This article is on Salivary Gland Anatomy. It is intended to help inform patients, relatives of patients and health professionals. The information in the grey boxes is more technical and intended more for Health professionals that are reading this article

 

What are the Salivary Glands?

The salivary glands contain tissues that produce saliva. Saliva is important to the body because it, helps keep the mouth moist, contains enzymes that break down food and it helps prevent infections of the mouth and throat. There are 3 major clusters of salivary glands.
1) Parotid Glands
2) Submandibular Glands (70% of saliva production)
3) Sublingual Glands
4) Minor salivary glands: (widely distributed including the nasal cavity, pharynx, larynx, trachea)

Salivary Gland Anatomy

 

How do the Salivary glands work?

Saliva is produced in and secreted from salivary glands. The cells of salivary glands are in clusters called acini. These cells produce a secretion that contains water, electrolytes, mucus and enzymes, all of which flow out of the acinus into collecting ducts.

Within the collecting ducts, the composition of this secretion is altered. Most of the sodium (Na+) is actively reabsorbed in exchange potassium (k+) is secreted, and large quantities of bicarbonate (HCo3) are secreted this end product is Saliva! Bicarbonate secretion is of tremendous importance because it, along with phosphate helps neutralizing the stomach acids.

The Lysozymes, IgA & lactoferrin contained are protective in destruction of disease causing organisms

Salivary Gland Anatomy

 

What nerves are responsible?

Salivation is stimulated by Thought, Sight , Smell and Taste , while it is inhibited by Sleep , Dehydration , fatigue and Fear. The rest and digestion are controlled by the Parasympathetic Nervous system located in the Brain stem by the Pons and Medulla.

Salivation is controlled by the Superior Salivatory and Inferior Salivatory Nucleii located in the Pons and Medulla respectively through, via the Facial Nerves ( CN 7) and Glossopharyngeal Nerve (CN9) .

Superior Salivatory nuclei  >  CN7    via Parotid gland   >  Submandibular Ganglion  >  Sublingual /Submandibular glands

Inferior Salivatory Nuclei  CN9  Octic Ganglion  Parotid Gland

It is worth noting these parasympathetic nerves CN7 and CN9 work via producing Acetylcholine which act on Muscarinic receptors M3 and M1 located on the Acinar Cells (cells of the salivary glands) to release of NaCl / H2o into the collecting duct system (Salivation), ergo Anticholinergic drugs inhibit this.

 

What are some complications?

There are generally no major complications associated with Parotid gland Surgery (parotidectomy). but a common mention is ;

  • Damage/ injury to CN7 which passes through the parotid gland , causing weakness of the muscles of facial expression.
  • Damage to Auriculotemporal Nerve (branch of the Trigeminal nerve CN5), which results in Frey’s Syndrome : Gustatory sweating profuse flushing and sweating over the parotid area when eating

 

Further reading:

1. The patient Resource.com

 

References:

1.1. Oral and Oropharyngeal Cancer: Statistics
Statistics adapted from the American Cancer Society’s (ACS) publication, Cancer Facts & Figures 2020, and the ACS website (January 2020).
1.2 Sociodemographic differences in the incidence of oropharyngeal and oral cavity squamous cell cancers in New Zealand
Australian and New Zealand journal of Public Health
First published: 31 March 2015
1.3 National institute of Dental and craniofacial Research
Source: Surveillance, Epidemiology, and End Results (SEER) Program, National Cancer Institute
Surveillance Research Program, based on previous submissions of SEER data (1977-2003)
1.4 Thoeny HC. Imaging of salivary gland tumours. Cancer Imaging. 2007;7 : 52-62. doi:10.1102/1470-7330.2007.0008 – Free text at pubmed – Pubmed citation
1.5 Moonis G, Patel P, Koshkareva Y et-al. Imaging characteristics of recurrent pleomorphic adenoma of the parotid gland. AJNR Am J Neuroradiol. 2007;28 (8): 1532-6. doi:10.3174/ajnr.A0598 – Pubmed citation
1.6 Maria R. Bokhari, Joshua Greene. Pleomorphic Adenoma. (2019) Pubmed
https://radiopaedia.org/articles/pleomorphic-adenoma-of-the-salivary-glands
1.7 Gündüz AK, Yeşiltaş YS, Shields CL. Overview of benign and malignant lacrimal gland tumors. (2018) Current opinion in ophthalmology. 29 (5): 458-468. doi:10.1097/ICU.0000000000000515 – Pubmed
1.8 Karcioğlu ZA. Orbital tumors, diagnosis and treatment. Springer Verlag. (2005) ISBN:038721321X. Read it at Google Books – Find it at Amazon
1.9 Arch Pathol Lab Med 2008;132:1445 [http://www.pathologyoutlines.com/topic/salivaryglandspleomorphicadenoma.html. Accessed June 29th, 2020.]

 

Author + Affiliation:
Dr Tonye Onyemelukwe, Department of Otolaryngology, Waikato Hospital.
Reviewed by Dr James Sanders, Otolaryngology, Waikato Hospital.

Date of Publication +/- Review:
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Salivary Gland Anatomy

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