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Küttner's syndrome
Last reviewed: 12.07.2025
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Kuttner's syndrome (synonyms: sclerosing inflammation of the submandibular salivary glands, Kuttner's "inflammatory tumor") was described in 1897 by H. Kuttner as a disease that includes the simultaneous enlargement of both submandibular glands, the clinical picture of which resembles a tumor process.
[ Causes of Kuettner syndrome
The etiology of the disease is unknown. Currently, doctors assume that the cause of the disease is diabetes mellitus, probably type 1. The disease is often a precursor to the development of diabetes, which can be clinically detected at a later stage after the detection of sialadenosis.
Symptoms of Kuettner syndrome
Patients are concerned about painless swelling of soft tissues in the submandibular areas, the clinical picture of which resembles a benign tumor. When examining patients, a violation of the facial configuration is determined due to symmetrical swelling of soft tissues in the submandibular areas.
Patients repeatedly come to the clinics to have one of the submandibular glands removed because of an "alleged tumor." After receiving the results of a pathomorphological study, chronic inflammation of the salivary glands was discovered (as happened with Kuttner), then the patients were referred to a specialist, which indicated the difficulties of differential diagnosis of this disease.
The skin does not change color, and palpation reveals dense, painless, relatively mobile submandibular glands. Regional lymph nodes remain within the anatomical norm. The mouth opens freely. The mucous membrane remains pale pink. There is a decrease in secretion from the submandibular ducts, sometimes significant. In the late stage, the gland may be intimately adjacent to or fuse with the mucous membrane of the oral cavity. Body temperature remains within normal limits, the general condition does not change.
Diagnosis of Kuettner syndrome
Pathomorphological examination of the removed salivary glands reveals chronic interstitial inflammation of the salivary gland, pronounced proliferation of connective tissue, and in places, pronounced small-cell infiltration. The lobules of the salivary gland are preserved, but they are compressed by connective tissue and small-cell infiltration.
Sialometry shows a decrease in the functional activity of the salivary glands, sometimes quite pronounced. Cytological examination of the secretion allows us to identify individual inflammatory cells. Sialograms show pronounced sclerosis of the gland: medium and small-caliber ducts are not filled with contrast agent due to their compression by connective tissue, the parenchyma is not determined, 1st-order ducts are visible.
Treatment of Kuettner syndrome
Treatment of patients with Kuttner's syndrome is a difficult task. Long courses of novocaine blockades with mexidol are used in the area of the submandibular glands. A good effect can sometimes be achieved after hyperbaric oxygen therapy. It is possible to achieve a short-term therapeutic effect after using antispasmodics. Corticosteroid and radiation therapy are ineffective. The previously proposed tactics of surgical removal of the glands is inappropriate.
The prognosis for Kuettner syndrome is favorable, with recovery following treatment.
Some authors classify sialadenosis as a dysfunction of the salivary glands of unclear genesis, in which the leading symptom is xerostomia or hypersalivation.