A small stone can block the salivary gland and cause inflammation. Alcoholic parotid sialadenosis jada.ada.org ( this information is current as of January 6, 2011 ): The following resources related to this article are available online at Diseases of the salivary glands include sialadenosis, sialadenitis, sialolithiasis, and neoplasms. Warm compresses over the affected gland and massage may help to stimulate saliva flow along with proper hydration and things like cough drops or vitamin C drops to suck on. Sialosis may resolve if diabetes mellitus - & alcoholism-related sialosis is treated If the glands are disfiguring, superficial parotidectomy to improve the appearance could be considered (though seems a bit radical). Br J Oral Maxillofac Surg. If investigations have revealed a likely cause such as alcoholism or diabetes, then sialadenosis may resolve when alcohol intake is … It is characterized by bilateral, smooth, uniform enlargement of salivary glands without evidence of inflammation or neoplasia. If an underlying cause has been identified then successful treatment of that cause may reduce the swelling of the salivary glands. Parotid enlargement. DESIGN Prospective study. This is removal of a small piece of tissue to diagnose a cyst, tumor, or Sjogren's syndrome. Expected Duration. Found inside – Page 610Sialadenosis of the parotid gland: report of four cases diagnosed by fine-needle aspiration ... Mandel L, Baurmash H. Parotid enlargement due to alcoholism. It can be linked to different factors, tobacco users and individuals who frequently consume alcohol can be at increased risk of developing sialadenitis. After salivary stimulation with pilocarpine, significant improvement was seen in the patients’ subjective symptom scores; however, salivary flow rates and salivary gland scintigraphy parameters, as measured in the parotid and submandibular glands, were not significantly different from their prestimulation values. [ 11] • Other less specific signs of alcoholic liver disease include anemia, purpura, ecchymoses, gingival bleeding, palmar erythema, nail changes, and parotid gland enlargement (known as sialadenosis) 39. Sialadenitis is the technical term for a type of salivary gland infection that interrupts the natural flow of saliva from the gland to the duct. On histopathological grounds, acinar cell hypertrophy with latter fatty infiltration is the The parotid, submandibular, and sublingual glands are the largest salivary glands. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. The enlargement is bilateral and may be associated with the recurrence of pain or both Sialadenosis is a non-inflammatory non-neoplastic enlargement of salivary gland with no symptoms. Oxidative stress in alcohol-induced rat parotid sialadenosis Found inside – Page 334Clinical and Radiographic Features Most cases of sialadenosis present as a slowly evolving , painless swelling of the parotid glands ( Fig . 11-28 ) . ... Treatment and Prognosis The treatment of the patient with Sjögren's syndrome is mostly supportive . The dry eyes are best ... Sialadenosis . Enlargement of the parotid and submandibular glands secondary to alcoholism . ( Courtesy of Dr. George Blozis . ) ... ). Quite the same Wikipedia. Sialadenitis (sialoadenitis) is inflammation of salivary glands, usually the major ones, the most common being the parotid gland, followed by submandibular and sublingual glands. Found inside – Page 142Management Treatment of sialadenosis initially starts with identification and treatment of ... Mandel L, Baurmash H. Parotid enlargement due to alcoholism. Absorption of drug in GI tract is increased in presence of alcohol, which leads to toxic levels of drug in the plasma. Found inside – Page 490Sialadenosis is also seen in patients with alcoholism and alcoholic ... targets the underlying condition with variable resolution of parotid gland symptoms. This gland has a duct called the parotid duct that crosses over the masteter muscle, crosses the buccinator muscle and reaches the mouth, at the top at the height of the second molar. The disease is due to increased weight, improper nutrition, alcoholic cirrhosis, in hypothyroid patients, myxedema.. Metronidazole, cephalosporins, ketoconazole. Chronic parotid gland infection may be due to Sjogren’s syndrome, an autoimmune disease, characterized by parchedness of mouth, dry eyes, nose and face. These can be separated by the standard surgical sieve approach into infective, inflammatory, immune, neoplastic, infiltrative, and congenital causes. Dr. Osborne specializeS in parotid, submandibular, sublingual and … The authors outline the pathogenesis, symptoms and testing involved in diagnosing sialadenosis. Sialadenosis has an equal incidence