Acute serous sialadenitis of the parotid salivary gland symptoms. How and how to treat sialoadenitis of the submandibular salivary gland
Inflammation of the tissues of the salivary gland has an acute and chronic genesis, is both primary and complicates other inflammatory processes (periodontitis, furuncle, conjunctivitis).
Therefore, sialadenitis of the submandibular salivary gland requires diagnosis and timely treatment.
What is sialadenitis
Treatment Methods
Conservative therapy
It is the main way to treat the disease, includes the fight against an infectious agent, symptomatic and physiotherapy.
Etiotropic
With the established viral etiology of the pathology, antibiotic therapy a course of 5-10 days, depending on the severity of the disease.
Antibiotics are used in standard therapeutic doses orally, intramuscularly and by injection into the excretory duct.
The groups of drugs used include:
- synthetic penicillins (Amoxiclav, Amoxicillin, Ampicillin);
- sulfonamides (Biseptol, Ftalazol, Sulfasalazine);
- III generation cephalosporins (Ceftriaxone, Cefosin, Cefotaxime).
For viral sialadenitis:
- interferon alpha preparations (Altevir, Viferon, Herpferon) by injection into the duct, rinsing the mouth, instillation into the nasal passages for up to 10 days;
- intraductal application of ribonuclease 5-10 mg, diluted in 3-5 ml of 0.9% saline, daily for 5-8 days;
- Oseltamivir 75 mg twice a day for 5 days.
pathogenetic
- Pilocarpine hydrochloride 5-6 drops 3-4 times a day to restore salivation, Prozerin, Neostigmine.
- Anti-inflammatory therapy with drugs from the NSAID group (Baralgin, Ibuklin, Indomethacin). In addition to stopping inflammation, they also have an antipyretic effect, which makes their use rational in the acute period of the disease. With long-term use of NSAIDs (more than 5 days), it is necessary to prescribe Omeprazole 40 mg / day for the prevention of gastropathy.
- Compresses with a 30% solution of dimexide on the area of the submandibular gland for 20-30 minutes 1-2 times a day.
- Novocaine blockade according to Vishnevsky.
symptomatic
- Vitamin therapy with groups C, PP, A (Ascorbic acid, Askorutin, Rutin) has a general strengthening effect, reduces the symptoms of intoxication.
- Rinsing the mouth with antibacterial solutions (Furacilin, Miramistin, Chlorhexidine) 4-5 times a day moisturizes the mucous membranes, fights the growth of microorganisms, and also flushes out food particles that irritate inflamed tissues.
- Antipyretic therapy is carried out in the acute period to relieve fever: Acetylsalicylic acid 500 mg 2 times a day, Paracetamol, Baralgin.
Physiotherapy
Physiotherapy treatment is used for the serous nature of the pathology (viral etiology of the disease) and is aimed at eliminating symptoms, stopping the inflammatory process and restoring the normal outflow of salivary gland secretion into the oral cavity.
- electrophoresis with novocaine, heparin, iodine preparations is carried out daily with a course of 5 to 10 procedures.
- Galvanization– exposure to direct current of low voltage on the skin of the submandibular region, stimulates the restoration of secretory function.
- Fluctuating(exposure to alternating low-frequency currents) in the acute period helps to limit the inflammatory process, prevent the formation of abscesses. It is carried out in 2-3 days within two weeks from the onset of the disease.
- UHF therapy indicated in the chronic course of the disease. The duration of the session is 20-25 minutes, the course accounts for an average of 15 procedures performed every 1-2 days.
Folk methods of treatment
Includes:
- Rinsing the mouth with decoctions of peppermint leaves and lemon peel stimulates salivation, moisturizes the mucous membranes, and has an analgesic effect.
- Rinsing the mouth with a decoction of the leaves walnut, sage, rhizomes of cinquefoil and calendula flowers every 2 hours.
- Compresses from echinacea tincture: dilute 30 drops of a pharmacy form with water in different parts, moisten a gauze bandage in the resulting solution, apply to the skin of the submandibular region for 20-30 minutes 2 times a day.
- A decoction of eucalyptus leaves helps relieve inflammation, take half a glass of warm infusion 3 times a day.
- Area massage mandible to reduce pain and stimulate the outflow of saliva.
Surgery
Indications:- blockage of the duct by a foreign body (calculus, clot of pus, dead tissue or a foreign object that became the initial cause of inflammation);
- abscess localized in the parenchyma of the gland;
- salivary strictures;
- purulent fusion (phlegmon) of tissues;
- gangrenous sialadenitis.
Methods of surgical treatment:
- Bougienage of ducts. It is carried out with strictures and severe stenoses, when an independent restoration of the outflow of salivary secretion is impossible. It consists in introducing a special bougie of the appropriate diameter into the duct and mechanical expansion of the stenotic area. If necessary, the procedure is repeated.
- opening of an abscess localized in the stroma of the gland. It is carried out under intravenous anesthesia, the abscess is opened, the cavity is washed with disinfectants, drainage is installed in the form of a rubber strip and sutures are applied. To stimulate the outflow of exudate, a bandage moistened with hypertonic sodium chloride solution is applied.
