INTRODUCTION: Acute inflammation of the submandibular salivary glands and submandibular lymph nodes in humans are common diseases. Their clinical manifestation largely overlaps, but there are also a number of significant differences between them.
MATERIALS AND METHODS: This is a review article whose aim is to provide clear and understandable information on the diagnosis, treatment and prognosis of acute inflammation of the submandibular salivary glands and submandibular lymph nodes in humans. It was written after analyzing information on the topic from 57 full-text articles from peer-reviewed medical journals.
RESULTS AND DISCUSSION: The causes of sialoadenitis of the submandibular glands are mainly the anatomical features of the submandibular duct, the high viscosity of the saliva produced by them, and previous sialolithiasis of the duct or of the parenchyma of the gland. In children, acute lymphadenitis of the submandibular lymph nodes is most often due to infections of the upper respiratory tract, and in adults it has an odontogenic origin. The treatment of both diseases includes the mandatory intake of antibacterial drugs, and in the presence of purulent exudate, surgical treatment is carried out in the form of incision, lavage and drainage.
CONCLUSION: With early diagnosis and treatment, the prognosis of these diseases is good, but with high virulence of the bacterial causative agents and/or congenital and acquired diseases of the patient’s immune system, the treatment may be prolonged.
Grewal JS, Jamal Z, Ryan J. Anatomy, Head and Neck, Submandibular Gland. 2022. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023.
Saitou M, Gaylord EA, Xu E, May AJ, Neznanova L, Nathan S, et al. Functional specialization of human salivary glands and origins of proteins intrinsic to human saliva. Cell Rep. 2020;33(7):108402. doi: 10.1016/j.celrep.2020.108402.
Patel S, Bhatt AA. Imaging of the sublingual and submandibular spaces. Insights Imaging. 2018;9(3):391-401. doi: 10.1007/s13244-018-0615-4.
Pachisia S, Mandal G, Sahu S, Ghosh S. Submandibular sialolithiasis: A series of three case reports with review of literature. Clin Pract. 2019;9(1):1119. doi: 10.4081/cp.2019.1119.
Bujoreanu I, Gupta V. Anatomy, Lymph Nodes. [Updated 2023 Jul 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557717/
Casale J, Varacallo M. Anatomy, Head and Neck, Submandibular Triangle. 2023. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023.
Ghannam MG, Singh P. Anatomy, Head and neck, salivary glands. [Updated 2023 May 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538325/
Rzymska-Grala I, Stopa Z, Grala B, Gołębiowski M, Wanyura H, Zuchowska A, et al. Salivary gland calculi - contemporary methods of imaging. Pol J Radiol. 2010;75(3):25-37.
Togni L, Mascitti M, Santarelli A, Contaldo M, Romano A, Serpico R, et al. Unusual Conditions impairing saliva secretion: developmental anomalies of salivary glands. Front Physiol. 2019;10:855. doi: 10.3389/fphys.2019.00855.
Wilson KF, Meier JD, Ward PD. Salivary gland disorders. Am Fam Physician. 2014;89(11):882-8.
Eleftheriadis I, Papadimitriou P, Tzelepi H. Hypognathies diogkoseis: prosegise ste diaphorike tous diagnose [Submandibular swelling and its differential diagnosis]. Hell Period Stomat Gnathopathoprosopike Cheir. 1990;5(2):59-68. Greek, Modern.
Adhikari R, Soni A. Submandibular sialadenitis and sialadenosis. [Updated 2022 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK562211/
Proctor GB, Shaalan AM. Disease-induced changes in salivary gland function and the composition of saliva. J Dent Res. 2021;100(11):1201-9. doi: 10.1177/00220345211004842.
Ugga L, Ravanelli M, Pallottino AA, Farina D, Maroldi R. Diagnostic work-up in obstructive and inflammatory salivary gland disorders. Acta Otorhinolaryngol Ital. 2017;37(2):83-93. doi: 10.14639/0392-100X-1597.
Chandak R, Degwekar S, Chandak M, Rawlani S. Acute submandibular sialadenitis-a case report. Case Rep Dent. 2012;2012:615375. doi: 10.1155/2012/615375.
Vestby LK, Grønseth T, Simm R, Nesse LL. Bacterial biofilm and its role in the pathogenesis of disease. Antibiotics (Basel). 2020;9(2):59. doi: 10.3390/antibiotics9020059.
Hammett JT, Walker C. Sialolithiasis. 2022. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023.
Badash I, Raskin J, Pei M, Soldatova L, Rassekh C. Contemporary review of submandibular gland sialolithiasis and surgical management options. Cureus. 2022;14(8):e28147. doi: 10.7759/cureus.28147.
