SALIVARY GLANDS

AND DUCTS
Prof Omoregie F.O.
BDS, MSc, FWACS (Oral Path)

Professor and Consultant Oral Pathologist,

Dept of Oral & Maxillofacial Pathology and Medicine,
School of Dentistry, UNIBEN
 OUTLINE:
Development/embryology.
Gross anatomy.
Histology.
Function.
Clinical significance.
 Development/embryology:
Salivary glands are formed from the proliferation
of a solid cord of oral epithelium of the
stomatodeum into the underlying
ectomesenchyme
The epithelial cord branches deep into the
ectomesenchyme and canalize to ductal system
by degeneration of the central cells.
The terminal cells form the secretory end-pieces
(acini cells) under the inductive influence of
ectomesenchyme.
The epithelial component forms the parenchyma
of the gland (acini cells and ducts)
Development/embryology 2
The ectomesenchyme forms the connective
tissue component of the gland consisting of the
fibrous septal and the capsule that separate the
gland into lobes and lobules.
Branches of parasympathetic and sympathetic
nerves and blood vessel (artery and veins)
migrate to the gland before the formation of the
capsule,
The parotid gland is formed between 4-6 weeks
in-utero,
The submandibular gland at 6 weeks
The sublingual and minor salivary glands at 8-12
weeks.
 Gross anatomy:
The parotid gland
the largest salivary gland weighing about 14-
28g; it is wedged shaped with the base outwards
lies in front of the ear lobe behind the ramus of
the mandible,
covered by the parotid fascia derived from the
investing layer of the deep cervical fascia.
It is vaguely divided into three parts: superficial,
deep and glenoid lobes
the superficial lobe formed by the base of the
gland, from it emerges the parotid duct and the
five divisions of branches of the facial nerve
the deep lobe formed by the tapered edge at the
deep part of the gland, lying in contact with the
internal jugular vein
 Gross anatomy: 2
the glenoid lobe formed by the upper limit of the
gland extending to the glenoid fossa behind the
temporomandibular joint lying in contact with the
external acoustic meatus and the auriculo-
temporal nerve
The parotid duct extends from superficial lobe,
cross the masseter along its anterior border to
piece the buccinator and open at the buccal
mucosa in a papilla opposite the maxillary 2nd
molar.
The blood supply is the branches of external
carotid artery and drained by retromandibular
vein, while lymph drainage is into the anterior
superior cervical lymph nodes.
The nerve supplies are: the secreto-motor fibres
(post-gg parasympathetic nerve) from otic
ganglion through the auriculo-temporal nerve
 Gross anatomy: 3
pre-gg fibres from cell bodies in the inferior
salivatory nucleus in the medulla to the otic gg
via the glossopharyngeal nerve, its tympanic
branch, tympanic plexus and the lesser
(superficial) pertrosal nerve.
The sympathetic fibres from superior cervical
gg through the plexus on the external carotid
and middle meningeal arteries.
The sensory fibre is from the auriculotemporal
nerve,
the parotid fascia receives sensory fibres from
the great cervical nerve (C2).
 Gross anatomy: 4
The Submandibular gland
It weighs about 10-15g (size of walnut).
The superficial part lies in the submandibular fossa
in the medial part of the body of the mandible below
the mylohyoid ridge
The facial artery lie in the deep groove between the
gland and the mandible before arching upwards
around the inferior border of the mandible to reach
the face in front of the masseter.
The common facial vein slopes downwards to the
internal jugular vein and grooves the surface of the
posterior part of the gland
the mandibular branches of the facial nerve crosses
the gland
 Gross anatomy: 5
The gland narrows posteriorly and curves around
the posterior border of the mylohyoid muscle to lie
in the floor of the mouth (the small deep part)
between the mandible and the tongue
main duct of the gland run within the gland and
curves also around the posterior part of the
mylohyoid and emerges from the anterior end of
the deep part of the gland to open into the mouth
underneath the tongue by a small orifice lateral to
the lingual frenum.
Blood supply is from the facial artery and drainage
is by the common facial vein. Its lymph drains to the
submandibular lymph node.
.
 Gross anatomy: 6
Nerve supplies are: parasympathetic post gg
fibres are the secreto-motor fibres from cell
bodies in submandibular gg or in small ganglionic
masses on the surface of the gland.
Pre-gg fibres from cell bodies in the superior
salivatory in the pons
via the nervus intermedius, the facial nerve up to
the stylo-mastoid canal
leave the facial nerve in the chorda tympani
nerve (with taste fibres to the anterior third of the
tongue) which joins the lingual nerve at the base
of the skull
 Gross anatomy: 7
The sublingual gland
almond shaped, the smallest of the three major
salivary glands, weighing about 2g.
It lies in the floor of the mouth between the tongue
and the teeth, that is, in front of the anterior border of
the hyoglossus, between mylohyoid and the side of
the tongue.
lies below the termination of the duct of the
submandibular gland. It opens through about fifteen
ducts, half opens into the submandibular ducts and
the others into the sublingual papilla at floor of the
mouth.
Blood supply is from the lingual and submental
arteries and their corresponding veins.
The lymph drains into the submental and
submandibular lymph nodes.
 Gross anatomy: 8
Nerve supplies are: parasympathetic pre-gg fibres
from lingual nerve (chorda tympani) to the
submandibular gg
post-gg fibres are secreto-motor fibres from the gg.
sympathetic fibres are from the plexus around the
facial artery (grey rami from the superior cervical
gg). Sensory fibres are from the lingual branch of
the trigeminal nerve.
There are many minor salivary glands (600-1000)
in the submucosa throughout the oral cavity except
within the gingival and anterior part of the hard
palate.
They open directly through into the oral cavity
without ductal system
 Histology: 1
Three cell types may be found in the terminal end piece:
mucous cells; serous cells and myoepithelial cells.