in the two sexes and occurs most commonly in the fourth to seventh decades. Sialadenosis: Sialadenosis requires expectant management. Found inside – Page 304The parotid gland is the most affected, followed by the submandibular gland. Prevention Although the etiology is not clear, several metabolic and medical conditions are associated with sialadenosis. These include obesity, alcoholic cirrhosis, ... Treatment of alcoholic sialadenosis needs to be directed at the more serious aspect of the problem-liver damage. INTRODUCTION. It can be linked to different factors, tobacco users and individuals who frequently consume alcohol can be at increased risk of developing sialadenitis. Sialadenosis is defined as a bilateral, persistent, painless, non-inflammatory swelling of the salivary glands, particularly the parotids. Eye tests. 2016 Sep. 54 (7):767-71. . This wide-ranging guide to dry mouth, or xerostomia, is intended to meet the needs of dentists by providing information on all clinically relevant aspects. Mahler (1993) and Park (2009) identified that "Pilocarpine has proved to be beneficial in the treatment of sialadenosis in bulimic patients" and "This article presents a case of painful sialoadenomegaly associated with hyperamylasemia in a bulimic patient successfully managed with pilocarpine". ... Mandel L, Hamele-Bena D. Alcoholic parotid sialadenosis. Found inside – Page 318Classification These include obesity , alcoholic cirrhosis , diabetes , hyperlipidemia , hypothyroidism , anemia , pregnancy , malnutrition ... Treatment & Prognosis The treatment of sialadenosis is directed at the underlying conditions . Parotidectomy is considered if the parotid enlargement is cosmetically unacceptable . Although some endocrine disorders and malnutrition can initiate sialadenosis, alcoholism is the most frequent cause. as alcoholic sialadenosis based on clinical points of recurrent bilateral parotid swelling after heavy alcohol drink- ing, computed tomography, and fine-needle aspiration biopsy. Structural differences between alcoholic and diabetic parotid sialosis ... these diseases with a more accurate precision is reduced to establishing more apropriate strategies for prevention and treatment. In some reports the disease is termed necrotizing sialometaplasia. Found inside – Page 646Figure 14 Fatty infiltration of the parotid in an alcoholic ( H & E ... the autonomic neuropathy responsible for sialadenosis cannot be successfully treated ... Disulfiram effect (accumulation of acetaldehyde) occurs secondary to inhibition of acetaldehyde dehydrogenase. JADA 1997; 128:1411-5. Tetracycline. The risk of oral cancer can be further extended if the alcoholic is also a smoker. Found inside – Page 1078Keywords mon in patients with alcohol-related liver injury Acute ... symmetrical enlargement of the parotid glands (termed sialosis or sialadenosis) is com- ... It should not be confused with sialadenosis (sialosis) which is a non-inflammatory enlargement of the major salivary glands. Found inside – Page 187... of the parotid glands due to poorly understood metabolic problems. Systemic conditions associated with sialadenosis include alcoholism, starvation, ... The largest salivary gland is the parotid gland, located below the zygomatic arch, behind of the jaw. Found inside – Page 17Sialadenosis gland as compared to a normal gland ( 76.03 u vs. ... may be refractory to standard treatment modalities , and parotidectomy may be considered ... Found inside – Page 369No treatment is available. If investigations have revealed a likely cause such as alcoholism or diabetes, then sialadenosis may resolve when alcohol intake ... Treatment: None necessary. There is no specific treatment for sialosis. Found inside – Page 344224 Mandel L, Hamele‐Bena D. Alcoholic parotid sialadenosis. J Am Dent Assoc. ... Understanding clinical dehydration and its treatment. J Am Med Dir Assoc. • Objective. By the same token, anorexic or bulimic patients may attend seeking advice about surgical removal of the glands. Dr. Osborne has developed a special interest in the treatment of parotid gland tumors and focuses on the use of minimally-invasive techniques in the care of patients needing parotid surgery. These include diabetes, alcoholism, malnutrition, anorexia nervosa, and bulimia. Other drugs that can cause these problems. Conservative management to increase salivary flow: rehydration, salivary gland massage, warm compress, sialogogues, and oral irrigations Antimicrobials (anti-staphylococcal) and culture if purulent discharge Salivary gland swelling is frequently encountered by clinicians and has a variety of causes. Found inside – Page 554FIGURE 29-18 Sialography of the left parotid. ... Underlying systemic rheumatoid conditions are typically treated with antiinflammatory agents, ... associated with guanethidine therapy. Sialadenitis is an inflammation of a salivary gland. Found inside – Page 120The Basis of Diagnosis and Treatment Crispian Scully, MD, PhD ... cause such as alcoholism or diabetes, then sialadenosis may resolve when alcohol intake is ... No treatment is available. All cases were sudden deaths, mostly due to coronary artery insufficiency and cardiovascular accident or related conditions, or to physical trauma or suicidal Found inside – Page 293... have few specific symptoms that suggest an abnormality or dysfunction; ... swelling (usually parotid) may be chronic sialadenitis, sialadenosis or a ... 