118 DISEASES OF THE SALIVARY GLANDS 



SUBMAXILLARY AND SUBLINGUAL GLANDS. 



These glands owing to their position are not as often 

 injured as the parotid, therefore inflammation due to trau- 

 matism is rare. Occasionally infection develops in the glands 

 by gaining entrance through the ducts and producing an 

 acute inflammation. 



Symptoms.— Enlargement of the glands, profuse salivation 

 with the head held extended. Abscesses often form in the 

 glands which open and discharge a reddish colored pus. 

 The opening may be through the skin or into the mouth. 



Treatment.— See Parotitis. 



SALIVARY FISTULA. 



Definition.— A fistula which discharges secretions from the 

 salivary glands. 



Etiology.— Mechanical.— Injuries (cuts, bites, etc.) in 

 which Steno's duct or any of the smaller ducts are opened 

 so as to permit the escape of saliva; often follows operations 

 for the removal of a calculus from Steno's duct. 



Infectious.— Abscesses which develop within the gland 

 may rupture and leave an opening through which the saliva 

 escapes. 



Pathology.— When the injuries or abscesses open a duct, 

 the overlying tissues heal until there is only a small opening 

 left through which the saliva continues to be discharged. In 

 some cases, however, the healing of the skin is complete and 

 then the accumulated secretions burrow along under the 

 skin. When there is enough fluid to cause necrosis of the 

 skin by the pressure, it opens and thus forms a fistula. This 

 in turn may heal only to reopen in another place. Such 

 openings have been found in the lumbar region. 



Symptoms.— A small opening will be noted partially 

 covered with matted hair and from which is discharged a 

 thin serous fluid (saliva) and occasionally a small amount 

 of pus. When probed, it will be found to be only subcu- 

 taneous unless in the region of the gland when it will be 

 deeper and lead to the gland or duct. A history of these 



