Salivary gland cysts can occur in the three pairs of major salivary glands and all minor salivary glands. There are two types: retention cysts and congenital cysts. Retention cysts are the most common, frequently occurring in the sublingual gland and minor salivary glands, followed by the parotid gland. Submandibular gland cysts are very rare and are caused by duct narrowing or obstruction due to tumors, dental calculus, injury, Chinese Taxillus Herb worms, etc. This condition represents an intermittent obstruction, where the proximal acinus of the duct dilates in the absence of inflammation, forming a retention cyst. Congenital cysts are most often found in the parotid gland and develop from epithelial remnants left in deep tissues during embryonic development. Retention cysts occurring in minor salivary glands are called mucoceles, while cysts in other salivary glands are named according to their location, such as sublingual gland cysts, submandibular gland cysts, and parotid gland cysts.

bubble_chart Etiology

The most common cause of the disease is obstruction of the salivary gland ducts and retention of saliva due to various reasons.

bubble_chart Clinical Manifestations

1. Mucous gland cysts occur under the oral mucosa, are small (often the size of a soybean), have clear borders, appear as transparent vesicles, and are painless. There is often a history of injury (local biting is the most common). After rupture, thick white fluid is discharged, the mass temporarily disappears, but the ruptured area heals quickly, and the mass reappears.

2. Major salivary gland cysts (sublingual gland, submandibular gland, and parotid gland) present as swelling in the affected area and may have obstructive symptoms (i.e., increased swelling sensation during meals, gradually relieved after eating). Secretions cannot be expressed from the salivary duct orifice, or discolored and foul-smelling fluid may be discharged. Thick white fluid can be aspirated by puncture.

1. For small cysts that are clinically easy to diagnose, "A" examination can be selected for confirmation.

2. For large masses that are difficult to distinguish from other lumps, "B" and "C" examinations may be included.

bubble_chart Diagnosis

1. Mucous gland cyst: A small, transparent vesicle-like mass under the oral mucous membrane, containing viscous, egg-white-like fluid; with a history of local biting trauma.

2. Major salivary gland cyst: Occurs in the corresponding major salivary gland area of the oral and maxillofacial region, presenting as swelling and obstructive symptoms in the affected area, with abnormal secretion function at the duct orifice. Sublingual gland cysts yield viscous, egg-white-like fluid upon puncture, while submandibular and parotid gland cysts yield thinner fluid; the extracted fluid tests positive for amylase.

3. Confirmed by pathological diagnosis.

bubble_chart Treatment Measures

Surgical treatment is more effective, and the affected gland should be removed during the operation.

For general surgical prevention of infection, sulfonamide drugs (such as compound formula sulfamethoxazole) or drugs mainly effective against Gram-positive bacteria (such as erythromycin, penicillin, etc.) are selected; for patients with poor constitution or concurrent infections, combination therapy is often used. The more common regimen includes: drugs effective against Gram-positive bacteria (such as penicillin) + drugs effective against Gram-negative bacteria (such as gentamicin) + drugs effective against anaerobic bacteria (such as metronidazole); for patients with severe infection or complications before or after surgery, effective antibiotics can be chosen based on clinical conditions and drug sensitivity tests.

If residual damaged glands remain after surgery, it is inevitable that saliva retention will recur, leading to cyst reformation.

bubble_chart Prevention

Mainly to avoid injury and maintain oral hygiene.