- Removal of foreign bodies. It is usually performed under local anesthesia, takes from 5 to 20 minutes, after the procedure is completed, it is injected into the salivary ducts antiseptic drug, broad-spectrum antibiotics (Ceftriaxone, Cefotaxime) are supported.
- Sialectomy - complete removal of the salivary gland involved in the pathological process. It is indicated for frequent relapses of the disease, purulent fusion and ineffectiveness of previous treatment.
The outcome of the disease is favorable: with timely treatment of submandibulitis, recovery is observed after 2 weeks.
With a late visit to the doctor, the lack of proper therapy and non-compliance with the recommendations, the risk of complications increases: the development of strictures, stenosis, and a persistent decrease in the production of salivary fluid.
Sialoadenitis is a disease of inflammatory etiology, which is localized in the salivary glands, manifested for one reason or another (developmental anomaly, traumatic impact, infection). In a situation where the substrate for the occurrence of sialadenitis is an infectious disease, then the diagnosis must indicate its secondary nature of origin.
There are also primary sialadenitis, they are usually noted in pediatric practice and occur due to a violation of the embryogenesis of the salivary glands. Usually, the process of pathology during sialadenitis has an asymmetric unilateral character, however, in world practice there is information about multiple lesions.
The main causes of the disease
In the general structure of this disease, the most common etiopathogenetic method is sialadenitis parotid gland . All the factors why sialadenitis of the salivary gland appears belong to one of two etiological groups (non-epidemic and epidemic group). main reason The appearance of an epidemic form of sialadenitis is considered to be the penetration into the body of bacterial or viral particles that cause a general and local inflammatory reaction.
The appearance of inflammatory changes in the salivary glands, which is always noted during sialoadenitis, is facilitated by the presence in the oral cavity of infectious chronic foci in the form of dental caries. In addition, sialadenitis of the parotid gland of a non-epidemic form may appear as a complication of surgical interventions or other diseases of an infectious nature.
Signs and symptoms of the disease
Acute sialadenitis of the salivary gland is characterized by:
- infiltration;
- the appearance of puffiness;
- necrosis of glandular tissue with replacement by connective tissue and the appearance of a scar;
- purulent fusion.
Not in all cases, the result of an acute process is necrosis and suppuration, as a rule, inflammatory changes subside at earlier stages. If a person has sialadenitis of the parotid gland, then the pathognomonic symptom is the development of a pronounced pain sensation during head movements, as well as opening the mouth. After a while, soft tissue edema passes to adjacent areas:
- submandibular;
- buccal;
- upper part of the cervical region;
- posterior region.
During deep palpation, which is complicated due to severe pain, in the projection of the presumed location of the parotid gland, an infiltrate of a dense consistency is felt. When if a person has a complication in the form of purulent fusion is connected, then a positive sign of fluctuation is noted above the lesion.
A specific symptom of sialoadenitis is hyper- or hyposalivation, with changes in the qualitative composition of saliva (desquamated epithelium, an admixture of pus and flakes of mucus are noted in saliva). Submandibular sialadenitis It is expressed by such signs as pain during swallowing movements, swelling of the sublingual and submandibular region with spread to the cervical part.
except clinical symptoms, a good help for the correct diagnosis is a cytological examination of the secretion of the salivary gland. During sialadenitis, which is provoked by blockage of the salivary ducts by a foreign body, a person may experience different clinical symptoms.
In certain cases, this disease is expressed only by a small increase in the gland, and in others there is extensive inflammation in the form of phlegmon and abscess. foreign body briefly begins to provoke a slight swelling of the submandibular and parotid gland, as well as a delay in salivation. For this form of sialadenitis pain syndrome is not typical.
Purulent inflammation of the salivary gland, in the absence of proper treatment, inevitably provokes the melting of the iron capsule and the spread of the pathology process to adjacent tissues. In certain cases, there is an independent opening of the abscess with the release of a foreign body.
Acute sialadenitis
Most often, the acute form of the disease appears against the background of poor hygiene. oral cavity, disorders of salivation, with neurovegetative reactions, as well as dehydration of the body. parotid gland in this case is the predominant localization of the process of inflammation. Among the local causes of acute sialoadenitis, it is also necessary to consider a malfunction of the gland during a traumatic effect on it, as well as during inflammatory changes in periodontal tissue.
The pathognomonicity and intensity of clinical symptoms during acute sialoadenitis correlate with the localization and inflammation of the pathology process. Serous acute sialadenitis is expressed sharp pain sensations in the projection of the parotid region, which increase during chewing food. The deterioration of the human condition in this disease develops very quickly and is expressed pain syndrome, a feeling of dry mouth and the appearance of febrile fever.
During the examination of a patient with acute sialoadenitis, all the symptoms of inflammation are visualized in the form of pain on palpation, a strong increase in soft tissues at the affected area. During the accession of the purulent nature of the inflammatory process, both clinical symptoms and laboratory tests worsen.
