Non-neoplastic salivary gland disease with reference to minor salivary gland tuberculosis

Objective: To evaluate incidence, type and treatment of non-neoplastic salivary lesions. Design: Retrospective case record review, follow-up review and literature review. Setting: University Hospital, Banaras Hindu University a tertiary care centre. Patients: All patients with non-neoplastic salivary lesions presenting to the Surgical Oncology Unit from July 1997 to Dec 2001. Results: There were 31 non-neoplastic salivary gland lesions. Age of the patients varied from 22-62 years, median age 42 years, and male female ratio 1.2:1.0. The parotid gland had 17, the submandibular gland had 13 and minor salivary glands had 1 lesion. 7 abscesses, 5 cysts, 3 stones and 1 vascular malformation were seen in the parotid gland. 8 cases of adenitis and 5 Wharton's duct stone were observed in the submandibular gland. Tuberculosis was found in a single minor salivary gland lesion. A combination of clinical examination and USG was diagnostic for abscess, adenitis and calculus disease. FNAC did not detect minor salivary gland tuberculosis. The most common operative procedure for the submandibular salivary gland was the excision of the gland for recurrent adenitis. For Wharton's duct stone it was marsupialization. In the parotid gland, incision and drainage for abscess, and superficial parotidectomy for cysts were the common operative procedures. Conclusion: A variety of non-neoplastic lesions occur in the salivary glands. Clinical examination, assisted by USG and FNAC is diagnostic. A complete excision in case of the sumandibular gland and a conservation excision in case of the parotid gland, with careful preservation of the facial nerve, constitute the modality of treatment in these cases.