Salivary gland treatment. Inflammation of the parotid, submandibular and sublingual salivary glands. Causes of submandibular lymphadenitis

25.03.2016

The salivary glands play an important role in the digestive process. When chewing, food is moistened with saliva produced by the glands. In addition, saliva prevents the penetration of bacteria and viruses, thanks to which the oral mucosa does not dry out.

In the oral cavity there are small large paired salivary glands - sublingual, submandibular, parotid. If inflammation of the salivary gland, otherwise called sialadenitis, appears, the amount and composition of the secreted saliva changes, digestion is disturbed, and the protection of the oral cavity decreases.

Causes of inflammation

Penetrating into the salivary glands, bacteria and viruses cause an inflammatory process. This can happen against the background of viral infections, for example, during the flu or pneumonia.

If the parotid salivary glands are affected by viruses, mumps or mumps develops. The disease is common, especially in children. If it appears in adults, then the treatment becomes more complicated.

Inflammation can be caused by:

• pneumococci,
• streptococci,
• staphylococci.

They are activated against the background of general weakness of the body, reduced immunity.

The inflammatory process can begin after surgery. Anesthesia, administered before the operation, acts depressingly on the work of the salivary glands. If you take care of oral hygiene in time, you can avoid bacterial inflammation.

Often, diseases of the salivary glands manifest themselves in oncology due to reduced immunity. The infection can penetrate into the salivary ducts with inflammation of the lymph nodes, gums, stomatitis, diseased teeth.

There are cases of inflammation in newborns. The reason for this is the cytomegalovirus, which passes through the placenta during pregnancy and infects the fetus.

Symptoms of the disease

Inflammation of the salivary glands is accompanied by unpleasant symptoms:

• the glands are enlarged
• harden,
• hyperemia may occur
• there are pains in the mouth and in the neck.

If the parotid glands are inflamed, then pain in the ear, temple, and head may be felt. Similar symptoms are observed with otitis media, which complicates the diagnosis at an early stage.

There is constant pressure on the inflamed area of ​​the salivary gland. This indicates the accumulation of purulent infiltrate.

Forms of the disease

Acute sialadenitis is of two types: viral and bacterial - depending on what is the causative agent of the disease.

One of the varieties of a viral disease is influenza sialadenitis. Usually appears during or after the flu. There is discomfort in the affected area, acute pain, general weakness, fever. In addition, there is swelling in the area of ​​the gland, the outflow of saliva decreases. The acute period lasts about 7 days, then the symptoms disappear, but the infiltrate remains, which resolves slowly. In this case, a seal is formed, salivation may stop. Proper treatment, even at this stage of the development of the disease, can restore the activity of the salivary gland.

Especially severe forms of influenza sialadenitis are rare. Severe pain occurs, body temperature rises. Purulent fusion and necrosis may occur. The disease, starting in one gland, can go to the steam room. The structure of the gland changes in just a couple of days. After purulent fusion, necrosis begins. Requires surgery.

Influenza sialadenitis develops in most cases in the parotid gland, rarely in the submandibular. In 50% of cases, inflammation of the salivary gland extends to the steam room. Treatment consists in irrigation of the oral cavity with interferon. If there are signs of secondary infection, antibiotics are introduced into the gland. Small salivary glands become inflamed extremely rarely.

With beriberi, impaired water-salt metabolism, violation of the properties of the secretion of the salivary gland, salivary stone disease can develop. Salivary stones form in the sublingual glands. Contribute to their development salivary blood clots or foreign bodies in the duct. Increasing in size, the stone clogs the duct. This is accompanied by severe pain and accumulation of pus. Duct massage, heat compresses, or stone removal are prescribed.

Treatment

If symptoms appear that indicate the onset of inflammation of the salivary glands, you should consult a dentist. With timely treatment, treatment passes quickly.

If pus appears when pressing on the affected area, then a surgeon will be required. In such a situation, the inflamed area is opened, pus is removed and drainage is placed.

If there is an acute form of the disease of the salivary glands, then inpatient treatment is prescribed. Symptoms of a mild form of inflammation are relieved by rinsing the mouth with a solution of soda, furacilin or potassium permanganate. To reduce fever, antipyretic drugs are prescribed.

