. Palpation of minor glands should be done bidigital when ever possible. This can be performed for examinning minor glands in the lips and cheek.