Chronic sialadenitis
Chronic passage of sialoadenitis is a very common phenomenon and in pediatric practice it has at least 15% in the structure of diseases of maxillofacial surgery. Most often noted chronic sialadenitis, which has nothing to do with mumps. Given the prevalence of the pathology process in the salivary gland, it is customary to classify parenchymal (usually prevalent in children) and interstitial sialadenitis.
Many doctors in the field of maxillofacial surgery believe that the appearance of chronic sialoadenitis is due to congenital failure of the glandular tissue. The exacerbation of the disease is steady decline protection indicators human body, which are not restored even during clinical remission, this causes the primary chronic process of inflammation. The specificity of chronic sialoadenitis is its tendency to cyclic passage.
Chronic interstitial submandibular sialoadenitis may be accompanied by narrowing of the ducts, therefore, during radiation imaging methods, a decrease in the intensity of the parenchyma can be observed without any violations of its structure. The use of contrast methods of X-ray examination is possible only during complete remission.
Treatment of a patient with symptoms of chronic sialoadenitis depends directly on the stage of the disease. Thus, during an exacerbation, it is mandatory to use desensitizing agents(Cetrin one tablet once a day), antibacterial drugs(Ampiox at a daily dosage of 2 grams orally). During the onset of symptoms of purulent inflammation, the use of daily instillation of the infected gland is prescribed until saliva analysis for the presence of pus is restored.
Instillation is used with the help of proteolytic enzymes and antiseptics, which promote dehydration and anti-inflammatory effects, as well as lysis of necrotic tissues. For local treatment the use of compresses is prescribed with 40-55% dimexide and ointment compresses. In the role of preventive measures during chronic sialoadenitis, salivation stimulation is used, which can be provided by introducing 1.6 ml of 10% xanthinol nicotinate into the salivary passage. Patients with symptoms of chronic sialoadenitis require medical examination, and the implementation of preventive measures that are aimed at preventing the occurrence of exacerbations.
Sialadenitis: Treatment of the disease
Sialoadenitis of the salivary gland responds well to treatment acute stage disease progression, while chronic treatment is difficult to treat. The pathogenetic treatment of sialadenitis is based on medicines, which enhance the secretion of saliva and its passage through the salivary canal (2% composition of Pilocarpine). In addition, physiotherapeutic methods of treatment in the form of UHF at the site of infection, as well as the use of alcohol-camphor compresses, have an excellent therapeutic property during sialoadenitis.
Non-specific treatment options for the disease include compliance with the rules of oral hygiene by the patient, which implies regular brushing of the tongue and teeth. after every meal using dental floss and brush. Patients should also stop smoking. The organization of food intake, which involves grinding products, increasing the drinking regimen, which helps prevent the transition of the inflammatory process to nearby tissues.
A pronounced reaction of the inflammatory process can provoke a fever, it must be stopped with the help of antipyretic drugs (Nimide in a single dose of 100 mg). For relief of feelings of pain, which often accompanies submandibular sialadenitis, you need to use different massage techniques for the affected area. Chronic sialoadenitis is difficult to treat, and the percentage of full recovery in this case is not more than 25%.
All the methods of treatment used during the chronic passage of sialadenitis are mostly used to prevent the occurrence of complications. The time of exacerbations in chronic sialoadenitis is also due to the appearance inflammatory process in the salivary gland, this makes it advisable to use antibacterial drugs. During remission of this category of patients, a course of galvanization of the salivary glands is indicated. If a person has calculous sialoadenitis, then the use of surgical intervention is justified.
Also surgical intervention is prescribed in cases where there is a parenchymal purulent sialadenitis with symptoms of melting. Operational allowance and scope surgical intervention will directly depend on the degree of damage to the salivary gland and is most often limited to drainage or opening of the gland with the concomitant administration of an antibiotic to the affected area.
Which doctor can help with sialadenitis? If you suspect or have the appearance of sialoadenitis, you should seek help from doctors such as a surgeon and an infectious disease specialist as soon as possible.
Prevention and prognosis of sialadenitis
Most often, the outcome of sialoadenitis is favorable. In acute sialoadenitis, recovery usually occurs within 14 days. In advanced or severe situations, sialadenitis accompanied by congestion of the ducts or cicatricial deformity, necrosis of the gland, persistent violation of salivation. Prevention of the disease consists in maintaining oral hygiene, strengthening immunity, eliminating somatogenic foci of chronic infection, and treating concomitant diseases.
Inflammation of the salivary glands in medicine is called sialoadenitis and has the ICD-10 code - K11.2. Such a disease is of a bacterial nature and is very dangerous, because. in the absence of adequate therapy, it can lead to clogging of the saliva ducts, the formation of stones in them, purulent lesions and destruction of surrounding tissues.
To know when it's time to sound the alarm, read the material below - it will help you navigate and discern the first symptoms of danger, diagnose the pathology and cure it correctly.
A few words about the salivary glands
The oral cavity of each is lined with a mucous membrane, and on its surface there are several pairs of salivary glands:
- parotid: they are located under the auricle and are the largest. They become inflamed more often than others, then sialoadenitis of the parotid gland occurs,
- submandibular: located under the lower jaw and lower dentition. When they become inflamed, submandibular sialadenitis occurs,
- sublingual: they are located to the right and to the left of our tongue.