Physiotherapy helps:

• electrophoresis,
• sollux.

If the inflammation is accompanied by symptoms characteristic of the acute form of the disease - fever, significant abscess, etc. - a course of antibiotics is prescribed. A constant outflow of saliva is required, which contributes to the removal of the bacteria that caused the disease. To do this, it is recommended to include in the diet:

• citrus,
• sour, salty foods
• chewing gum is good.

If inflammation occurs frequently, taking on a chronic form, then antibiotics are injected directly into the salivary gland.

Surgical intervention is required if therapeutic treatment has not worked. Then the iron is removed completely or part of it.

Inflammation of the salivary glands in children

In children, most often, especially during the cold period, epidemic parotitis develops. It is transmitted by airborne droplets, but can also spread through objects. The disease manifests itself in the gland on day 3, and after 7 days, antibodies to this infection are produced in the child's body.

With a mild form of mumps - there is a slight swelling, mild pain, the temperature does not rise. Within a week, the symptoms disappear.

In the middle form, common symptoms appear at the beginning of the disease:

• weakness,
• chills,
• muscle and headache
• the child's appetite decreases
• the temperature rises.
• edema appears
• impaired salivation,
• it becomes difficult to chew food,
• thirst appears.

Improvement occurs in 3-4 days.

In severe cases, both glands are affected. Inflammation from the parotid glands can go to the submandibular glands, which causes the neck to swell, and there are difficulties with swallowing. The development of the disease leads to the release of pus. The child's temperature may rise to 40°C. This form of mumps is dangerous with complications, meningitis, encephalitis, and optic nerve paralysis may develop. The disease is curable, but if the brain and central nervous system are affected, then the prognosis is unfavorable, a fatal outcome is possible.

For preventive purposes, it is necessary to control the condition of the oral cavity, preventing the occurrence of inflammatory processes, and to treat gum disease and caries in a timely manner. Otherwise, the disease can become chronic.

Organs that constantly secrete saliva and moisten the mucous membrane of the oropharynx. The salivary glands of a person secrete 1-2 liters of saliva per day.

Saliva is a transparent, viscous secretion of the salivary glands secreted into the oral cavity. Saliva contains water and inorganic and organic compounds dissolved in it, it also contains digestive enzymes and disinfectants.

In addition to numerous small glands located in the mucous membrane of the tongue, lips, cheeks, hard and soft palate, there are three pairs of large salivary glands (parotid, sublingual and submandibular) located outside the oral cavity and communicating with it by a duct system.

The parotid salivary glands are located in front of and behind the external auditory canal on the chewing muscles and go to the zygomatic arch. The sublingual and submandibular salivary glands are located at the bottom of the oral cavity under the tongue and under the lower jaws. All excretory ducts of the salivary glands open into the oral cavity. The secretion of saliva is regulated by the autonomic nervous system.

Tumors of the salivary glands

More often, tumors occur in the parotid salivary glands, less often in other salivary glands. As a rule, such tumors are benign, affect only the corresponding salivary gland and do not spread beyond its borders. Malignant tumors spread throughout the body. Benign tumors of the salivary glands are often asymptomatic.

Symptoms

Symptoms of malignant tumors of the salivary glands:

• spontaneous or prolonged pain at the site of pressure of the tumor on the nerve;
• ulceration;
• paralysis of the facial nerve.

The reasons

Tumors of the salivary glands arise due to changes and abnormal growth of their cells. The reasons for this growth have not yet been studied. It is possible that the main role belongs to infection. Genetic and external environmental factors have a great influence on the occurrence of tumors.

Diagnostics

In all these cases, you must consult a doctor. The doctor will examine the patient's mouth, feel the face, jaw and neck. Do a saliva test. If a tumor of the salivary glands is suspected, an X-ray examination (sialography), scintigraphy or computed tomography of the salivary glands will be performed.

When a tumor is found, a tissue sample is usually taken to examine and determine the type of tumor. However, even a biopsy is quite dangerous: it can stimulate tumor growth.

