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Inflammation of the salivary gland: symptoms and treatment

The disease occurs when an inflammatory reaction develops inside the tissue of the salivary gland and is called sialadenitis (or sialadenitis). Most often, sialadenitis affects the parotid salivary glands, less frequently submandibular and sublingual.

The disease develops in both adults and children, although for each age group there may be a specific type of sialadenitis, taking into account the causative factor. Depending on the nature of the course of the disease, sialadenites are divided into acute and chronic.

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The main causes of sialoadenitis

symptoms of inflammation of the salivary gland, photo

symptoms of inflammation of the salivary gland, photo

The cause of acute inflammation of the salivary glands is always the presence of any infectious agent inside the gland. Depending on the causative agent, sialadenitis may be:

1. Viral. It develops when infected with a mumps virus (popularly, this condition is called “mumps”), to which the salivary glands are very sensitive. The virus is transmitted by airborne droplets.

After entering the body through the mucous membrane of the respiratory tract, it penetrates the tissue of the parotid salivary gland, multiplies in its cells, causing inflammation. When the infection is generalized, it enters the testicles of boys, leading to their damage, which can later lead to infertility.

Perhaps the development of inflammation with cytomegalovirus infection .

causes of sialoadenitis

2. Bacterial , or non-specific. It occurs when an infection is brought from the oral cavity through the ducts of the glands, as well as from the inside through the blood and lymph.
The microflora of the oral cavity can lead to the development of acute sialadenitis as a result of the following factors (circumstances):

  • With poor oral hygiene.
  • Due to reactive obturation. Its occurrence is facilitated by abdominal surgery, as well as diseases that lead to general exhaustion, such as malignant neoplasms, chronic gastrointestinal diseases, stress, eating disorders, and diabetes mellitus. In these conditions, a reflex narrowing of the lumen of the ducts and a decrease in salivation occurs. Saliva begins to accumulate in the salivary gland, which is a good breeding ground for microorganisms present in the oral cavity;
  • Due to mechanical obstruction, when the duct is blocked with a stone or a foreign body. In this case, bacteria inside the oral cavity also begin to actively proliferate inside the gland, resulting in inflammation.

The introduction of infection through the blood can be observed in severe infectious diseases such as typhoid, scarlet fever. Through lymph, sialdenitis develops in inflammatory diseases of the face, pharynx, oral mucosa: furunculosis, purulent facial wounds, tonsillitis, periodontitis.

Chronic sialadenitis in most cases are not the result of acute (they are independent in their development). This disease is initially chronic, as there is a predisposition of the salivary gland to changes in its tissue. The causes of chronic sialadenitis may be due to genetics, may be a consequence of autoimmune processes in the body, may occur as a reaction to a common disease.

Some factors provoke the development of chronic sialadenitis - stress, illness, hypothermia, trauma, general weakening of the body.

Often the development of chronic inflammation occurs in old age, which is associated with a deterioration in the blood supply to the salivary glands as a result of atherosclerosis, as well as as a result of free radicals and general aging of the body.

Symptoms of inflammation of the salivary gland, photo

Symptoms of inflammation of the salivary gland foto1

photo 3

Epidemic parotitis is characterized by an acute onset, body temperature 39-40 ° C. There is swelling of the parotid salivary glands on both sides, pain around the ears, which is aggravated by chewing. Edema of the parotid gland is clearly visible and spread to the sides, therefore, this disease has received the name "mumps".

symptoms of sialadenitis photo 4

symptoms of sialadenitis photo 4

In adults, the sublingual and submandibular glands may be involved. Thus, the clinical manifestations of sialdenitis are divided into local and systemic.

In acute nonspecific salivary gland inflammation, the symptoms depend on the type of inflammation. Manifestations of acute sialadenitis in the parotid salivary gland in case of untimely delivery of assistance pass through a series of successive stages - serous, purulent and gangrenous.

Serous sialadenitis is characterized by dry mouth, tenderness and swelling in the ear, while the earlobe is elevated.

