Sialosis

Definition:

Sialosis is an uncommon non neoplastic and non inflammatory disorder causing bilateral non painful enlargement of the major salivary glands.

Age of occurrence: Starts to arise in the middle age. Its peak incidence occurs during the 5th and 6th decades.

Females tend to predominate.

Among the major salivary glands the parotid gland undergoes the maximum enlargement. The enlargement develops rather slowly with some decrease in the salivary flow.

Etiology:

Precise etiology not known. The underlying pathogenesis points towards a neuropathy.

Sialosis is commonly associated with:

1. Diabetes mellitus

2. Hypothyroidism

3. Malnutrition

4. Alcoholic / other hepatic cirrhosis

5. Puberty (rare)

6. Menopause

7. Anti hypertensive medications

Histopathology:

It is characterized by acinar cell hypertrophy, atrophy of striated ducts associated with oedema of interstitial connective tissue.

In end stage disease there is widespread replacement of acini with fatty tissue.

Management:

Rather difficult. Should always be directed at the underlying systemic disorder. In patients with huge enlargement of parotid salivary glands, then surgical reduction could be a possibility.

Use of pilocarpine has shown varying results.