Swollen salivary glands can be a symptom of diseases:

Treatment of tumors of the salivary glands

Usually the affected salivary glands are removed. At the initial stage of the tumor, it is possible to remove only part of the salivary gland, but more often the entire gland is removed. If the tumor is malignant, then radiation therapy and chemotherapy are additionally used. With its growth, the cervical lymph nodes are also removed.

Benign tumors of the salivary glands are usually asymptomatic. In the presence of a malignant tumor of the salivary glands, spontaneous pain often occurs, less often - prolonged pain. This pain is the result of tumor pressure on the facial nerve. Over time, as the tumor grows, paralysis of the facial nerve, the occurrence of ulcers, is possible.

There are two main types of tumors of the salivary glands - a mixed tumor (pleomorphic adenoma), which in approximately 60% of cases is located in the parotid salivary gland, and mucoepidermoid carcinoma.

Treatment of both types of tumor is usually successful. The most common is pleomorphic adenoma. Its symptoms: swelling of the parotid, which gradually increases and becomes nodular. Pain and damage to the facial nerve are absent. There are other types of tumors of the salivary glands.

Quite often tumors of large salivary glands meet. Small salivary gland tumors account for only 20% of all tumors. Malignant are: a sixth of all tumors of the parotid salivary glands, about a third - tumors of the submandibular salivary glands, almost all tumors of the sublingual glands and less than half - tumors of the small salivary glands. If malignant tumors are not removed in a timely manner, they metastasize through the lymph and blood to other organs.

Questions and answers on the topic "Salivary glands"

Question:Yesterday, when eating, I stung near the earlobe like a sore throat. This morning, during breakfast - the same thing. And at one point, a bump began to swell in the region of the salivary gland. There was a burst. No temperature. Feeling good. Salivation seems to be normal (but has not yet understood).

Answer: Possible inflammation of the lymph node. You need to see a therapist.

Question:Which doctor should I contact with the following symptoms and what it could be: profuse salivation, inflammation of the submandibular lymph nodes, constant feeling of oscomia and pressure in the ears, burning tongue. Thanks in advance for your reply.

Answer: In this case, it is most likely necessary to conduct an examination of the salivary glands. Dentists deal with this issue. Not everyone has the proper knowledge of the salivary glands, so you need to contact a specific doctor who specializes in this.

Question:What to pass the diagnosis of diseases of the salivary gland (there is a suspicion of salivary stone disease).

Answer: Ultrasound research in the diagnosis of diseases of the salivary glands has occupied a key position in recent years. In this regard, I do not see any restrictions in conducting an ultrasound of the salivary glands for you. When solving specifically the problem of diagnosing salivary stone disease, ultrasound can detect calculi both in the parenchyma of the gland and in the projection of the salivary ducts. New technologies of echography - dopplerography allows to determine the severity of the accompanying inflammatory process in the salivary glands.

Question:Good afternoon! I'm 31, 11 weeks pregnant. This happened for the first time. In the evening, a bulge appeared in the oral cavity, in the region of the upper six, which was not painful to the touch. In the morning, when eating, there was a sharp pain in the area of ​​\u200b\u200bfastening the jaw and swelling that grew before our eyes. The bulge in the mouth increased, a white tip appeared on the edge of the bulge, and the bulge itself became more formed. After 2 hours the swelling subsided. During a consultation with a dentist-surgeon, a diagnosis was made - blockage of the salivary gland. A recommendation was given to the oral cavity, massage the edematous area and eat lemons. And it is said that everything will pass by itself. But at the moment my body temperature has risen to 38 degrees, I have a headache and pain in my eyes. Didn't have parotitis. I rinse my mouth with Glister and lubricate with fucarcin. Please advise what else can be done at home. Maybe take an antibiotic? Really looking forward to your reply. And thanks in advance.

Answer: Unfortunately, without a personal examination of the affected area, we cannot assess your condition and prescribe adequate treatment. You need a personal consultation with a surgeon (not necessarily maxillofacial).

Question:Hello! I had the flu with a complication. Inflamed salivary gland under the chin. I visited an otolaryngologist, he did not see any complications. It still hurts to swallow and replenishment does not come off. What else can be done to reduce inflammation. Thank you!

Answer: With pharyngitis, Imudon is effective.