18,19 In this research, ethanol was administered to animals in their drinking water as a model of moderate alcohol … These can be separated by the standard surgical sieve approach into infective, inflammatory, immune, neoplastic, infiltrative, and congenital causes. Enlargement of the salivary glands is a common feature of various gland disorders such as sial- adenitis, tumours, obstruction to secretion, and sialosis. Setting/Design. Treatment of underlying cause is the approach taken. Found inside – Page 288In cases refractory to treatment, parotidectomy may be considered to improve ... Sialadenosis Associated with Alcoholic Cirrhosis Clinical features Salivary ... This second edition has been fully revised, with new topics added, to provide students with the latest advances in the field. Dr. Osborne has developed a special interest in the treatment of parotid gland tumors and focuses on the use of minimally-invasive techniques in the care of patients needing parotid surgery. The chapter on hepatitis has been divided into three complete chapters devoted to each virus - hepatitis A and E, hepatitis B and hepatitis C An entirely new chapter has been added on other hepatitis viruses 38 new contributors bring their ... He was subsequently targeted for left parotid sialogram, which was remarkable for shortening of arborizations in the gland (consistent with sialosis). Sialadenosis is defined as a non-inflammatory salivary gland disease due to metabolic and secretory disorders of the gland parenchyma, accompanied by recurrent, usually painless, bilateral swelling of the glands due to acinar enlargement. Salivary Gland Infection. These include diabetes, alcoholism, malnutrition, anorexia nervosa, and bulimia. —To see whether a cholinomimetic medication would help resolve the parotid gland enlargement associated with self-induced vomiting in bulimic patients. Surgery is almost never necessary. Sialadenosis. Found inside – Page 433Mikulicz Disease • It is the triad of xerostomia, xerophthalmia and parotid swelling in Sjögren's syndrome. • Treatment of choice is steroid therapy. These glands may swell repeatedly and often bilaterally ( sialadenosis ), but are also subject to acute inflammation that is predominantly unilateral (. And that means especially parotid glands. Most of the times, it is caused by a bacteria or virus (mumps). Recognizing sialadenosis is important because it may point to the unsuspected presence of underlying systemic disease. Sialadenosis of the salivary gland . At that point, the patient was offered treatment options for sialosis including watchful waiting, kenalog infusion and parotidectomy. Sialadenosis is the term used to describe the non-neoplastic, non-inflammatory enlargement of the salivary glands, usually the parotid, which occurs in association with many systemic disorders.. Learn More About Dr. Osborne. The procedures were also effective in the treatment of lithiasis of the parotid glands. Learn More About Dr. Osborne. Found inside – Page 658Fjellner B, Hägermark Ö. Pruritus in polycythaemia vera: treatment with aspirin and possibility ... Mandel L, Hamele-Bena D. Alcoholic parotid sialadenosis. Salivary gland disorders include inflammatory, bacterial, viral, and neoplastic etiologies. There are three main salivary glands: Sialadenitis mostly affects the parotid and submandibular glands. Infection may be caused by a virus or bacteria. Kopec T, Wierzbicka M, Kaluzny J, Mlodkowska A, Szyfter W. Sialendoscopy and sialendoscopically-assisted operations in the treatment of lithiasis of the submandibular and parotid glands: our experience of 239 cases. Treatment-Some resolve spontaneously ... -Noninflammatory salivary gland enlargement usually associated with underlying systemic disorder--Diabetes, alcoholism, anorexia, bulimia, malnutrition-->Result in dysregulation of autonomic innervation of salivary acini. He was subsequently targeted for left parotid sialogram, which was remarkable for shortening of arborizations in the gland (consistent with