Ganeshalingam S, Koh DM. Nodal staging. Cancer Imaging. 2009;9(1):104-11. doi: 10.1102/1470-7330.2009.0017.
Fives C, Feeley L, Sadadcharam M, O'Leary G, Sheahan P. Incidence of intraglandular lymph nodes within submandibular gland, and involvement by floor of mouth cancer. Eur Arch Otorhinolaryngol. 2017;274(1):461-466. doi: 10.1007/s00405-016-4205-0.
Koroulakis A, Jamal Z, Agarwal M. Anatomy, Head and Neck, Lymph Nodes. [Updated 2022 Dec 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513317/
Maini R, Nagalli S. Lymphadenopathy. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK558918/
Schulte F, Zhang EP, Franke J, Ignatius R, Hoffmann F. Ipsilateral submandibular lymphadenectomy does not prolong orthotopic corneal graft survival in mice. Graefes Arch Clin Exp Ophthalmol. 2004;242(2):152-7. doi: 10.1007/s00417-003-0784-8.
Banjar FK, Wilson AM. Anatomy, head and neck, supraclavicular lymph node. [Updated 2023 Aug 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK544300/
Pecora F, Abate L, Scavone S, Petrucci I, Costa F, Caminiti C, Argentiero A, Esposito S. Management of Infectious Lymphadenitis in Children. Children (Basel). 2021;8(10):860. doi: 10.3390/children8100860.
Strabbing EM, de Visscher JG, van der Waal I. Een submandibulaire zwelling: de speekselklier? [A submandibular swelling: the salivary gland?]. Ned Tijdschr Geneeskd. 2004;148(51):2525-9. Dutch.
Qureshi FG, Newman KD. Lymph node disorders. Pediatr Surg. 2012:737–43. doi: 10.1016/B978-0-323-07255-7.00057-X.
Verhoef J, van Kessel K, Snippe H. Immune response in human pathology: infections caused by bacteria, viruses, fungi, and parasites. In: Parnham MJ, Nijkamp FP, Rossi AG, editors. Nijkamp and Parnham’s Principles of Immunopharmacology. 2019:165–78. doi: 10.1007/978-3-030-10811-3_10.
Klimpel GR. Immune defenses. In: Baron S, editor. Medical Microbiology. 4th edition. Galveston (TX): University of Texas Medical Branch at Galveston; 1996. Chapter 50. Available from: https://www.ncbi.nlm.nih.gov/books/NBK8423/
Carlson ER. Diagnosis and management of salivary gland infections. Oral Maxillofac Surg Clin North Am. 2009;21(3):293-312. doi: 10.1016/j.coms.2009.04.004.
Mandel L. Salivary gland disorders. Med Clin North Am. 2014;98(6):1407-49. doi: 10.1016/j.mcna.2014.08.008.
Nazarochkin IuV, Mazurin OE, Fernando DR, Proskurin AI. [Diagnostics of acute cervical lymphadenitis and adenophlegmona in patients with diabetes mellitus]. Vestn Otorinolaringol. 2010;(2):14-6. Russian.
Leung AK, Davies HD. Cervical lymphadenitis: etiology, diagnosis, and management. Curr Infect Dis Rep. 2009;11(3):183-9. doi: 10.1007/s11908-009-0028-0.
Zielnik-Jurkiewicz B, Pysz-Kuć M. Ostre zapalenie wezłów chłonnych szyi u dzieci [Acute lymphadenitis of the neck in children]. Otolaryngol Pol. 2005;59(2):209-14. Polish.
Iaremenko AI, Petrov NL, Matina VN, Kirillov AL. [Application of ultrasonography in diagnosis and treatment of acute inflammation of soft tissues in maxillofacial region and neck]. Stomatologiia (Mosk). 2011;90(4):41-4. Russian.
Kargaltseva NM, Kotcherovets VI, Mironov AY, Borisova OY, Burbello AT. [Inflammation markers and bloodstream infection (review of literature).]. Klin Lab Diagn. 2019;64(7):435-442. Russian. doi: 10.18821/0869-2084-2019-64-7-435-442.
Bishop GB, Born T, Kakar S, Jawa A. The diagnostic accuracy of inflammatory blood markers for purulent flexor tenosynovitis. J Hand Surg Am. 2013;38(11):2208-11. doi: 10.1016/j.jhsa.2013.08.094.
Cho J, Lee JH, Lee DH, Kim J, Uh Y. Performance comparison of procalcitonin, Delta Neutrophil Index, C-reactive protein, and serum amyloid A levels in patients with hematologic diseases. Diagnostics (Basel). 2023;13(7):1213. doi: 10.3390/diagnostics13071213.