Question:Hello! My 19-year-old son had a salivary gland adenoma removed. On October 23, the surgeon who operated on him gave a referral to the hospital for the diagnosis of lymph nodes. The surgeon, having touched his neck, immediately made a diagnosis - a relapse, a lesion of the left side of the face and neck. Is it possible to determine the spread of adenoma only by touch? What are the diagnostic methods?

Answer: The presence of a recurrence or primary tumor of the parotid salivary gland can be determined by examination and palpation in most cases. Additional methods (MRI, CT) are not always used.

Question:Hello. I had an operation to remove a pleomorphic adenoma of the salivary gland on the right (the branches of the facial nerve were preserved). It has been almost 10 months since the operation, but there is a thickening at the site of the tumor. On the advice of a doctor, I do periodic ultrasounds. On the latter, the lymph nodes of all groups on the right were enlarged. Plus, a slight temperature rose for a couple of days and the place where the operation was performed was noticeably swollen. Is it possible that the tumor reappeared in the same place?

Answer: Relapses of this disease are quite rare and, as a rule, many years after surgery. Contact the doctor who operated on you.

Question:Good afternoon! 3 weeks ago I had an operation, total removal of the salivary gland, they sent a biopsy for histology, it turned out to be cancer! What are the treatments? Could it be that not all cancer cells were excised?

Answer: Depending on the stage of the disease, after surgery, according to indications, radiation therapy is also carried out.

Inflammation of the salivary gland belongs to the category of rather insidious diseases. There are frequent cases of its almost asymptomatic course at the initial stage of development. Therefore, it is very important to suspect and diagnose the disease in a timely manner in order to conduct surgical treatment.

Large salivary glands are located on the surface of the human oral mucosa. The first pair - parotid - are located under and in front of the auricle and are the largest.

Two submandibular glands are located just below the mandible, and a third pair, consisting of sublingual salivary glands, is localized in the floor of the mouth on either side of the tongue. All salivary glands are occupied with the production of saliva, the process is carried out through special ducts located in the human oral cavity.

Features of the inflammatory process

Inflammation of any of the salivary glands is called sialadenitis. The parotid glands are most susceptible to the disease, less often the inflammatory process affects the submandibular and sublingual glands.

As a rule, the disease develops secondarily, however, cases of the primary form of the disease have also been reported.

The developing inflammatory process leads to a failure in the process of salivation, after which it can cause the occurrence of salivary stone disease, which is more susceptible to the submandibular salivary glands.

In particularly difficult cases, obstruction (blockage) of the salivary duct is observed.

Causes of the disease and provoking factors

The primary cause of sialadenitis is infection. The role of pathogens is played by various harmful microorganisms. The mixed bacterial flora usually found in the salivary glands consists of staphylococci, streptococci, and pneumococci.

Among the provoking factors may also be:

Bacteria and viruses reach the salivary glands through foreign bodies: hygiene items, hard food, etc. In the case of sialadenitis, there is a hematogenous or lymphogenous method of infection.

Symptoms and features of the manifestation of the disease

Regardless of which salivary gland is affected, the symptoms of the disease are the same. Acute sialadenitis at the initial stage is manifested by swelling of the tissues.

This is followed by infiltration, suppuration and completes the process of necrosis of the tissues of the salivary gland. A scar remains at the site of the lesion. Often the acute form of the disease stops its development at the very beginning of the process.

The patient observes the following series of symptoms:

Inflammation of the sublingual gland may also be accompanied by a feeling of discomfort under the tongue and at the time of opening the mouth, pain under the tongue. Pain in case of damage to the submandibular salivary gland is paroxysmal in nature, often severe pain is observed at the bottom of the oral cavity.

As the disease progresses, mucus, pus, and epithelial cells appear in the saliva.

The chronic form of sialadenitis does not express itself so brightly. In the process of growth of the connective tissue in the stroma, the ducts of the gland are compressed, while the latter increases in size, but not immediately. Soreness of the inflamed gland is absent.

Disease classification

Sialadenitis can occur in acute and chronic forms.