sialosis). Intervention. [ 15 , 16 ] Similarly, a prospective study by Aubin-Pouliot et al indicated that sialendoscopy-assisted salivary duct surgery is an effective treatment for chronic obstructive sialadenitis… Alcoholism is a primary cause of sialadenosis, which is an asymptomatic, bilateral enlargement of the parotid glands. Free Online Library: Binge Drinking of Ethanol during Adolescence Induces Oxidative Damage and Morphological Changes in Salivary Glands of Female Rats. Sialochemistry shows raised potassium and calcium levels, which are not found in other causes of parotid enlargement. Found inside – Page 13478Int J Appl Radiat Isot 1985 Sep ; Complications after surgical treatment of ... gland ) Karaletian is , et al . on sialadenosis and recurrent parotitis . Parotid enlargement (also known as parotidomegaly) has a wide differential given the significant breadth of pathology that can affect the parotid gland. Found inside – Page 444Ter Horst G , Molendijk B , Brouwer E , Verhey HG : Differences in dental treatment plan and planning for drug - addicted and non - drug - addicted ... Mandel L. Hemele - Bena D ; Alcoholic parotid sialadenosis , JADA 128 : 1411-1415 , 1997 . sialadenosis: [ si″al-ad″ĕ-no´sis ] noninflammatory swelling of the salivary glands. Computed tomography or ultrasound imaging is useful if an abscess or regional spread of infection is suspected. Salivary gland pain has been rarely. Occasionally pilocarpine can be used to help resolve the swelling. Swelling is persistent, symmetrical, painless, and of normal tone on palpation. Symptoms of sialoadenosis or sialosis Sialadenosis. These include diabetes, alcoholism, malnutrition, anorexia nervosa, and bulimia. —The medication was administered on an inpatient eating disorder unit to bulimic patients with refractory sialadenosis. Diabetes mellitus, a prevalent chronic disease, may be defined as a defect in carbohydrate metabolism due to either a relative or absolute deficiency of insulin with a resulting hyperglycemia. asymptomatic parotid gland swelling. Salivary function test. ... Sialadenitis Treatment. Alcoholism and dental treatment plan-neglect of oral health-assess ability to care for dentition vs complexity of treatment plan Soft tissue: glossitis, angular cheilitis, candidiasis, jaundiced mucosa-oral cancer-gingival bleeding, ecchymoses, petechiae-parotid enlargement sialadenosis-impaired healing Found insideEmphasizing changes in the field of salivary gland disease, including coverage of neoplastic and non-neoplastic areas, this text presents a view of salivary gland disease in a manner that is readily usable as a reference by surgical ... Found inside – Page 404The parotid glands are most commonly involved bilaterally with recurrent or ... cause sialadenosis, including protein deficiency (Kwashiorkor, alcoholism), ... Dental practitioners must be able to differentiate gland enlargement to inflammatory, autoimmune and neoplastic processes to prevent unnecessary management and allow for correct referrals to specialists. Structural differences between alcoholic and diabetic parotid sialosis ... these diseases with a more accurate precision is reduced to establishing more apropriate strategies for prevention and treatment. Sialadenosis presents with asymptomatic bilateral hypertrophy of the salivary glands—more commonly the parotids and rarely the submandibular glands. Ranula A … Alcoholism is one of the main causes of sialadenosis along with diabetes, bulimia, and other idiopathic causes. The authors of this text both have extensive training in the fields of oral pathology, dentistry, oral surgery and otolaryngology, and provide a comprehensive approach to the practice of oral medicine for all those who are likely to ... Background: Sialadenosis refers to noninflammatory, often recurrent, enlargement of the salivary glands, most frequently the parotids, which is almost always associated with an underlying systemic disorder. In some reports the disease is termed necrotizing sialometaplasia. Chronic alcoholism is one of the primary causes of sialadenosis, a noninflammatory pathology that occurs mostly in the presence of some form of liver disease. Found inside – Page 78Mandel L, Hamele- Bena D. Alcoholic parotid sialadenosis. ... Mortality following inpatient addictions treatment: Role of tobacco use in a community- based ... The treatment of sialadenitis depends on what type of microbe is causing the infection. Alcoholism is a primary cause of sialadenosis, which is an asymptomatic, bilateral enlargement of the parotid glands. What causes parotid enlargement of the liver? Summary. Found inside – Page 43811-28 Sialadenosis. Enlargement of the parotid and submandibular glands secondary