Signs and Symptoms
- Located at the junction of the hard and soft palate
- Can arise anywhere minor salivary glands are located
- May involve major salivary glands
- Can be present on one side or both sides
- Lesion is typically 1-4cm in diameter
- Initially a tender, erythematous swelling
- Progresses to an ulcerated stage with a yellow-gray ulcer
- Usually minor pain or entirely painless
- Prodromal symptoms similar to flu may occur
- Healing takes 6-10 weeks
Causes
- Exact cause is unknown
- Vascular infarction and ischemic necrosis of salivary gland lobules are possible mechanisms
- Local anaesthetic injections and tying of arteries can trigger similar tissue changes
- Factors that may cause ischemia
- Differentiation from SCC based on recent trauma or dental treatment
Treatment
- No surgery required
Prognosis
- Healing is prolonged, usually takes 6-10 weeks
- Ulcer heals by secondary intention
Epidemiology
- Condition is rare
- Typical age range of those affected is 23-66 years
- More common in smokers
- Male to female ratio reported as 1.95:1 and 2.31:1
- First reported by Abrams et al. in 1973
Necrotizing sialometaplasia (NS) is a benign, ulcerative lesion, usually located towards the back of the hard palate. It is thought to be caused by ischemic necrosis (death of tissue due to lack of blood supply) of minor salivary glands in response to trauma. Often painless, the condition is self-limiting and should heal in 6–10 weeks.
| Necrotizing sialometaplasia | |
|---|---|
 | |
| Specialty | ENT surgery |
Although entirely benign and requiring no treatment, due to its similar appearance to oral cancer, it is sometimes misdiagnosed as malignant. Therefore, it is considered an important condition, despite its rarity.