Acute course of the disease

The following varieties of the acute form of sialadenitis are distinguished:

In the photo, acute sialadenitis of the parotid gland in a child

1. Contact. The disease can be caused by the development of purulent inflammation of fatty tissue near the salivary gland or be the result of a violation of the integrity of the purulent focus. The patient has swelling and soreness of the affected gland. Possibly difficult salivation with pus. The main preventive measure in the case of contact sialadenitis is to control the state of the salivary glands in the presence of phlegmon in neighboring areas.
2. Bacterial inflammation, which is a consequence of surgery or an infectious disease. As a rule, the disease affects the parotid salivary glands. There is necrosis of the tissue of the inflamed gland, concomitant disorders. There is a risk of transition of suppuration to the peripharyngeal and lateral region of the neck.
3. Sialadenitis, provoked ingestion of a foreign body. Symptoms of the disease are expressed in an increase in the salivary gland, difficulty in the process of salivation, pain. The disease can progress into a purulent phase, accompanied by the appearance of phlegmon and the development of abscesses in the parotid-masticatory and submandibular regions.
4. Lymphogenic occurs due to a weakened immune system. There are mild, moderate and severe forms of the disease. At the initial stage of the development of the disease, only a slight swelling of the affected area is noticeable, with an average degree of sialadenitis, the general somatic state is disturbed, a seal is formed. At the final stage, the patient's well-being worsens, a phlegmon or abscess occurs.

Chronic form of the disease

Depending on the causes of the development of the disease, the following types of chronic form of sialadenitis are distinguished:

Pictured is interstitial inflammation.

1. interstitial. As a rule, it develops against the background of diabetes mellitus or hypertension. In the course of the development of the disease, both glands are affected. There is an early stage of the disease, expressed and late. At the initial stage, the functionality of the glands is preserved, only their soreness is observed. With a pronounced form, the glands increase, remain painful, however, continue to function. At the final stage, salivation is markedly reduced.
2. Parenchymal occurs due to structural changes in the gland and the formation of cysts. The process is accompanied by saliva retention and inflammation. The initial stage of the disease may not make itself felt at all. When a patient has a salty taste in the mouth, the salivary gland swells, one can speak of a clinically pronounced stage of the disease. In this case, a small amount of pus, mucus may be released. Later, the patient has a feeling of dryness in the mouth, salivation is difficult, there is a seal in the parotid region.
3. Sialodochit causes changes in the excretory ducts of the salivary glands. Due to the accumulation of saliva in the ducts, the patient complains of pain in the affected area. Then there is swelling of the gland, salivation with mucus, pain during meals. At the last stage, the function of salivation is disturbed, saliva with pus is released during palpation.

Possible Complications

In the absence of proper treatment of sialadenitis, the following consequences are possible:

• salivary stone disease;
• failures in the process of salivation;
• deterioration in the functionality of the gland;
• phlegmon of soft tissues;
• duct stenosis.

How to treat inflammation?

Treatment of the disease may involve the appointment of antibacterial or antiviral drugs, it depends on the type of causative agent of sialadenitis. In the viral form of the disease, they resort to irrigation of the oral cavity with interferon, in the case of bacterial sialadenitis, proteolytic enzymes are instilled into the duct of the gland.

With an abscess, it is necessary to open the abscess. In the case of strictures (narrowings), bougienage of the ducts of the affected gland is prescribed, with stones, their removal is indicated by one of the methods (lithotripsy, lithoextraction, etc.).

Removal of the submandibular gland with a stone:

In the process of treating a disease, a special place is occupied by physiotherapeutic measures, such as:

• electrophoresis;
• galvanization;
• fluctuorization.

In addition, the patient is advised to follow the rules of oral hygiene. You should brush your teeth twice a day, and use after each meal, you should not forget about dental floss and, of course, stop smoking.

You should also pay attention to the diet. Food should be well chopped, have a soft texture. A plentiful warm drink will help to recover the affected salivary glands - juices, fruit drinks, milk, rosehip broth.

Treatment of the chronic form of sialadenitis, unfortunately, can not always give the desired effect. A cure for the disease is not guaranteed. The patient during the period of exacerbation is prescribed antibiotics and drugs that stimulate the process of salivation. Shown antibacterial therapy, the use of direct current.

Treatment with folk remedies

The traditional method of treating sialadenitis will be perfectly complemented by:

Sialadenitis of the salivary gland is a very difficult disease, the development of which is accompanied by unpleasant symptoms.