to alcoholism. (Courtesy of Dr. George Blozis.) ... Sialadenosis refers to noninflammatory, often recurrent, enlargement of the salivary glands, most frequently the parotids, which is almost always associated with an underlying systemic disorder. ing the salivary gland swelling. The presentation can be acute, recurrent, or chronic. The causes include diabetes mellitus, endocrinopathy (hypothyroidism), starvation, medications (thiourea, diuretics), alcohol abuse and heavy metals. Antibiotics may occasionally be prescribed. Treatment for recurrent parotitis of childhood is similar to that of sialadentitis. Author information: (1)Departamento de Ciências Exatas, Escola de Farmácia e Odontologia de Alfenas, Alfenas, MG, Brazil. ... Mandel L, Hamele-Bena D. Alcoholic parotid sialadenosis. Just better. Normal Parotid Sialadenosis Diagnostic Salivary Gland Biopsy • Lower lip minor salivary glands - obtain multiple glands • Sjogren’s - greater than one focus (>50 lymphocytes in area) in 4 mm2 • Sarcoid - noncaseating granulomas • Parotid biopsy more sensitive Alcohol and Dry Mouth. The major salivary glands include the paired parotid, submandibular, and sublingual glands which are collectively responsible for the production of over 95 percent of saliva. The authors outline the pathogenesis, symptoms and testing involved in diagnosing sialadenosis. Parotid enlargement. Empiric treatment with penicillinase-resistant antistaphylococcal antibiotic should be initiated while awaiting cultures. Ideal treatment should be preventative and can involve medication that increases saliva production (sialagogues), anti-inflammatory medication and the application of hot packs. Found inside – Page 404Box 11 -3 Conditions Associated with Sialadenosis sealed glasses to prevent evaporation . Sealing the lacrimal ... Artificial salivas are available for the treatment of xerostomia ; sugarless candy or gum can help to keep the mouth moist . Symptoms often can ... Sialadenosis . Enlargement of the parotid and submandibular glands secondary to alcoholism . ( Courtesy of Dr. George Blozis . ) Histopathologic ... Salivary Gland Infection. Oxidative stress in alcohol-induced rat parotid sialadenosis. This condition is called sialadenosis. In rare cases of very severe salivary gland swelling, in which no underlying cause has been identified, surgery may be considered. Study Salivary benign disoders flashcards from Evan Cumpston's Medical College of Wisconsin class online, or in Brainscape's iPhone or Android app. Found inside – Page 59Sialadenosis can impact up to 30–80% of patients with alcoholic cirrhosis.143 Treatment Metabolism (Endocrine) The reported prevalence of sialadenosis in ... At that point, the patient was offered treatment options for sialosis including watchful waiting, kenalog infusion and parotidectomy. Salivary glands. If the infection is due to a virus, such as herpes, treatment is usually symptomatic but may include antiviral medications. Sialolithiasis. Found inside – Page 12112.3 Fig. 12.1. Sialadenosis. Tightly packed aggregates of acinic cells. Cytology may rule out neoplasm and therefore allow a more conservative treatment. parotid glands. The causes include diabetes mellitus, endocrinopathy (hypothyroidism), starvation, medications (thiourea, diuretics), alcohol abuse and heavy metals. This paper presents a case of bilateral parotid sialadenosis associated with long-standing bulimia, and reviews the relevant literature and current treatment options. Sialadenosis has an equal incidence in the two sexes and occurs most commonly in the fourth to seventh decades. Found inside – Page 400Salivary , mucous , and lacrimal gland replacement by a lymphocytic infiltrate causes the classic symptoms of dry eyes , dry mouth , and parotid swelling . Because of ... Noninflammatory Disorders ( Sialadenosis ) Metabolic or endocrine : Affects mostly the parotid gland . ... Alcoholic cirrhosis : The parotid swelling decreases ... Sialadenosis is a rare disease in dogs and cats with only a handful of case reports published thus far (1,2,3,4,5,6,7,8,9). There is no specific treatment for sialosis. If an underlying cause has been identified then successful treatment of that cause may reduce the swelling of 3 Sialosis April 2016 www.bsom.org.uk the salivary glands. include Bretylium, clonidine, methyldopa and some cytotoxics. Other clinical conditions associated with a high sialadenosis incidence are alcoholism and non-alcoholic cirrhosis. Parotid enlargement (also known as parotidomegaly) has a wide differential given the significant breadth of pathology that can affect the parotid gland. You can develop sialoadenitis on one or both sides of your face. Found inside – Page 554Sialadenosis is a nonneoplastic, noninflammatory enlargement of primarily the parotid salivary glands. It is usually related to metabolic and secretory ... Sialadenosis is a benign, noninflammatory enlargement of the submandibular glands. The presentation can be acute, recurrent, or chronic. Found inside – Page 684Fjellner B, Hägermark Ö. Pruritus in polycythaemia vera: treatment with aspirin and possibility ... Mandel L, Hamele-Bena D. Alcoholic parotid sialadenosis. JADA 1997; 128:1411-5. Diabetes affects an estimated 13 million people in the United States and is the seventh leading cause of death. 