Serous glands: the parotid gland secrets serous saliva
(watery) and consists mainly of serous cells, pyramidal in
shape with a darkly stained cytoplasm with H&E because of
the eosinophilic secretory Zymogen granules, a spherical
nucleus at basal third and the end piece is arranged in a
roughly spherical acinus.
Mucous gland (viscous) eg sublingual and minor salivary
glands that secrets mucous saliva and consists mainly of
mucous cells, pyramidal in shape with clear cytoplasm
(stores mucin) when stained with H&E, flattened nucleus at
the basal part, the end piece is arranged in tubular acinus
with a large central lumen
sero-mucous or mixed gland eg the submandibular gland
secrets slightly viscous saliva consists of both serous and
mucous cells, with two-third serous cells in man.
 Histology: 2
The myoepithelial cells are found in relation to the
terminal secretory end piece and to the intercalated
ducts within the space between the basement
membrane and the basal plasma membrane of the
secretory epithelial cells. There is usually one
myoepithelial cell per secretory end piece, each cell
consists of a central body with a nucleus and 4-8
processes radiating from the body and follows the long
axis of the secretory unit,
Those that follows the intercalated ducts are more
spindle shaped and with fewer processes.
The myoepithelial cells are thought to contract in order
to support the secretory cells preventing over distension,
rupture of the acini cells packed with mucous secretion
and control the flow of saliva through the intercalated
ducts by increasing or reducing its diameter.
 Histology: 3
The ductal system consists of three classes of ducts:
Intercalated ducts that collect salivary secretion from
the intercellular canaliculi.
It is lined by short cuboidal cells join together by
junctional complexes and desmosomal attachments,
with surface microvili projecting into the lumen.
It has a centrally placed nucleus and secretory
granules occasionally found close to the secretory
end piece.
It is prominent in serous glands producing watery
secretion e.g. parotid gland.
Striated ducts; saliva passes from the intercalated
ducts into the striated ducts lined by columnar cells
join together by junctional complexes and
desmosomal attachments with surface stubby
microvili.
 Histology: 4
It has a centrally placed nucleus, an eosinophilic
cytoplasm with a few scattered vesicles apically
and prominent striation (deep in-folding of the basal
plasma membrane into the cell) at the basal end of
the cells.
It is surrounded by longitudinally oriented blood
vessels.
It modify the primary salivary secretion from the
secretory end piece, which consists of isotonic
protein containing fluid, high sodium and
potassium, to hypotonic fluid with low sodium and
chloride and secretion potassium and bicarbonate.
 Histology: 5
Terminal excretory ducts saliva passes from the
striated ducts into the terminal excretory ducts
before it is secreted into the oral cavity.
Near the striated ducts it is lined by a
pseudostratified epithelium consisting of tall
columnar, small basal cells and goblet cells.
Towards the duct orifice and emerging with oral
cavity region, it consists of true stratified
squamous epithelium.
The main excretory ducts modify the final saliva
by altering the electrolyte concentration and may
add a mucoid component
 Histology: 6
The connective tissue component forms mainly
the fibrous septal and the capsule which divides
the gland into lobes and lobules,
Nerves, blood vessels and lymphoid tissues are
within the stroma of the salivary gland.
The connective tissue cells consist of fibroblasts,
macrophages, mast cells, adipose cells and
plasma cells
Embedded in an extracellular matrix of collagen
fibres with ground substance consist of
glycoproteins and proteoglycan.
Oxytalan fibres are found in connective tissues
around mucous acinus and intralobular ducts of
submandibular and minor salivary glands.
 Functions:
Protection the lining mucosa of the oral cavity by
lubrication with (glycoproteins) and water, lavage,
waterproofing and formation of pellicle, as barrier
against noxious stimuli, microbial toxins and minor
trauma.
Buffering capacity of saliva helps to protect the oral
cavity from growth and colonization by bacteria and
neutralizes the acid produced by sugar fermentation
these organisms to prevent dental caries. Saliva
buffers are mainly phosphate and bicarbonate ions,
and sialin a salivary peptide (residue of salivary
protein).
Digestion; it provide taste acuity, neutralize
oesophageal contents, dilute gastric chyme forms food
bolus and breaks down starch with salivary amylase
Taste; it dissolves substances to be tasted and carry
them to the taste buds and it contains gusten which
helps in growth and maturation of taste buds.
 Function: 2
Antimicrobial; using its mucous content as barrier and
lysozyme as enzyme against microorganisms. It uses
lactoferrin to bind free iron so depriving bacteria of
essential element. While antibodies (IgA) is used to
agglutinate microorganisms.
Maintenance of tooth integrity; posteruptive maturation
following interaction between saliva and tooth resulting
in diffusion of salivary ions e.g. calcium, phosphate,
magnesium and chloride into the surface apatite
enamel. There is also remineralization of enamel to
arrest carious process especially in presence of fluoride
in saliva.
Tissue repair; there experimental evidence of increased
wound contraction due to presence of epidermal growth
factor in saliva secreted by submandibular glands in
mice. While in human the occurrence of growth factor is
low but its effect on repair has not been demonstrated.
 Clinical significance:
Salivary stone which is common in
submandibular and sublingual glands.
Neoplasm; Sublingual and minor salivary glands
commonly associated with malignancies, while
benign tumours are common in parotid gland.
Cyst; mucous retention or extravasation cysts
(mucocele).
Sjogren’s syndrome with bilateral parotid
enlargement.
Infections; bacteria siaoadenitis, and mumps
and sarcoidosis.
Trauma; with damage to branches of facial
nerve and facial artery.
Salivary fistula