Fortunately, modern medicine is able to win in the fight against the disease, however, a lot depends on the patient. Attentive attitude of the patient to their own health is an indisputable guarantee of success.

Each person in the body has 3 pairs of large salivary glands (parotid, sublingual, submandibular) and many small ones, which are grouped on the tongue, inside of the cheeks, lips and palate.

At first glance, it may seem that both the salivary glands themselves are of very minor importance for health, and their diseases are not dangerous at all, which means that you should not pay attention to them.

This is a harmful delusion, since the normal functioning of the salivary glands ensures the health of the oral cavity, plays an important role in digestion and speaking, mineral and protein metabolism.

Therefore, any problem with the salivary glands can be an insidious source of serious health consequences.

Sialadenitis - literally translated from Greek, this means "inflammation of the salivary gland." In this case, both one and all salivary glands at once can become inflamed. With this disease, the iron ceases to perform its functions normally - to secrete saliva, which leads to such unpleasant sensations as dry mouth and difficulty in swallowing.

If you do not pay attention to these alarming symptoms and start the disease, then suppuration or so-called salivary stones may occur in the salivary glands and their ducts. This means that sialadenitis is aggravated by phlegmon (focal purulent disease), sialolithiasis or salivary stone disease, which complicates the treatment itself and exacerbates the prognosis of the disease.

Causes

Sialadenitis is an infectious disease that occurs as a result of pathogenic microorganisms entering the salivary glands..

The risk of inflammation of the salivary glands increases significantly with:

• dehydration and exhaustion;
• fever
• hypercalcemia - elevated levels of calcium in the blood;
• infectious diseases;
• surgical interventions on the abdominal organs;
• injury to the salivary duct (when brushing your teeth or solid food) and its blockage with the occurrence of stagnation of saliva.

The immediate cause of infection of the salivary glands with the subsequent development of sialadenitis are:

• oral bacteria;
• a variety of bacterial infections- staphylococcal, pneumococcal, streptococcal, tuberculosis and syphilis;
• viruses- in particular, human cytomegalovirus, influenza virus and mumps ("mumps");
• actinomycosis- a common fungal infection;
• cat scratch disease- appears due to bites and scratches of cats;
• oncological diseases can also cause secondary sialadenitis.

Once in the salivary gland through the blood or directly through the salivary duct, the bacteria begin to actively multiply, which leads to its inflammation and swelling. Normal salivation is disturbed, which prevents the gland from being cleansed of infectious agents - and the disease is aggravated. Therefore, it is very important to start treating sialadenitis already when its first symptoms appear.

Symptoms of inflammation of the salivary glands

Regardless of which salivary glands are inflamed, the following symptoms are observed at the onset of the disease:

• the gland is enlarged in size, which can be determined by probing it and even visually;
• temperature rise to 37.5 - 38.5 degrees;
• pain when pressing on the affected area;
• general weakness and malaise;
• unpleasant taste in the mouth;
• dry mouth due to decreased salivation;
• redness and swelling in the area of ​​​​the outlet of the salivary duct;
• profuse salivation is less common.

What to do if they constantly appear? Learn about their causes and treatment tactics.

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If adequate treatment is not carried out, then the following symptoms are added to the above symptoms:

• pain when opening the mouth, chewing and swallowing;
• an increase in body temperature up to 40 degrees;
• suppuration of the gland itself: when pressed, purulent contents can be released from the salivary duct, mucus and pus appear in saliva;
• swelling and suppuration of surrounding tissues;
• obstruction of the salivary duct with the subsequent formation of fistulas.

In addition to these unpleasant consequences of untimely treatment of sialadenitis, the disease is fraught with serious complications:

• transition to a chronic form;
• orchitis (inflammation of the testicles) and infertility - the most common consequence of mumps (sialadenitis of the parotid glands of a viral nature);
• necrosis of the salivary gland;
• meningitis;
• encephalitis;
• inflammation of the cranial and spinal nerves;
• damage to the kidneys and urinary tract.

In rare cases, if left untreated, sialadenitis can be fatal.

