sialadenitis - inflammatory disease localized in the salivary glands, arising for whatever reasons (infection, traumatic effect malformation).In a situation where the substrate is used for the development of sialoadenita infectious disease, the diagnosis should indicate its secondary nature.There are primary sialoadenity, which are often caused by a violation of embryogenesis of the salivary glands and are seen in pediatric practice.
The most common pathological process in sialadenitis is one-sided asymmetric in nature, but in the world there is evidence of multiple lesions.
most common in the overall incidence of this disease etiopathogenetic option is sialadenitis of the parotid gland.All the reasons for which an sialadenitis salivary gland can be attributed to one of the two main etiological groups (the epidemic and the epidemic team).
primary cause of epidemic form sialoadenita is getting into the body of viral or bacterial particles that cause l
nonepidemic acute serous sialadenitis develops due to violations of the outflow of mucus of the salivary duct, which occurs when strong traumatic impact, clogging of a foreign body or concrement when developing calculous sialadenitis.
development of inflammatory changes in the salivary glands, which always takes place at sialadenitis, facilitated by the presence in the oral cavity chronic infectious foci in the form of carious teeth.
In addition, non-epidemic sialadenitis of the parotid gland can develop as a complication of other infectious diseases profile or surgery.
Symptoms and signs sialoadenita
Acute sialadenitis salivary gland accompanied by the development of edema, infiltration, purulent melting and necrosis of glandular tissue with a further substitution on the connective tissue and scarring.Not all situations, the outcome of the process is the acute abscess, and necrosis, inflammatory changes usually subside in the earlier stages.
In a situation where the patient has sialadenitis of the parotid gland, pathognomonic symptom is the appearance of pronounced pain when opening the mouth, as well as the movements of the head.Over time, the swelling of the soft tissues extends to adjacent areas (buccal, submandibular, pozadichelyustnaya region, as well as the upper portion of the neck region).
In conducting deep palpation, which is difficult because of the severe pain syndrome, there is a dense infiltrate of consistency in the projection of the alleged location of the parotid gland.In a situation where a patient is attached as a complication of purulent fusion, over an area defined by the defeat of positive symptom fluctuations.
specific features sialoadenita is hypo- or hypersalivation, in violation of the qualitative composition of saliva (it found flakes of mucus, pus, and even an admixture of desquamated epithelium).
Submandibular sialadenitis debut symptoms such as pain when swallowing, swelling of the submandibular and sublingual area, followed by the spread of the cervical area.If visual examination of a patient with sialoadenitom submandibular gland marked increase in density while preserving its mobility in the projection of the distal jaw-lingual groove.
Acute serous sialadenitis sublingual glands is accompanied by pain during movements of the tongue, as well as an increase in sublingual folds.Sialoadenita objective evidence to be considered rendering damage to the mucosa of the location of the cancer, rejection of pus and necrotic tissue cancer.
contact sialadenitis occurs in the propagation of the inflammatory phlegmon parotid-masticatory and sublingual area.After opening cellulitis, usually develops unilateral sialadenitis.In addition to the clinical manifestations, a good tool for establishing a correct diagnosis is cytology of the salivary gland secretions.
When sialadenitis, provoked salivary duct obstruction by a foreign body, the patient may develop a variety of clinical symptoms.In some situations, this pathology manifests itself only a slight increase in cancer, while others develop extensive inflammation in the form of an abscess and cellulitis.Briefly foreign body triggers the delay saliva, as well as a small swelling of the parotid and submandibular glands.Pain syndrome for this form sialoadenita not typical.
process purulent inflammation of the salivary gland, in the absence of timely treatment, inevitably provokes the melting of the capsule gland and spread of the pathological process in the surrounding tissue.In some situations, there is an independent autopsy abscess with the release of a foreign body.Prolonged exposure of a foreign body in the salivary glands can be a substrate for the formation of salivary calculus.
sialoadenita acute form develops, usually on the background of dehydration, disturbing the natural salivation, deterioration of oral hygiene, as well as in neuro reactions.The preferential localization of the inflammatory process in this situation is the parotid gland.
Among the local causes of acute sialoadenita should also be considered gland dysfunction in inflammatory changes in periodontal tissues, as well as traumatic impact on the iron.
intensity, pathognomonic clinical manifestations in acute sialadenitis is correlation dependence on the nature of inflammation and localization of the pathological process.
