Sialoceles

Sialoceles are accumulations of saliva that occur when a salivary gland duct is obstructed or injured. This blockage causes saliva to leak from the duct and collect in the surrounding tissues, forming a cyst-like swelling. The most commonly affected glands are the mandibular and sublingual glands, though parotid and zygomatic glands can also be involved.

The cause of a sialocele can be trauma, such as a bite wound or surgical manipulation, or an inflammatory process within the salivary duct. Sialoliths, which are salivary stones, can also lead to obstruction. Clinical signs typically include a soft, fluctuant swelling, often in the floor of the mouth or under the chin, depending on the affected gland. The swelling may increase in size and can sometimes be painful. If the sialocele ruptures, it may present as a sudden, painful swelling that can drain saliva.

Diagnosis is usually made based on physical examination and aspiration of the swelling, which yields saliva. Imaging techniques like ultrasound or sialography, where contrast dye is injected into the duct, can help confirm the diagnosis and identify the location and extent of the lesion. Treatment aims to remove the accumulated saliva and prevent recurrence. This often involves surgical excision of the affected salivary gland, as simply draining the sialocele is usually temporary. In some cases, marsupialization, where the cyst is opened and sutured to the surrounding tissue to allow continuous drainage, may be considered. Recurrence is possible if the underlying cause of obstruction is not addressed or if the entire gland is not removed.