What do salivary glands do in our body? During normal functioning, they secrete a secret or simply saliva through special ducts located in the mouth. This clear, viscous liquid helps us soften the pieces of food before they enter the esophagus and stomach. Thanks to her, the process of swallowing and digestion goes smoothly. In addition, sublingual saliva produces protective enzymes that help fight pathogenic microflora in the mouth, destroy bacteria and wash off plaque. Thus, it protects teeth and gums from excessive accumulation of cariogenic bacteria, plaque and from development.
If bacteria somehow get into the salivary duct, then it becomes infected and in 42-54% of all cases a person becomes ill with sialadenitis of the salivary gland. The disease can affect one type of gland, it can spread symmetrically, or it can capture absolutely all the ducts located in the oral cavity. And if at the same time a person continues to ignore anxiety symptoms diseases, then saliva simply ceases to be produced in the required quantity, from which the quality of nutrition and digestion begins to suffer, dental problems appear. But let's talk about everything in order.
Why does the salivary gland become inflamed
The main instigators of the disease are always bacteria and viruses that take advantage of weakened human immunity, poor oral hygiene, colds, bad habits and poor nutrition, stress, beriberi, overload at work, and begin to multiply actively. Only now they get into the salivary gland in different ways.
The most common way is through the oral cavity, where a large number of streptococci, staphylococci, colibacilli, and anaerobic flora colonize. Less commonly, bacteria can enter through airborne transmission, through blood vessels and lymph. The risk of getting sick with sialoadenitis, i.e. inflammation of the parotid, submandibular or sublingual salivary glands especially increases in those who during this period are sick or have been ill with caries, tonsillitis, acute forms of SARS and respiratory diseases, tracheitis, periodontitis, furunculosis, mumps (mumps) and even conjunctivitis. Are at risk and people suffering from malignant tumors, endocrinology, diabetes, HIV infection, dysbacteriosis, anorexia.
The disease can also develop if, for example, tissues that are located near the salivary gland are inflamed or have undergone surgery. A pathological process also manifests itself when a blockage occurs in the duct of the gland caused by the ingress of solid food residues or foreign objects, trauma, salivary stone disease (then doctors call the pathology calculous sialadenitis).
Important! Inflammation of the sublingual, parotid or submandibular salivary gland can be triggered by Coxsackie and Einstein-Barr viral microorganisms, cetamegalovirus, herpes simplex, influenza viruses, Koch's bacillus, Mycobacterium tuberculosis, treponema pallidum (occurs in the body against the background of syphilis).
Classifications and forms of the disease
We have analyzed the causes of inflammation of the salivary glands. But due to the variety of factors leading to the disease, doctors distinguish different types of pathology. Naturally, based on the form of sialadenitis, treatment is subsequently prescribed. Therefore, for example, to carry out therapy at home, without going to the doctor, is meaningless. After all, you cannot be sure exactly what provoked the disease.
| Characteristic | Classification |
|---|---|
| By etiology |
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| According to the clinical picture |
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| According to the mechanism of appearance |
|
| By area of localization |
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| By type of localization within one salivary gland |
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| With the flow |
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Symptoms of pathology
Acute sialadenitis leads to enlargement and hardening of the affected salivary gland. It's natural to swell around her soft tissues blush skin. What else does a sick person feel:
- on the part of the body: a weak condition, a person may feel chills, body temperature may rise to a mark of 38-39 degrees, shortness of breath may appear,
- pain: they occur when probing the inflamed area, when opening the mouth, when chewing and swallowing food, when turning the head. The pains are sharp, shooting, can irradiate to the ear, head, neck, temples, frontal lobe,
- in rare cases ear congestion occurs
- taste sensations change or are disturbed: a person loses appetite,
- saliva may stop being produced in the right quantities: dry mouth is felt. In the separated saliva, there is also an admixture of pus, heterogeneity, clots of mucus, it becomes cloudy.
On a note! When a person's parotid salivary glands become inflamed and increase in size, the inhabitants talk about mumps. It is easy to explain this, because outwardly the patient's neck swells and is very similar in structure to the neck of a well-known animal.
If a person ignores the manifestations of the disease and does not treat it, then he is not immune from chronic sialadenitis. Which proceeds with periods of exacerbation, accompanied by minor pain, unpleasant, dry mouth, a change in taste perception.
“Despite the fact that inflammation of the salivary glands has characteristic symptoms, many patients do not look for the causes of its occurrence and do not seek to quickly undergo qualified treatment. And all because pathology is very insidious. Short-term periods of deterioration are replaced by stabilization of the state, total absence symptoms, when the patient feels completely healthy again and writes off everything as temporary difficulties. But the bad thing is that the inflammatory process continues, the microbes living in the ducts make their way further, damage the nervous apparatus, and cripple the renal system. Sometimes they can get to the brain and render a person incapacitated. More often, everything can end with surgery, an abscess, the formation of abscesses, a chronic violation of salivation and necrosis of the affected areas, ”- warns the therapist Simonov K.R.
