Sialosis or sialadenosis refers to diffuse, non-inflammatory, non-neoplastic recurrent/persistent enlargement of the major salivary glands, caused by hypertrophy of the acinar components. Typically, the parotid gland is most affected, although submandibular gland enlargement is not uncommon.
It is uncommon and has a variety of systemic causes:
- endocrine: diabetes mellitus, hypothyroidism, Cushing syndrome
- metabolic: alcoholism, anorexia, bulimia, obesity, malnutrition
- gastrointestinal: liver disease, celiac disease
- neurogenic: dysautonomia, multiple system atrophy
- iatrogenic: anticholinergic drugs, antihypertensives, heavy metals, psychotropic drugs
- others: depression
The commonest causes are diabetes mellitus (50% of sialosis cases 3) and alcoholism, but some cases have no known underlying systemic disease.
- sparse peripheral ducts
- a normal or enlarged gland
- normal density throughout most of the disease
- end stage glands may be diffusely dense and large
- greater fatty infiltration in diabetic sialadenosis
- reduction of fatty tissue in alcoholic sialadenosis
- 1. Scully C, Bagán JV, Eveson JW et-al. Sialosis: 35 cases of persistent parotid swelling from two countries. Br J Oral Maxillofac Surg. 2008;46 (6): 468-72. doi:10.1016/j.bjoms.2008.01.014 - Pubmed citation 2. Mehanna H, McQueen A, Robinson M, Paleri V. Salivary gland swellings. (2012) BMJ (Clinical research ed.). 345: e6794. doi:10.1136/bmj.e6794 - Pubmed 3.Si Chen, Benjamin C. Paul, David Myssiorek. An Algorithm Approach to Diagnosing Bilateral Parotid Enlargement:. (2013) Otolaryngology--Head and Neck Surgery. 148 (5): 732-9. doi:10.1177/0194599813476669 - Pubmed 4.Worathumrong N, Grimes AJ. The effect of o-salicylate upon pentose phosphate pathway activity in normal and G6PD-deficient red cells. (1975) British journal of haematology. 30 (2): 225-31. Pubmed