Types of sialadenitis and diagnosis

A specific type of sialadenitis is diagnosed based on:

• patient complaints of swelling, soreness in the face and neck, difficulty swallowing and chewing, dry mouth and feeling unwell;
• information about chronic and recent diseases, contacts with patients with mumps;
• laboratory studies (general blood count and examination of the contents of the salivary ducts and glands);
• sialogram (x-ray of the salivary glands).

Treatment and prevention of inflammation of the salivary glands at home

Treatment of chronic and acute sialadenitis includes:

• with a mild form of the disease, one can limit oneself to symptomatic treatment, elimination of foci of possible infection in the environment (perform daily wet cleaning and disinfection of housing), rinsing the mouth with a soda solution;
• adherence to a diet that stimulates salivation (more sour, chewing gum, drinking peppermint decoction);
• irrigation of the oral cavity with antiseptics (furatsilin, chlorhexidine, chlorophyllipt);
• analgesia with analgesics, with a severe form of the disease, novocaine blockade can be carried out;
• the use of antihistamines: suprastin, loratadine;
• physiotherapy treatment (UHF, solux, electrophoresis, heating pads, warming compresses and dressings);
• compresses with Dimexide gel;
• antibiotic therapy with penicillin, streptomycin or erythromycin, in severe cases of the disease, antibiotics are injected directly into the salivary duct;
• if the causative agent of the disease is a virus or fungus, appropriate antiviral or antifungal drugs are used;
• surgical intervention: opening the capsule of the gland and duct with removal of the contents or complete removal of the affected gland with the duct.

• observe oral hygiene;
• strengthen immunity;
• timely treat infectious diseases;
• eliminate existing chronic foci of infection (caries, tonsillitis, pharyngitis, stomatitis, etc.).

If the treatment of acute inflammation of the salivary glands was started on time, the disease can be cured well, the prognosis is favorable.

Chronic sialadenitis, unfortunately, is difficult to cure completely. In this case, it is important to prevent exacerbations of its course and the transition of the disease to severe forms.

In any case, if you suspect this disease, a doctor's consultation is the first thing to do. After all, sialadenitis itself is not so terrible as its consequences and complications.

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 often the submandibular and sublingual glands.

The disease develops in both adults and children, although each age group may be characterized by a certain type of sialadenitis, taking into account the causative factor. Depending on the nature of the course of the disease, sialadenitis is divided into acute and chronic.

The main causes of sialadenitis

The cause of acute inflammation of the salivary glands is always the presence of some infectious agent inside the gland. Depending on the pathogen, sialadenitis can be:

1. Viral. It develops when infected with the 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 respiratory mucosa, it penetrates into 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 subsequently lead to infertility.

Perhaps the development of inflammation with.

2. Bacterial, or non-specific. Occurs when an infection is introduced from the oral cavity - through the ducts of the glands, and also 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 operations on the abdominal organs, as well as diseases that lead to general exhaustion, such as malignant neoplasms, chronic diseases of the gastrointestinal tract, stress, malnutrition, and diabetes mellitus. Under these conditions, there is a reflex narrowing of the lumen of the ducts and a decrease in salivation. Saliva begins to accumulate in the salivary gland, which is a good breeding ground for microorganisms present in the oral cavity;
• Due to mechanical obturation, when the duct is blocked by a stone or foreign body. In this case, bacteria from the oral cavity also begin to actively multiply inside the gland, resulting in inflammation.

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

Chronic sialadenitis in most cases are not the result of acute ones (they are independent in their development). This disease is initially chronic, since 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 the result 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 is observed 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 exposure to free radicals and general aging of the body.

Symptoms of inflammation of the salivary gland, photo

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 near the ears, which is aggravated by chewing. Swelling of the parotid gland is clearly visible and spread to the sides, so this disease is called "mumps".

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

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

Serous sialadenitis characterized by dry mouth, soreness and swelling in the ear area, while the earlobe is raised.

The pain is aggravated by eating, and also after reflex salivation at the sight of food. The skin in the region of the gland is not changed. Body temperature may rise slightly. When pressing on the gland, saliva is not secreted at all or very little is secreted.

Purulent sialadenitis 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 spreads to the temples, cheeks, lower jaw.

When pressing on the gland, pus is released into the oral cavity. When probing, the gland is dense, painful, reddening of the skin is observed above it.