Who will help diagnose the disease and prescribe treatment
Which doctor should I contact? Depending on the concomitant diseases and the clinical picture, a therapeutic specialist or a pediatrician, a dentist, an infectious disease specialist or a venereologist, a rheumatologist or a phthisiatrician will be able to help the case. Sometimes you can not do without a surgeon.
To confirm the external manifestations of the disease and differentiate it by form, the doctor diagnoses sialadenitis: he can prescribe a biochemical or cytological examination saliva, biopsy and histology. Necessarily in this case, ultrasound and the sialography method are prescribed, when specialists inject a contrast agent into the salivary ducts, which is then displayed using X-rays and allows you to testify to pathological and structural changes in tissues and ducts. With the help of sialometry, the amount of secretion secreted is also determined. The patient is taken for analysis of blood in order to understand the background of what the disease developed.
Important! It is necessary to differentiate pathology from salivary stone disease, from malignant tumors, cysts, monoculosis, lymphadenitis.
Features of treatment
Correct diagnosis of the form of sialoadenitis allows you to prescribe effective treatment. It is good when in the early and acute stages it does without surgical intervention. A set of measures saves the situation:
- treatment of inflammation of the salivary gland with antibiotics,
- antiviral and antibiotic therapy,
- therapy aimed at stimulating the activity of the salivary glands: drugs help well for this purpose penicillin group, "Erythromycin", as well as a change in diet - it includes lemon juice, chewing sweets, sauerkraut, berries,
- antiseptic, resorption of serous and purulent infiltrate, elimination of puffiness and inflammation: "Pyrogenal", "Dimexide", novocaine blockades. Again, penicillin or "Gentamicin", which are directly administered orally and at the same time prescribed in the form of tablets in the most advanced cases. With suppuration, opening and drainage of abscesses can also be shown,
- applying compresses: for example, a 30% solution of dimexide,
- physiotherapy: electrophoresis, galvanization,
- massage.
“My mother is a doctor, so I say for sure that sialadenitis folk remedies cannot be cured. They can only alleviate the symptoms. Calendula, chamomile, yarrow and echinacea are perfect for this. You can simply rinse your mouth with soda solution. For those who do not have allergies, you can try propolis and birch tar.”
Lola, a fragment from the correspondence on the forumwoman. en
Usually, after the start of therapy, the patient's relief occurs after a few days, on the seventh day the disease disappears. But if the pathology has flowed into the chronic stage and is neglected, and is also complicated by the fact that the ducts of the salivary glands are clogged with solid formations, stones, doctors insist on surgery. With the help of a special tool, they crush and remove stones. In some cases, when the rarest, gangrenous form of the disease has developed, one cannot do without the removal of the salivary gland itself.
Large and small salivary glands (hereinafter referred to as SG) are referred to the anterior part of the digestive tract. Due to the fact that they synthesize a special secret (saliva) enriched with a mass of enzymes, SF are directly involved in the digestion of food and ensure a "healthy" state of the oral cavity.
Structure and functions
The anatomy of the salivary glands involves the allocation of small and large, protein, mucous, mixed formations. Large SF are paired organs located symmetrically on both sides of the neck. These include parotid, sublingual and submandibular salivary glands (hereinafter referred to as PSG). The latter are equipped with excretory ducts leading to the anterior sublingual region. These SF are supplied by branches of the facial artery.
PSG perform several important functions in the human body:
- endocrine (synthesize hormone-like substances);
- exocrine (produce saliva);
- excretory (remove metabolic products);
- filtration ("supply" blood plasma components from the capillaries of the oral cavity into saliva).
The PSG secretion formed with the help of enzymes promotes articulation and chewing of food, enhances the taste of food, protects teeth and gums from chemical, mechanical, thermal "attacks", plays the role of local immunity (saliva has antibacterial properties).
Major pathologies
Like any other internal organs of the human body, parotid, sublingual and submandibular SF can be subjected to various diseases. So, for example, a clear leader among the "local" problems is salivary stone disease. Its occurrence is associated with the formation of calculi, sialoliths (stones), which impair the outflow of saliva from the glands.
Sialoadenitis is accompanied by an increase in size, swelling of the PSG, a change in the structure and color of the skin in the affected area, a pronounced pain syndrome (increased during meals)
Such a pathological phenomenon results in the appearance of symptoms of PSG inflammation (sialoadenitis), which include swelling, swelling under the lower jaw, pain that worsens with eating or when pressing on the inflamed gland, an unpleasant putrid taste in the mouth (if suppuration is present), chills , weakness, fever and other systemic signs of inflammation.
Important! The main danger of salivary stone disease (calculous sialolithiasis) is that over time, the calculus can reach a huge size, completely block the discharge of saliva from the gland - it becomes necessary to remove the stone itself or the entire PSG.
An operation involving excision of the submandibular salivary gland is associated with a number of risks and complications:
- the possibility of damage to the hypoglossal nerve;
- injury trigeminal nerve with subsequent violation of facial expressions;
- the development of dangerous bleeding due to trauma to large vessels of the neck;
- scar formation and soft tissue deformity.