The pain increases with eating, as well as after reflex saliva at the sight of food. The skin in the area of ​​the gland is not changed. Body temperature may rise slightly. When pressed on the gland, saliva is not released at all or very little is emitted.

Purulent sialadenitis is manifested by a sharp increase in pain, which leads to sleep disturbance, an increase in body temperature above 38 ° C, there is a restriction when opening the mouth, swelling extends to the temples, cheeks, lower jaw.

When pressing on the gland in the mouth, pus is secreted. The gland is palpable, painful, and redness of the skin is observed above it.

Gangrenous sialadenitis may occur rapidly, with a rise in temperature, although, with a general weakening of the body, its manifestations may be moderate. Above the gland, a site of destruction of the skin tissue is revealed, through which a constant excretion of the rejected parts of the dead salivary gland occurs.

The disease can be fatal when the infection spreads throughout the body and the development of sepsis , as well as fatal bleeding when the walls of the major vessels of the neck melt.

Inflammation of the submaxillary salivary gland is characterized by the appearance of edema in the submandibular region. The gland becomes enlarged, hilly, and very painful when palpating. With increasing inflammation, swelling increases, pain appears when swallowing. In the mouth, under the tongue there is redness and swelling, it is also possible to observe the release of pus from the duct of the gland through its duct.

Inflammation of the submandibular salivary gland can often be calculous. In this case, the cause of inflammation becomes overlapping duct stone, which is formed when a foreign body enters, frequent inflammation in the ducts, as well as an increased amount of calcium in the blood plasma.

Signs of calculous inflammation will be:

  1. A sharp stabbing pain, worse during meals;
  2. Impaired saliva discharge;
  3. Dry mouth;
  4. Swelling and tuberosity of the submandibular gland.

When massaging the gland under the tongue, pus appears. The patient may notice an increase in the gland during the meal, which makes eating uncomfortable, and in the severe case - impossible.

Inflammation of the hypoglossal salivary gland is extremely rare and is a complication of an abscess or phlegmon of dental origin. Manifested in swelling and soreness, localized in the hypoglossal region. The development of suppuration exacerbates the situation.

Manifestations of chronic inflammation of the salivary gland also differ depending on the form:

1 . в 85% поражает околоушные слюнные железы. Chronic interstitial sialadenitis in 85% affects the parotid salivary glands. Older women are affected more often. For a long time may occur without symptoms. The appearance of clinical signs is associated with the slow progression of the pathological process and the gradual narrowing of the ducts of the gland.

An aggravation may begin abruptly, with the appearance of dry mouth. The gland is enlarged, painful, its surface is smooth. After exacerbation of iron, the size of the gland does not correspond to the norm (it is somewhat larger than the proper size).

2 в 99% случаев развивается в околоушной железе. Chronic parenchymal sialadenitis in 99% of cases develops in the parotid gland. More often women are ill. Due to congenital changes in the structure of the ducts, the age range is very wide - ranging from 1 year to 70 years. Sometimes the disease lasts for decades without any manifestations.

The aggravation develops as acute sialadenitis. The initial stage of the disease can have only one sign - the release of a large amount of brackish mucous fluid when pressed on the gland.

In the future, you may experience a feeling of heaviness in the area of ​​the gland, its consolidation, salivation with an admixture of pus and lumps of mucus. Mouth opening is free (unlimited). The late stage is characterized by an enlarged and hilly, but painless gland, the secretion of purulent saliva, dry mouth rarely occurs as a sign of the disease.

3 возникает у пожилых, вследствие расширения протоков околоушных слюнных желез. Sialodochitis (damage to the ducts only) occurs in the elderly, due to the expansion of the ducts of the parotid salivary glands. A characteristic sign - increased salivation during conversation and eating. This leads to maceration of the skin around the mouth (formations of the buns).

During an exacerbation, the gland swells and purulent saliva secretes.

Diagnostics

Acute sialadenitis is detected by examining and interviewing the patient. Sialography is not widely used in practical medicine, because accompanied by aggravation of the pathological process with the introduction of a contrast agent. Against this background, the pain intensifies.