Kim H, Kim Y, Lee HK, Kim KH, Yeo CD. Comparison of the delta neutrophil index with procalcitonin and C-reactive protein in sepsis. Clin Lab. 2014;60(12):2015-21. doi: 10.7754/clin.lab.2014.140528.
Molher J. Pathologies infectieuses des glandes salivaires ou sialadénites [Salivary gland infections or sialadenitis]. Rev Prat. 2023;73(7):744-746. French.
Knöbber D, Wilhelm HJ, Schätzle W. Differentialdiagnostische Betrachtungen zur akuten Sialadenitis [Differential diagnostic observations on acute sialadenitis]. Laryngorhinootologie. 1990 Jun;69(6):324-6. German. doi: 10.1055/s-2007-998201.
Afanas'ev VV, Starodubtsev VS. Differentsial'naia diagnostika limfogranulematoza (bolezn' Khodzhkina) i sialoadenita podnizhnecheliustnoĭ sliunnoĭ zhelezy [The differential diagnosis of lymphogranulomatosis (Hodgkin's disease) and sialoadenitis of the submandibular salivary gland]. Stomatologiia (Mosk). 1997;76(1):30-1. Russian.
Roccia P, Di Liberto C, Speciale R, La Torretta G, Lo Muzio L, Campisi G. Scialoadeniti ostruttive. Aggiornamento in tema di diagnosi e di terapia [Obstructive sialoadenitis: update of diagnosis and therapy issues]. Recenti Prog Med. 2006;97(5):272-9. Italian.
Miranda-Rius J, Brunet-Llobet L, Lahor-Soler E, Farré M. Salivary secretory disorders, inducing drugs, and clinical management. Int J Med Sci. 2015;12(10):811-24. doi: 10.7150/ijms.12912.
Vu M, Lopez Ortiz C, Sosa M, Peplinski B, Ganti L. Acute submandibular sialadenitis. Cureus. 2022;14(4):e24435. doi: 10.7759/cureus.24435.
de Dios Azorín Abraham J, Durán GT, Pabón NST, Peña-Fernández A, Fernández MÁP. Development of a formulation of potassium iodide tablets as an antidote against nuclear incidents. Saudi Pharm J. 2023;31(11):101814. doi: 10.1016/j.jsps.2023.101814.
Nidzović Z, Popović R, Bodiroga M, Odavić M. Izrada i ispitivanje preparata kalijum-jodida za zastitu stitaste zlezde posle kontaminacije radioaktivnim jodom (131I) [The preparation and study of potassium-iodide preparations for the protection of the thyroid gland after contamination with radioactive iodine (131I)]. Vojnosanit Pregl. 1989;46(5):330-3. Serbian.
Shchipskiĭ AV, Afanas'ev VV. Differentsial'naia diagnostika sialadenoza i khronicheskogo sialadenita [Differential diagnosis of sialadenosis and chronic sialadenitis]. Stomatologiia (Mosk). 2001;80(3):31-5. Russian.
Habermann TM, Steensma DP. Lymphadenopathy. Mayo Clin Proc. 2000;75(7):723-32. doi: 10.4065/75.7.723.
Prasad R, Arthur LG. Cervical Lymphadenopathy. Fundamentals of Pediatric Surgery. 2010:213–9. doi: 10.1007/978-1-4419-6643-8_28.
Karpf M. Lymphadenopathy. In: Walker HK, Hall WD, Hurst JW, editors. Clinical methods: the history, physical, and laboratory examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 149. Available from: https://www.ncbi.nlm.nih.gov/books/NBK256/
Choi MG. Modified drainage of submasseteric space abscess. J Korean Assoc Oral Maxillofac Surg. 2017;43(3):197-203. doi: 10.5125/jkaoms.2017.43.3.197.
Maharaj SH. A review of the microbiology of submandibular space infections. J Maxillofac Oral Surg. 2019;18(4):584-8. doi: 10.1007/s12663-018-1159-3.
DiNardo LJ. Lymphatics of the submandibular space: an anatomic, clinical, and pathologic study with applications to floor-of-mouth carcinoma. Laryngoscope. 1998;108(2):206-14. doi: 10.1097/00005537-199802000-00009.
Yotsova R. Submandibular triangle - in normal conditions and in acute purulent inflammatory diseases. Varna Med Forum. 2023;12(2):180-5. doi: 10.14748/vmf.v12i2.9332
Jevon P, Abdelrahman A, Pigadas N. Management of odontogenic infections and sepsis: an update. Br Dent J. 2020;229(6):363-70. doi: 10.1038/s41415-020-2114-5.
Nikolaev NN, Yankov YG. Lymph Nodes of the Head and Neck: In Normal and Pathological Conditions. Varna Medical Forum. 2023, 12(1): 69-74. doi: 10.14748/vmf.v12i1.9034.
Email this article (Login required) 