PSJ duct stricture is another common disease. The walls of the excretory duct of the salivary gland narrow, the outflow of saliva stops, sialadenitis develops. Mumps - another lesion of PSG - can be of infectious origin (then it is called epidemic) or be a consequence of hypothermia, occur when wounds localized in the oral cavity become infected.
Symptoms of parotitis: an increase in the affected PSG, soreness of the gland, aggravated during meals, general manifestations: fever, chills, weakness, loss of appetite. The disease can proceed in a mild form (only PSG are affected), but in severe cases, the pathology reaches other internal organs. In this case, against the background of parotitis, serious systemic diseases can develop:
- meningitis;
- myocarditis;
- arthritis;
- mastitis;
- nephritis.
Treatment of parotitis is exclusively symptomatic, the main struggle should be aimed at eliminating the root cause (underlying disease) of its appearance.
Diagnosis of diseases of the submandibular gland includes examination and analysis of patient complaints, ultrasound, CT scan of the neck
Other PSG diseases:
- saladenitis;
- obstructions (eg, polyps);
- Sjögren's syndrome;
- sialdochit;
- sialosis of hormonal, neurogenic and autoimmune origin;
- Mikulich's disease.
Dobro- (adenomas) and malignant tumors(cancer) also do not "bypass" the submandibular glands. Symptoms and prognosis for such pathologies depend on the shape, size, stage of development and localization of the neoplasm.
Signs and treatment of PSG sialadenitis
It is the inflammatory process in the submandibular gland that is the most common pathology that develops in this area. The culprit of sialoadenitis may be the formation of a stone in the duct (or its stricture), metabolic and hormonal failure in the body, infectious infections. Sialoadenitis can be of bacterial, viral, fungal origin. Diagnosis of sialadenitis involves an analysis of the patient's complaints, ultrasound, CT, and, if necessary, other laboratory and instrumental studies.
The course of the inflammatory process is accompanied by bursting, pain of varying severity, localized in the gland itself and radiating to the ear, neck, temples. The amount of secretion synthesized decreases, the saliva itself becomes viscous, dryness is felt in the mouth. In the presence of suppuration, an unpleasant putrefactive odor from the mouth occurs, purulent exudate can flow into the sublingual region.
Inflammation should be treated comprehensively. First of all, the patient must adhere to the so-called acid diet to stimulate the secretion of the submandibular gland. The menu is recommended to be enriched sauerkraut, cranberries, any other sour foods.
Drug treatment of sialoadenitis of the submandibular salivary gland without fail includes:
- taking antibacterial, antiviral, antifungal drugs (depending on which pathogens provoked the inflammatory process);
- washing the cavity of the gland with an antiseptic solution (carried out using a catheter);
- introduction into the oral cavity of a 1% solution of Pilocarpine to relieve spasm of the PSG duct;
- compresses with Dimexide (applied outside to the inflamed focus);
- novocaine blockade (only for chronic sialadenitis).
Treatment of PSG inflammation is also carried out by physiotherapeutic methods: UHF, electrophoresis, galvanization, with the help of massage (stimulation of secretion production). In case of suppuration, abscess, PSG is opened to accelerate the outflow of exudate, drains are installed, washed with antiseptic and anti-inflammatory compounds.
For treatment, it is necessary to differentiate the pathological condition
Additional measures
At home, you should rinse your mouth with a solution of Furacilin, manganese or ordinary baking soda (with a mild form of inflammation). Hyperthermia is an indication for taking antipyretics (Paracetamol, etc.). Compliance with simple rules will help speed up the recovery process with sialadenitis of the submandibular gland: bed rest, eating liquid or viscous food, enhanced drinking regimen, combating the symptoms of intoxication, carrying out manipulations aimed at stimulating local and general blood flow.
The success of treatment and the prognosis will depend on the intensity of the inflammatory process, the causes of its occurrence and common features the patient's body. With untimely measures taken, sialadenitis can turn into an abscess and sepsis (blood poisoning) - life-threatening conditions.
Prevention
To prevent any disease of PSG, it is necessary to carefully monitor the condition of the oral cavity, eliminate dental problems. Equally important is a balanced diet and a reasonable drinking regimen. Regular exercise and other activities aimed at strengthening the immune system will allow you to “tighten up” your health in general and avoid diseases of the salivary glands of various nature, in particular.
Inflammation of the parotid gland is a common disease that requires urgent medical attention. The article discusses the main reasons clinical manifestations, methods of diagnosis and treatment of the presented disease.
General information
The structure of the glands
Parotid salivary gland is a paired organ that performs secretory function. The glands are below auricles, on the lateral lower jaw, in close proximity to the posterior chewing muscles.
An inflammatory disease in which the submandibular parotid glands are affected is medically called mumps. This disease is a type of sialadenitis (inflammation of the salivary gland).
Sialoadenitis develops mainly through the spread of the inflammatory process from the Stenon's papilla - the duct through which the produced salivary fluid enters the oral cavity.
