S.C. Angulo-Gómez, DVM
La Salle University, Bogotá, Colombia; Postgraduate Specialization in Veterinary Dentistry, University of São Paulo, São Paulo, Brazil; Director, DentalVet Veterinary Dentistry Service, Bogotá, Colombia
The salivary glands are divided into major and minor, the major salivary glands are the parotid, zygomatic, mandibular and sublingual while minor salivary glands are distributed by the oral submucosa. In addition to these, the cat has other salivary gland called the molar gland, which is located disto-lingually to the first lower molar.1
Regarding the salivary glands, there may be certain alterations, as is the subcutaneous or submucosal accumulation of mucinous saliva into or near the oral cavity, the eye region and the cervical region, which is known by the name mucocele or sialocele. These lesions occur secondary to rupture of a salivary duct resulting in mucinous saliva spillage in the surrounding soft tissue.2 Potential causes for the development of sialocele includes trauma in salivary ducts or glands, foreign bodies, sialoliths, and neoplasms; however, in most cases the actual cause is unknown.3
The sialocele is characterized by inflammation of thin wall, fluctuating and painless. The diagnosis is confirmed by a content aspiration of the inflamed área.4
As for the treatment of choice after making the diagnosis, surgery is indicated, although there are times when these injuries are broken by themselves and heal, most of the time this does not happen, or when it occurs are cases of sialoceles very small to be diagnosed in practice, for all others, surgery is the treatment of choice.5
The surgical technique of choice for large sialoceles is the excision of the salivar gland(s) that feeds this injury.5 Two techniques for surgical excision of the sublingual glands and mandibularare mainly described, one of them is doing the lateral approach and the other is through medial approach.4
In the lateral approach, the patient should be positioned in lateral recumbency with the affected side located higher. The neck extending over a roll positioned below the ear opposite the lesion.4 A linear incision between the maxilla and linguofacial veins in the angle of the jaw is made. After this, it should be made an incision into the capsule and hold the mandibular gland, must be carefully applied caudo-lateral traction on the glandular chain and salivary duct. After this, the gland is removed and suturing is performed to complete finalize.1
The ventral approach is mainly in cases in which there is no certainty from which side comes the sialocele, since inflammation is located in the ventral neck region, for which the patient is placed in supine with the neck extended, and proceeds to make a longitudinal incision in the midline between the mandible ramus, this incision extends caudally beyond the level of the angular process where the mandibular gland is palpable. In this approach, the sialocele will generally be incised, which helps to clarify which is the affected side, and thus able to perform the surgical excision of salivary gland.4
References
1. Gioso MA. Odontologia Veterinaria para o Clínico de Pequenos Animais. 2nd ed. Barueri, SP: Minha Editora; 2007.
2. Neville BW, Damm DD, Allen CM. Salivary gland pathology. In: Bouquot JE, ed. Oral and Maxillofacial Pathology. 2nd ed. Philadelphia, PA: WB Saunders; 2002:389–436.
3. Ritter MJ, von Pfeil DJF, Stanley BJ, Hauptman JG, Walshaw R. Mandibular and sublingual sialocoeles in the dog: a retrospective evaluation of 41 cases, using the ventral approach for treatment. N Z Vet J. 2006;54(6):333–337.
4. Lane JG. Surgical treatment of sialoceles. In: Verstraete FJM, Lommer MJ, eds. Oral and Maxillofacial Surgery in Dogs and Cats. Edinburgh: Saunders; 2012:501–510.
5. Niemiec BA. Chapter 10: Pathologies of the Salivary System. In: Small Animal Dental, Oral and Maxillofacial Disease: A Color Handbook. London: Manson Publishing Ltd; 2011.