In chronic sialadenitis, on the contrary, an effective diagnostic method will be to conduct contrast sialography, an x-ray study of the salivary glands with the introduction of iodolipol.

In the interstitial variant, narrowing of the ducts will be detected, and the amount of contrast material will be small - 0.5-0.8 ml, compared with the usual normal “capacity” of 2-3 ml.

When the parenchymal form, there are multiple cavities, 5-10 mm in diameter, the ducts and gland tissue are not visually detectable. To fill the cavities requires 6-8 ml of a contrast agent.

Treatment of salivary gland inflammation (sialoadenitis)

Treatment of salivary gland inflammation

When symptoms similar to acute inflammation of the salivary gland appear, treatment should be carried out in a hospital. Most often, therapy is carried out by conservative methods, only with the development of a purulent process, a surgical opening of the abscess is indicated.

Parotitis

Symptomatic treatment is carried out and interferon preparations are prescribed, for example, leukinferen. Symptomatic agents in this case are those that reduce the temperature and reduce pain in the area of ​​the inflamed gland.

Acute nonspecific sialadenitis

The goals of treatment are the elimination of the inflammatory process and the restoration of saliva secretion. Therefore, the following events are shown:

  1. Drool Diet. It consists in the use of rusks, sauerkraut, cranberries, lemon, supplemented by ingestion of 5-6 drops of 1% solution of pilocarpine hydrochloric acid (it promotes reflex contraction of the muscles of the excretory ducts of the salivary gland and secretion);
  2. Antibiotics - penicillin, gentamicin, as well as antiseptics - dioxidine, potassium furaginate are introduced into the duct;
  3. A compress with a 30% solution of Dimexidum is applied to the gland area, once a day for 30 minutes. It has anti-inflammatory, analgesic effect, stops the development of infection;
  4. Physiotherapy: UHF, heaters;
  5. With increased edema and inflammation - Novocain-Penicillin blockade;
  6. Antibiotics inside;
  7. Intravenous solution of trasilol, contrikala is injected.

Surgical treatment - With the development of purulent inflammation, an ulcer is dissected from the outside. In case of a gangrenous form, an urgent operation is performed under general anesthesia. In the presence of a stone, it is removed, because otherwise, the process will be repeatedly exacerbated.

Chronic sialadenitis

In the period of exacerbation, treatment is carried out as in acute sialadenitis. Outside the exacerbation, the following events are shown:

  • Massage of the ducts with the introduction of antibiotics inside to eliminate purulent masses;
  • in order to increase the secretory activity of the gland, Novocainic blockades are carried out into the subcutaneous tissue, electrophoresis with galanthamine or its subcutaneous administration within 30 days;
  • daily galvanization for 1 month;
  • introduction to the gland of 4-5 ml of iodolipol 1 time in 3-4 months, which prevents the development of exacerbations;
  • receiving 2% solution of potassium iodide inside 1 tbsp. 3 times a day for 30-35 days, the course is repeated after 4 months;
  • radiotherapy on the region of the salivary glands. It has a good anti-inflammatory and anti-infective effect;
  • removal of problematic salivary gland.

Prevention of inflammation

Specific prophylaxis (administration of vaccines) against sialadenitis does not exist, except for mumps. In the latter case, a three-component vaccine is introduced that is effective against measles, mumps and rubella. She is living inactivated. Vaccination do children in 1.5 years.

Resistant immunity is maintained in 96% of children.

Non-specific prophylaxis includes the following measures:

  • standard oral hygiene;
  • rehabilitation of foci of infection in the mouth;
  • prevention of saliva stagnation and infection multiplication in case of common infectious diseases, by ingestion of pilocarpine by mouth, rinsing the mouth with solutions of furacilin, potassium permanganate, rivanol and other antiseptics.

Which doctor to contact?

If inflammation of the salivary gland is suspected, consult a dentist or maxillofacial surgeon. If you suspect a “mumps”, you need to contact a pediatrician, and adults - to the therapist.

These specialists will refer the patient to an infectious disease specialist who deals with the treatment of mumps.

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