Speicheldrüsenerkrankungen im Kindesalter

Abstract

Salivary gland diseases in children are rare, apart from viral--induced diseases. Nevertheless, it is essential for the otolaryngologist to recognize these uncommon findings in children and adolescents and to diagnose and initiate the proper treatment. The present work provides an overview of the entire spectrum of congenital and acquired diseases of the salivary glands in childhood and adolescence. The current literature was reviewed and the results discussed and summarized. Besides congenital diseases of the salivary glands in children, the main etiologies of viral and bacterial infections, autoimmune diseases and tumors of the salivary glands were considered. In addition to the known facts, new developments in diagnostics, imaging and therapy, including sialendoscopy in obstructive diseases and chronic recurrent juvenile sialadenitis were taken into account. In addition, systemic causes of salivary gland swelling and the treatment of sialorrhoea were discussed. Although salivary gland diseases in children are usually included in the pathology of the adult, they differ in their incidence and some-times in their symptoms. Clinical diagnostics and especially the surgical treatment are influenced by a stringent indications and a less invasive strategy. Due to the rarity of tumors of the salivary glands in children, it is recommended to treat them in a specialized center with greater surgical experience. Altogether the knowledge of the differential diagnoses in salivary gland diseases in children is important for otolaryngologists, to indicate the proper therapeutic approach.

Seltene Erkrankungen der Speicheldrüsen und des Nervus Facialis

“…Hence, at least 4 of the following criteria should be fulfilled: ocular symptoms, oral symptoms, positive Schirmer’s test, lymphocytic infiltration, involvement of the salivary glands (reduced salivary flow, sialectasia), or auto-antibodies (SSA, SSB). Further findings might be increased amylase, renal tubular acidosis, leukopenia, ANAs, positive rheumatoid factors, and hypergammaglobulinemia 20 . Ultrasound reveals an enlarged parotid gland with anechoic cloud-like structural change, similar to adults 43 .…”

“…Due to the low penetration depth, transducers with 7.5–12 MHz are suitable to diagnose inflammations, sialoliths, tumors, and lymph nodes. The vascularization may be determined by color Doppler sonography which is helpful for hemangiomas and arteriovenous (AV) malformations 20 . MRI and CT scans are only applied in cases of tumorous masses or specific indications.…”

“…Also the indication for biopsy is reduced in children because it usually has to be performed under general anesthesia. However, biopsy taking would have the advantage that the tumor dignity can be determined and on the other hand that material for microbiological assessment or identification of pathogens may be gained 20 . In the context of general anesthesia, it must be taken into consideration to perform complete extirpation of the tumorous mass.…”

“…The salivary glands may also be affected in cases of mainly painless necrotizing inflammation leading to fistula development. The therapy of choice consists of penicillin application 20 .…”

“…Hier eignen sich wegen der geringen Eindringtiefe Schallköpfe mit 7,5–12 MHz, um Entzündungen, Steine, Tumoren und Lymphknoten zu diagnostizieren. Mittels Farbdoppler kann die Durchblutung bestimmt werden, was bei Hämangiomen und arteriovenösen (AV)-Malformationen hilfreich ist 20 . MRT und CT kommen nur bei Raumforderungen oder speziellen Indikationen in Betracht.…”