Classification of Salivary Gland Disorders
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SALIVARY GLAND DISORDERS (HT HOFFMAN, SECTION EDITOR)
Classification of Salivary Gland Disorders Henry T. Hoffman 1
&
Christopher H. Rassekh 2
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review To offer a fresh perspective on the evolving management of salivary gland disease by introducing a sequence of articles organized by a classification system grouping disorders by etiology. Recent Findings Sialendoscopy has been successful in improving the management of salivary gland disease. This endoscopic approach to imaging and instrumentation of the salivary duct system has been a focal point of recent discussion. The overall management of salivary pain and swelling as well as xerostomia and sialorrhea has improved through additional treatment options including increased application nonsurgical office techniques ranging from intraductal infusions to botulinum toxin injections. Refinements in radiographic as well as serologic and histopathologic assessment have restructured the understanding of and the approach to these clinical problems. Summary A classification system organized by etiology of salivary gland swelling provides structure to a collection of articles offering updates. Contemporary knowledge addressing underlying pathophysiology is provided through separate articles organized into a classification system designed to demystify the confusing assortment of terms that describe salivary disorders. This review additionally identifies the emergence of a subspecialty populated by salivary gland experts who have mastered the complex equipment, technology, and knowledge base required to provide state-of-art management. Keywords Salivary gland disorders . Sub-specialization . Sialendoscopy . Sialadenitis
The classification of salivary disorders is an inexact process due to overlapping clinical presentations and evolving knowledge about underlying mechanisms. A historical review of the salivary disorder first described by Johan von Mikulicz-Radecki in 1888 highlights this confusion This article is part of the Topical collection on Salivary Gland Disorders * Henry T. Hoffman [email protected] Christopher H. Rassekh [email protected] 1
Department of Otolaryngology, University of Iowa, Iowa City, Iowa 52242, USA
2
Otorhinolaryngology-Head & Neck Surgery (AC), University of Pennsylvania, Philadelphia, PA 19104, USA
and is further confounded by variably terming the process a “syndrome” versus a “disease” [1]. Mikulicz syndrome—as a group of symptoms without defining cause—was initially described as symmetric enlargement of the lacrimal and salivary glands due to their replacement with lymphoid tissue [2]. Mikulicz disease—as a disorder with a defining cause—was initially attributed by Mikulicz in 1892 to be a glandular response to infection initiated in the lacrimal gland and secondarily affecting the salivary glands by way of connections with the tear-duct, pharynx, and mouth [2]. Efforts to reclassify Mikulicz syndrome from a symptom comp
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