Sialoadenitis is included in the ICD 10 in the group of salivary fluid diseases (K11) under the code value K11.2. However, parotitis is excluded from this group, as it is referred to the group of viral diseases (code - B26). This is due to the fact that the most common form of mumps is provoked viral infection.
Causes of inflammation of the parotid salivary gland
How it looks outside
Mumps is an infectious disease caused by paramyxovirus. Pathogenic microorganisms affect the glandular epithelium, which makes up the salivary gland. The virus is transmitted by airborne and contact routes.
Other possible causes of inflammation of the gland include:
- Acute infectious diseases (flu, measles, typhus)
- Violation of oral hygiene
- The presence of a carious source of infection
- Associated diseases of the oral cavity
- Tissue damage in the area of the gland
- Exposure to harmful chemicals
Parotitis can also be provoked by diseases gastrointestinal tract, due to which the activity of the salivary ducts is disturbed. The duct of the gland narrows, as a result of which stagnation of saliva develops. There is an active reproduction of bacteria that cause inflammation.
At-risk groups
And this is what it looks like from the inside
Most often, parotitis develops in childhood. This is due to the increased sensitivity of the body to infections. In addition, while in preschool educational institution or at school, the child is in constant contact with other potentially ill children.
Also at risk include:
- smokers
- People who abuse alcohol
- People with reduced immunity
- Patients undergoing major surgery
- Residents of ecologically unfavorable regions
In general, inflammation of the parotid salivary gland develops due to the influence of pathogenic microorganisms.
Clinical manifestations
Inflammation is accompanied by pain.
When an infection occurs, average term incubation period is 14-16 days. During this period, pathogenic microorganisms spread throughout the body through the blood. In adults, the first symptoms of the disease occur 1-2 days before the onset of symptoms characteristic of mumps.
Early symptoms include:
- Joint pain
- Pain in the muscles
- Chills
- Fatigue
- Dry mouth
- Headache
These symptoms are provoked by the impact of infection on the body. Often the initial stage of parotitis is mistaken for other infectious diseases, as a result of which ineffective therapeutic procedures are performed.
In the acute stage, the following symptoms occur:
- Heat
- Pain on palpation in the parotid region
- Pain when chewing food
- Noise in ears
- Swelling at the site of inflammation
- Decreased salivation
- Bad taste in the mouth
Important to remember! Inflammation of the parotid salivary gland is accompanied by fever and general malaise. However, sometimes the disease can occur without such symptoms. In this case, inflammation is diagnosed due to external symptoms.
External manifestations
A patient with mumps develops swelling in the area of inflammation. In most cases, the gland becomes inflamed on one side, so the asymmetry caused by the tumor is pronounced. The skin in the affected area is hyperemic.
With a strong increase in glands, narrowing is possible ear canal. When opening the mouth, the patient experiences difficulty and discomfort.
Only a specialist can diagnose a disease based on external signs. Independent attempts at diagnosis and treatment can lead to serious complications.
Forms of the disease
Inflammations of the parotid salivary glands are classified depending on the form of the course and type. A detailed classification is presented in the table.
| Form of pathology | Description |
| Chronic parenchymal | Chronic inflammatory process occurring in the parenchyma. Differs in the protracted nature of the flow. Relapses develop with a frequency of 2-3 months. Accompanied by compaction of the parotid glands, pain, symptoms of intoxication. |
| Chronic interstitial | Growth of connective tissues in the region of the glands, as a result of which the parenchyma is pinched. Atrophy of the salivary ducts develops, which are covered fibrous tissue. It is characterized by a long course. Swelling in the area of the gland gradually increases over several years. During remission, the salivary glands decrease, but do not return to normal size. |
| Acute lymphogenous | It develops against the background of inflammation of the intraglandular lymph nodes. As a rule, it develops against the background of concomitant infectious diseases, including those affecting the nasopharynx. It is accompanied by the formation of a seal in the region of the gland, but there are no general symptoms characteristic of mumps. |
| Acute, accompanied by blockage of the ducts | Inflammation of the glands, in which the patency of the salivary ducts is impaired. It is considered a complicated form of parotitis. Due to blockage, a cavity is created in which saliva accumulates, which is the optimal condition for the development of infection. Dryness in the mouth, severe pain, reddening of the tissues of the oral cavity in the area of the ducts, and the growth of purulent formation may indicate the presence of blockage of the duct. |
| Acute contact | It develops with the spread of the inflammatory process against the background of the growth of phlegmon in the parotid region. Pathology proceeds, as a rule, in a mild form. |
| Viral | It is the most common form of mumps. It is characterized by a moderate course. Occurs when a viral microorganism enters the body. The acute stage lasts, on average, 4-5 days, after which the intensity of symptoms gradually decreases. |
| Calculous inflammation of the salivary glands | Also called salivary stone disease. Accompanied by the formation of stones that prevent the full outflow of saliva. As a result, the reproduction of bacteria that provoke inflammation is activated. |
Thus, several forms of inflammation of the parotid glands are distinguished, differing in the mechanisms of occurrence, the nature of the course, symptoms and methods of therapy.
