Diseases of the salivary glands in infants and adolescents

Abstract

BackgroundDiseases of the salivary glands are rare in infants and children (with the exception of diseases such as parotitis epidemica and cytomegaly) and the therapeutic regimen differs from that in adults. It is therefore all the more important to gain exact and extensive insight into general and special aspects of pathological changes of the salivary glands in these age groups. Etiology and pathogenesis of these entities is still not yet fully known for the age group in question so that general rules for treatment, based on clinical experience, cannot be given, particularly in view of the small number of cases of the different diseases. Swellings of the salivary glands may be caused by acute and chronic inflammatory processes, by autoimmune diseases, by duct translocation due to sialolithiasis, and by tumors of varying dignity. Clinical examination and diagnosis has also to differentiate between salivary gland cysts and inflammation or tumors.ConclusionSalivary gland diseases are rare in childhood and adolescence. Their pattern of incidence differs very much from that of adults. Acute and chronic sialadenitis not responding to conservative treatment requires an appropriate surgical approach. The rareness of salivary gland tumors is particularly true for the malignant parotid tumors which are more frequent in juvenile patients, a fact that has to be considered in diagnosis and therapy.

Tumors in the parotid are not relatively more often malignant in children than in adults

“…As reported in the literature pleomorphic adenomas are the most common of the benign SGT in general, and of the parotid gland tumors in particular [2,5,7,10,16,20]. In the adult population, Warthin's tumor accounts for 5.3-30% of all SGT [6,9,10], but is very rare in children [10,12,21], which is also evident by our finding of only one (1.6%) among the 61 parotid gland tumors in our study.…”

“…Peer-reviewed literature reports a tendency of higher proportions of malignant salivary gland tumors in children (40-54%) than in adults (15-46%) [2,7,10,13,16,19], but this is not the case in our population-based set of data.…”

“…This is in accordance with most studies [2][3][4]6,9,12] but in contrast to others [7,16]. This difference may be explained by the limited data regarding this particular demographic in general and by the fact that most previous reports are single-center studies and therefore to some extent selected.…”

“…Earlier studies have reported a larger fraction of malignant salivary gland tumors in children than in adults calling for alertness of parotid masses in children [10,13,15,16].…”

Parotid gland tumors in children – pre- and postoperative diagnostic difficulties

“…In the youngest children, the most common are hemangiomas, while the most commonly seen in pre-school and school children are inflammatory tumors [2,3]. The most common benign epithelial tumor of the major salivary glands is the pleomorphic adenoma: in both adults and children, its most common location is the parotid gland [4].…”