Disorders of the salivary glands

A careful history and physical examination is essential in diagnosing and treating salivary gland disorders. This alone may identify congenital lesions, trauma, acute and chronic inflammatory diseases, and a variety of other conditions affecting the salivary glands. The most common presenting complaint is that of a lump in a salivary gland, and the onus is on the physician to prove the presence or absence of malignancy. Laboratory and radiographic studies are of minimum value in making this distinction, and biopsy, under general anesthesia, by a competent head and neck surgeon with microscopic evaluation is often necessary. Office biopsy or large or fine-needle aspiration should not be attempted. Fortunately, most neoplasms are benign, and many malignant forms are low grade and have a good prognosis.