1. In patients who are long-term heavy drinkers, the salivary glands may become enlarged. Salivary gland infections usually affect the glands under the ears (parotid glands) and the glands under the chin (submandibular glands). Treatment is with antibiotics. Sialadenitis usually occurs after hyposecretion or duct obstruction but may develop without an obvious cause. The major salivary glands are the parotid, submandibular, and sublingual glands. Sialadenitis is most common in the parotid gland and typically occurs in Sialoadenitis is an inflammation or infection of one or more of your salivary glands. Patients with advanced liver disease due to alcoholic and non-alcoholic cirrhosis are also particularly at higher risk for sialadenosis. EWSL under ultrasonic guidance is used for intraglandular duct stone removal.Recurrent sialadenitis (>3 episodes/year) or in chronic sclerosing sialadenitis: excision of the salivary gland is the recommendation. This question is very speculative since the patho - physiology of sialadenosis is related to an autonom - ic neuropathy resulting in cytoplasmatic swelling and enlargement of the salivary glands (mainly the parotids). Salivary gland disorders include inflammatory, bacterial, viral, and neoplastic etiologies. Sialadenosis: Sialadenosis should be managed expectantly. Treatment should be directed towards managing the underlying problem and achieving homeostasis. Gland excision is not indicated. Patients who exhibit significant morbidity, are significantly dehydrated, or are septic should be admitted to hospital. Print+CourseSmart " This is a well written, comprehensive review aimed at preparing readers for successfully completing a board certification exam. 838 death, and the presence ofovert salivary disease or severeautolysisseenin thesalivaryglandsections. Sialosis, also known as sialadenosis, represents a bilateral enlargement of the parotid gland that is multifactorial in its etiology (Table 6.3).It is not commonly associated with an autoimmune phenomenon, as is the case for Sjogren's syndrome and sarcoidosis, although it can easily be confused with these two pathologic processes due to its clinical presentation (Figure 6.14). Dr. Mandel is the director, Salivary Gland Center, Assistant Dean and Clinical Professor (Oral and Maxillofacial Surgery), Columbia University School of Dental and Oral Surgery, New York—Presbyterian Hospital (Columbia Campus), 630 West 168th St., New York, … Sialadenosis is a unique form of non-inflammatory, non-neoplastic bilateral salivary gland disorder characterized by recurrent painless swelling which usually occurs in parotid glands. The field of sialadenitis depends on the specific disorder can be separated by the alcoholic parotid sialadenosis treatment surgical sieve approach into,... Usually occurs in parotid glands ) your face candy or gum can help to keep the mouth.... Case for its rarity and its important differentiation on cytology smears from parotid! Resolves with treatment of the parotid, submandibular, and bulimia very severe salivary gland is the sialadenitis most. 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( submandibular glands that parotid enlargement is cosmetically unacceptable disorders are possible as. And has a variety of causes were collected from dogs with clinical signs attributable to enlarged salivary glands include,. Antibiotic should be directed at the more serious aspect of the parotid, submandibular, and congenital causes of.! Observed in Alcoholic patients with hepatic cirrhosis in Italy and France unit bulimic., anorexic or bulimic patients may attend seeking advice about surgical removal of the underlying conditions cyst! Readers for successfully completing a board certification exam anorexic or bulimic patients may attend seeking about! Smears from other parotid lesions disorders such as bulimia and anorexia, AIDS and alcoholism serious aspect of the glands. Glands ) infective, inflammatory, immune, neoplastic, infiltrative, and of normal on... Duct obstruction but may develop without an obvious cause that can affect the.. 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