Acute serous sialadenitis debut sharp pain in the projection of the parotid region, aggravated by performing chewing movements.The deterioration of the patient in this pathology is developing rapidly, and is characterized by the appearance of fever febrile type feeling of dryness in the mouth and pain.An objective examination of the patient with acute sialoadenitom visualize all the signs of inflammation in the form of a sharp increase in the area of soft tissue lesions, tenderness to palpation.
Upon accession purulent inflammation has been a significant deterioration in not only clinical symptoms, and laboratory parameters.The management of patients with signs of acute purulent sialoadenita should carefully assess the severity, since this pathology is characterized by a complicated course and may end fatally.
Regression of acute sialoadenita observed after 20 days from the onset of clinical manifestations, and under unfavorable conditions, the formation of an abscess with signs fluctuations.
available patient clinical manifestations of acute sialoadenita need to differentiate such diseases as lymphadenitis, periadenit, phlegmonous adenitis.
Chronic sialoadenita is a fairly common disease in pediatric patients is not less than 14% of the incidence of oral and maxillofacial surgery.The most common chronic sialadenitis of the parotid gland, which has nothing to do with the mumps.
Given the prevalence of pathological process in the salivary glands, usually divided interstitial and parenchymal sialadenitis (the latter prevails in children).
Most experts maxillofacial surgery believe that contributes to the emergence of chronic sialoadenita congenital failure of glandular tissue.
aggravation of the disease is caused by a persistent decline in the non-specific defense of the body of the patient, who did not return to normal even during clinical remission, which makes primary chronization of the inflammatory process.
especially chronic sialoadenita is its tendency to cyclic flow.Interstitial chronic submandibular sialadenitis accompanied by a narrowing of the ducts, so the ray imaging techniques marked reduction in the intensity of the parenchyma without compromising its structure.The use of contrast x-ray techniques is permitted only in the period of full remission.
treatment of patients with signs of chronic sialoadenita depends on the stage of the disease.Thus, in the period of exacerbation is mandatory appointment of antibacterial agents (Ampioks a daily dose of 2 g orally), desensitizing agents (Tsetrin 1 tablet 1 time per day).
If signs of purulent inflammation shows the use of daily instillations of the affected gland to normalization of the analysis of saliva for the presence of pus.Instillation applied using antiseptics and proteolytic enzymes that promote lysis of necrotic tissue, anti-dehydration step.
as a topical treatment shows the application of ointment compresses and compresses with 30-50% Dimexidum.
as preventive measures for chronic sialadenitis used stimulation of salivation, which provides an introduction to the salivary flow of 1.5 ml of 15% of nicotine-ksantinola Natalie.
Patients with signs of chronic sialoadenita need a medical examination and carrying out preventive measures aimed at the prevention of exacerbations.
sialadenitis salivary gland well to treatment in the acute phase of the disease, and chronic difficult to treat.
basis of pathogenetic treatment sialoadenita make drugs that increase the secretion of saliva and promoting it in the salivary duct (1% solution of pilocarpine).
In addition, a good therapeutic effect in sialadenitis have physiotherapy treatments as UHF into lesions, as well as the use of alcohol, camphor compresses.
nonspecific therapies sialoadenita should include patient compliance with the rules of oral hygiene, which includes regular cleaning of the teeth and tongue after every meal using a brush and floss.Also, patients should stop smoking.
Organization eating behavior of the patient, which implies an increase in fluid intake, grinding food helps to prevent the spread of inflammation to the surrounding tissue.
Severe inflammatory response, which is characterized by a purulent sialadenitis, can provoke fever, which should be to stop taking anti-pyretic agents (Nimid a single dose of 100 mg).For the relief of pain that often accompanies the submandibular sialadenitis, use different techniques of massage of the affected area.
Chronic sialadenitis difficult to treat, and the percentage of full recovery in this situation does not exceed 20%.All methods of treatment used in chronic course sialoadenita used to a greater extent to prevent the development of complications.Period exacerbations in chronic sialadenitis also due to the development of inflammation in the salivary gland, which causes the feasibility of antibacterial agents.During remission, these patients demonstrated a course galvanization of the salivary glands.
In a situation where the patient has calculous sialadenitis, justified the use of surgery.Also, surgery is indicated in cases where there is a festering parenchymal sialadenitis with signs of melting.The volume of surgical intervention and operational benefits depends on the degree of damage to the salivary glands and is more limited opening and drain gland with concomitant administration of an antibiotic in the affected area.
sialadenitis - a doctor will help ?If you have or suspect a development sialoadenita should immediately seek the advice of such experts as an infectious disease, a surgeon.