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The lingual tonsil (LT), located at the base of the tongue posterior to the circumvallate papillae, consists of aggregates of lymphoid tissue separated by a median glossoepiglottic ligament that splits the LT into right and left halves. Tonsillar tissue on either side of the ligament exhibits discrete round nodules that project upward. Each prominence is covered by nonkeratinized epithelium and has a central crypt formed by an invagination of the overlying epithelium. Ducts of adjacent mucous glands empty into the crypt, serving as a flushing mechanism to cleanse the crypt. A thin fibrous connective tissue capsule isolates the LT from the underlying tongue musculature. Lingual tonsillar tissue tends to regress with aging. Hypertrophy and pathologic changes of the LT can develop and cause subjective symptomatology. Patient complaints include sore throats, dysphagia, globus sensation, dyspnea, obstructive sleep apnea, dysgeusia, halitosis, and otalgia. Tonsilloliths in the palatine tonsil are often reported, but the LT also can develop a tonsillolith. Only 1 report of LT tonsilloliths was found in the English-language dental literature. Because of its literary rarity, this report presents a case of an incidental finding of a lingual tonsillolith. Diagnostic skills are sharpened when such cases are brought to the attention of the profession.

Radioactive iodine (131I) is used effectively for the treatment of differentiated thyroid cancers. Because it is actively secreted by the salivary glands, radiation damage to these glands can occur. Obstructive swellings after mealtime salivary stimulation are common occurrences. Dry mouth is not usually seen if low doses of 131I are used. A subjective complaint of xerostomia in a patient treated with 131I 75.8 mCi proved to be related to the simultaneous presence of Sjogren syndrome (SS). Serologic, histologic, scintigraphic, and salivary volume findings and the patient's subjective complaints served to establish the pre-existence of SS.

Castleman disease (CD), a benign lymphoproliferative disorder that affects lymph nodes, is uncommon in children, with only approximately 100 cases published. Although 23% of pediatric CD cases are found in the neck, there is no substantial reported percentage found in the salivary glands, especially the submandibular salivary gland (SMSG). A pediatric case of CD involving the SMSG is reported because of its extreme rarity.

Sialosis is observed in relation to diabetes, alcoholism, and malnutrition. An assumed relation between gout and sialosis is probably based on confusion that originated from the therapeutic use of phenylbutazone for gout and the sialadenitis that the medication caused. This report describes a case of sialosis in a patient with a longstanding history of gout that was idiopathic in origin.

Polycystic ovarian syndrome (PCOS) is recognized by the presence of polycystic ovaries, irregular menstruation, and increased androgen levels. Many patients have insulin resistance or impaired glucose tolerance and an associated development of type 2 diabetes mellitus. A patient with PCOS is presented whose cosmetic concerns centered on the prolonged existence of substantial bilateral parotid swelling. The pathophysiology, diagnosis, and therapy of sialosis are discussed.

A rare phenomenon, the extraoral traumatic penetration of a foreign body into the lumen of the parotid duct, is described. The ensuing obstructive symptomatology and its diagnostic approach and therapy are reviewed.

Purpose The aim of this study is to call attention to the role that radioactive iodine ( 131 I) and stapes surgery may play in causing hyposalivation. Materials and Methods The manner in which 131 I and stapes surgery can cause salivary damage was reviewed. A case report is presented to illustrate the involved pathophysiology. Results The case report clearly shows the significant injury to the parotid glands caused by the 131 I. However, subjective symptoms of oral dryness only developed after injury to the chorda tympani nerve (CTN) during stapes surgery. Conclusions The loss of function of both parotid glands after 131 I therapy for thyroid cancer was initially compensated by the secretions of the more radiation-resistant submandibular and sublingual salivary glands (SMSG/SLSG). Damage to the CTN's secretory fibers in one SMSG/SLSG complex led to subjective oral dryness by accentuating an existing objective hyposalivation.

We present a patient who developed a delayed granulomatous reaction after injections of hyaluronic acid and bovine collagen glutaraldehyde that were introduced 6 and 4 years, respectively, previous to her present visit. She was a healthy 65-year-old woman, who was seen in November 2010 at the Columbia University Salivary Gland Center with a tentative diagnosis of a left buccal facial swelling caused by a "blocked parotid duct." The swelling was only slightly painful and had developed 1 month previously after a periodontal surgical procedure that involved the maxillary left quadrant. Questioning indicated that the swelling did not fluctuate in size nor had it changed its configuration since its sudden inception 2 days after the periodontal surgery. Visibly, the swelling was slightly erythematous. Palpation caused only mild discomfort and revealed the swelling to be quite firm in tone. The lesion involved the left facial buccal tissues, with its extraoral center corresponding to the intraoral location of the parotid duct orifice. The swelling was diffuse, with no definitive outline. It measured approximately 3 cm horizontally and 3.5 cm in height. Posteriorly, palpation of the left parotid gland revealed the gland to be painless, normal in tone, and not swollen. No swelling or discomfort was evident on the right side. No trismus was present.

Sialosis, rather than sialadenosis, has been recommended by the World Health Organization as the correct diagnostic term for a unique form of salivary gland swelling characterized by persistent painless bilateral parotid swellings with the occasional involvement of the submandibular salivary gland. Sialosis is known to occur in a variety of conditions including alcoholism, diabetes, malnutrition, and even idiopathically. However, it is most frequently observed in relation to high alcohol intake. The parotid swellings are soft in tone, noninflammatory, non-neoplastic, and usually symmetrical. There is no sex predilection, and its highest incidence occurs after the age of 30. The swellings fill the depression in the auricular area between the mandibular ramus and the superior segment of the sternocleidomastoid muscle. Although sialosis is generally associated with distilled liquor drinkers, beer may be causative as well. Because a thorough literature review did not reveal the occurrence of sialosis in beer drinkers, the authors wish to report such a case.

A case report of a 14-year-old girl, presumed to have PPD, is presented. Those manifestations of this patient's disease that can be added to the classic picture of PPD include a decreased salivary flow rate and a sialochemistry that reflects a mild chronic parotitis. In addition, cysts and sialoliths were demonstrated grossly rather than microscopically.

Necrotizing sialometaplasia (NS), first described by Abrams, I is a benign ulcerative lesion that usu­ ally manifests itself in the palate. It is thought to result from a compromise of the blood supply to the area involved. Although an uncommon lesion, its significance rests in the fact that it may be misdiag­ nosed as a squamous cell or mucoepidermoid carcinoma.i'?