Clinical and pathological study of salivary gland swellings

OBJECTIVES : 1. To study the age and sex distribution among patients presenting with Salivary Gland Swellings. 2. To study the mode of clinical presentation of various Salivary Gland Swellings. 3. To study the accuracy of Fine Needle Aspiration Cytology (FNAC) in the diagnosis of Salivary Gland Swellings. 4. To study the methods of current surgical treatments of Salivary Gland Swellings. BACKGROUND DATA : Salivary Gland Swellings are one of the most common clinical conditions encountered by the general surgeon. There are various causes of salivary swellings and they arouse much interest and debate because of their remarkable variability in structure, clinical presentation and behavior. This study was done with a interest to know the incidence, clinical presentation of swellings of the salivary glands, management, complications and correlation of the FNAC with the histopathology. METHODOLOGY : 50 cases of salivary gland swellings presenting to Surgery Dept. and Surgical Oncology Dept. of Govt. Royapettah Hospital and Surgery Dept. of KMC Hospital at Chennai, from November 2014 to August 2015 were prospectively studied. Age, Sex distribution, mode of clinical presentation would be entered in the proforma. Also correlation of FNAC with histopathological findings would be analysed. The various treatment options of different etiologies of Salivary Gland Swellings will also be studied. RESULTS : Salivary gland swelling occurred more commonly in 3rd and 4th decades of life (28.57%) and 65% of salivary swellings were present in females. All patients presented with salivary gland swelling (100%), 65% of patients presented with pain and 55% of patients presented with tenderness. Among the non inflammatory and neoplastic swellings, 65% of salivary swellings were neoplastic and 35% non inflammatory swellings. Among non inflammatory swellings 80% was sialolithiasis and 20% was ranula. 100% of sialolithiasis were present in submandibular salivary glands. 100% of ranula was present in sublingual salivary glands. Among the neoplastic swellings, 100% of the neoplastic swellings were present in parotid glands. FNAC has overall diagnostic accuracy of 100%. Superficial parotidectomy is the most common surgery performed for neoplastic lesions (56.4%). Wound infection is the most common post operative complications. CONCLUSION: Non-inflammatory and neoplastic salivary swellings are common in the middle age group and in females. Non-inflammatory swellings are more common in submandibular salivary glands. Sialolithiasis predominated the non-inflammatory swellings. Neoplastic swellings are more common in parotid gland and pleomorphic adenoma dominates the neoplastic swellings. FNAC has got a good accuracy in diagnosing salivary gland tumours. Pain X ray has got accuracy in diagnosing sialolithiasis. Surgery is the main modality in the treatment in both non inflammatory and neoplastic salivary gland swellings. Early diagnosis of the condition with subsequent surgical management carries a very good prognosis