Diagnostics
Palpation of the glands
If symptoms appear, you should contact your dentist. You may also need to consult a general practitioner, rheumatologist, infectious disease specialist. Diagnosis and treatment of inflammation of the gland in childhood is carried out by a pediatrician.
The diagnosis is made by examining the patient, asking for symptoms. A number of diagnostic procedures are used to determine the causes of the pathology.
These include:
- Ultrasound of inflamed glands
- Laboratory analysis of salivary fluid
- polymerase chain reaction
- CT and MRI of the skull
- Sialographic examination
The use of such methods makes it possible to determine the nature and possible reasons pathologies, and due to this, to prescribe effective treatment.
Treatment
For sialadenitis and mumps, various treatments are used. The therapeutic course includes drug therapy aimed at eliminating the causes and symptoms of the disease, physiotherapy, auxiliary methods of treatment.
Medical treatment
For therapeutic purposes, the following agents are used:
- Antibiotics. In the bacterial form of sialoadenitis, broad-spectrum antibiotics are prescribed. The method is expedient only in severe forms of pathology. For therapeutic purposes, the drugs Streptomycin and Benzylpenicillin are used.
- Drugs that increase salivation. Designed to prevent blockage of the ducts. In addition, salivary fluid is an aggressive substance for many bacteria, and therefore has a disinfecting effect. Pilocarpine is used in the treatment of mumps.
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- Painkillers, anti-inflammatory drugs. Used for purposes symptomatic therapy. Patients may be prescribed Paracetamol, Analgin, Ketanov, Ibuprofen, Nimesulide, Solpadein.
Local therapy
It is carried out using solutions for rinsing, antiseptic rinses for the oral cavity.
In the treatment of inflammation of the salivary glands can be used:
- Chlorophyllipt
- Furacilin
- Chlorhexidine
- Triclosan
- Peroxide
- Rotokan
Important to remember! Medicines for local treatment of the oral cavity must be used in strict accordance with the instructions.
Physiotherapy
Physiotherapy procedures are used for both acute and chronic sialadenitis.
Treatment procedures:
- Galvanization
- UHF therapy
- electrophoresis
- Fluctuating
Helper Methods
Injection blockades are applied on initial stages pathology. 40-50 ml of novocaine solution in combination with penicillin is injected into the parotid subcutaneous tissue.
To improve salivation, pilocarpine injections are made.
To relieve symptoms, compresses containing dimethyl sulfoxide, a potent anti-inflammatory agent, are put.
Diet food
In the treatment of sialadenitis and parotitis, the patient is prescribed a diet that includes foods that enhance the secretion of saliva. Patients are advised to consume acidic foods, citrus fruits. To eliminate the symptoms of intoxication, it is advised to drink milk, rosehip decoctions, juices, fruit drinks, teas.
- Apples
- oily fish
- sea kale
- Walnuts
- Carrot
It is advised to remove foods containing a large amount of sugar from the diet, as well as smoked meats, canned food, and spicy foods.
Folk methods
In the treatment of inflammation of the parotid gland, the following methods can be used:
In general, many different methods are used in the treatment of inflammation of the salivary gland in the parotid region.
Features of treatment in children
Treatment of parotitis and sialadenitis in children is performed by conservative methods. Antibiotics and antiviral drugs are used only when signs of complications occur. Treatment of parotitis is reduced to the elimination of the main symptoms.
The complex of therapeutic measures includes:
- Bed rest
- Taking antipyretic drugs
- Antiseptic treatment of the oral cavity
- Creation of favorable climatic conditions in the room
- Power correction
- Physiotherapy procedures
With purulent inflammation of the gland is prescribed surgery, which consists in opening the focus. With a burdened course of sialoadenitis, removal of the inflamed gland may be prescribed.
Complications
Chronic sialadenitis
The most common complication inflammatory disease is the transition to the chronic form of the course. Pathology is accompanied by the systematic development of relapses against the background of certain factors (a sharp decrease in immunity, concomitant diseases, intoxication of the body).
TO possible complications include the formation of an abscess in the oral cavity, the spread of inflammation to other salivary glands.
With viral parotitis, the following complications can occur:
- Orchitis
- pancreatitis
- Infertility
- Hearing disorders
- Meningitis and encephalitis
- Diabetes
- Arthritis
- kidney damage
- Inflammation of the myocardium
Attention! Timely diagnosis and treatment significantly reduce the risk of severe complications.
Prevention
Preventive measures are aimed at eliminating the factors that provoke inflammation of the salivary glands.
The main preventive measures:
- Compliance with oral hygiene
- Timely treatment of caries, gum disease
- Timely treatment of infectious diseases (especially tonsillitis, pharyngitis, laryngitis, stomatitis)
- Preventive vaccination against mumps (performed at the age of 1.5 to 7 years)
- Isolation of patients with mumps
Inflammation of the parotid salivary gland is provoked mainly by mumps, a disease of viral origin. Also, inflammation can develop against the background of bacterial sialadenitis. The presented diseases are accompanied by severe swelling in the parotid region, pain, signs of intoxication, and general malaise. Treatment methods are varied, and are prescribed in accordance with clinical picture and individual characteristics of the patient.