PART 13 — SALIVARY GLANDS

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Study use: Rapid revision of salivary-gland anatomy and innervation, obstructive and infective disease, Sjögren disease, ranula, salivary tumors, parotid-mass evaluation, and parotidectomy complications. Management is intentionally concise and should be interpreted with gland involved, lesion location, facial-nerve status, pathology, and clinical severity.

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Priority Guide: 🔴 Core / Must Know | 🟠 Important | 🟡 Additional

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🎯 High-Yield Overview

• Parotid parasympathetic pathway → IX → lesser petrosal → otic ganglion → auriculotemporal nerve.
• Submandibular/sublingual parasympathetic pathway → VII → chorda tympani → lingual nerve → submandibular ganglion.
• Facial nerve passes through the parotid but does not provide its secretomotor supply.
• Submandibular gland is the classic common site for salivary calculi; pain/swelling with meals is the key clue.
• Acute painful gland swelling + fever ± pus from duct → bacterial sialadenitis, classically S. aureus.
• Parotitis + orchitis → mumps; dry eyes + dry mouth → Sjögren disease.
• Pleomorphic adenoma = most common salivary/parotid neoplasm; mucoepidermoid carcinoma = classic most common malignant salivary tumor.
• Warthin tumor → smoker + parotid + bilateral/multifocal potential.
• Adenoid cystic carcinoma → perineural invasion + cribriform/“Swiss-cheese” pattern.
• Post-parotidectomy gustatory sweating → Frey syndrome; lower-ear/angle numbness → great auricular nerve injury.

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RED FLAGS: Salivary mass with facial weakness, rapid growth, fixation, severe persistent pain, skin involvement, or cervical nodes → suspect malignancy. Acute gland infection with sepsis, floor-of-mouth spread, dysphagia, or airway symptoms requires urgent assessment.

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1. MAJOR GLANDS, DUCTS & INNERVATION

2. SIALOLITHIASIS & ACUTE BACTERIAL SIALADENITIS

3. MUMPS & SJÖGREN DISEASE

4. RANULA

5. SALIVARY TUMOR HIERARCHY & PAROTID-MASS APPROACH