Gangrenous sialadenitis can proceed violently, with a rise in temperature, although, with a general weakening of the body, its manifestations can be moderate. Above the gland, a site of destruction of the skin tissue is revealed, through which there is a constant release of the torn off parts of the dead salivary gland.

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

Inflammation of the submandibular salivary gland is characterized by the appearance of swelling in the submandibular region. The gland becomes enlarged, bumpy and very painful when palpated. With an increase in inflammation, the swelling increases, pain appears when swallowing. In the mouth, under the tongue, there is redness and swelling, it is also possible to observe the discharge 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 is the blockage of the duct by a stone, which is formed when a foreign body enters, frequent inflammations in the ducts, and also with an increased amount of calcium in the blood plasma.

Signs of calculous inflammation will be:

1. Sharp stabbing pain, aggravated by eating;
2. Violation of the secretion of saliva;
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 meals, which makes eating uncomfortable, and in severe cases, impossible.

Inflammation of the sublingual salivary gland develops extremely rarely and is a complication of an abscess or dental origin. It manifests itself in swelling and soreness, localized in the sublingual region. The development of suppuration exacerbates the situation.

Manifestations of chronic inflammation salivary glands also differ depending on the shape:

1 . Chronic interstitial sialadenitis in 85% affects the parotid salivary glands. They are more common in older women. For a long time it can proceed 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.

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

2 . Chronic parenchymal sialadenitis in 99% of cases it develops in the parotid gland. Women get sick more often. Due to congenital changes in the structure of the ducts, the age range is very wide - it ranges from 1 year to 70 years. Sometimes the disease lasts for decades without any manifestations.

The exacerbation develops according to the type of acute sialadenitis. The initial stage of the disease can have only one sign - the release of a large amount of brackish mucous fluid when pressing on the gland.

In the future, there may be a feeling of heaviness in the region of the gland, its compaction, salivation with an admixture of pus and lumps of mucus. Mouth opening is free (unlimited). The late stage is characterized by an enlarged and lumpy but painless gland, purulent saliva, and rarely dry mouth as a sign of disease.

3 . Sialodochitis (damage to the ducts only) occurs in the elderly, due to the expansion of the ducts of the parotid salivary glands. A characteristic feature is increased salivation when talking and eating. This leads to maceration of the skin around the mouth (seizures are formed).

With an exacerbation, the gland swells, and purulent saliva is secreted.

Diagnostics

Acute sialadenitis is detected through examination and questioning of the patient. Conducting sialography has not found wide application in practical medicine, because. accompanied by an aggravation of the pathological process with the introduction of a contrast agent. Against this background, pain intensifies.

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

With the interstitial variant, narrowing of the ducts will be detected, and the amount of contrast agent will be small - 0.5-0.8 ml, compared with the usual normal "capacity" of 2-3 ml.

In the parenchymal form, multiple cavities are observed, 5-10 mm in diameter, the ducts and tissue of the gland are not visually determined. To fill the cavities, 6-8 ml of contrast medium is required.

Treatment of inflammation of the salivary gland (sialadenitis)

If 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 is surgical opening of the abscess indicated.

Parotitis

Symptomatic treatment is carried out and interferon preparations, for example, leukinferen, are prescribed. Symptomatic remedies 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, activities such as:

1. Salivary diet. It consists in the use of crackers, sauerkraut, cranberries, lemon, supplemented by ingestion of 5-6 drops of a 1% solution of hydrochloric acid pilocarpine (it promotes reflex contraction of the muscles of the excretory ducts of the salivary gland and secretion);
2. Antibiotics are introduced into the duct - penicillin, gentamicin, as well as antiseptics - dioxidine, potassium furaginate;
3. A compress with a 30% solution of dimexide is applied to the area of ​​\u200b\u200bthe gland, 1 time per day for 30 minutes. It has an anti-inflammatory, analgesic effect, stops the development of infection;
4. Physiotherapy: UHF, heating pads;
5. With increased edema and inflammation - novocaine-penicillin blockade;
6. Inside antibiotics;
7. A solution of trasylol, countercal is administered intravenously.

Surgery - With the development of purulent inflammation, an abscess is opened from the outside. In the gangrenous form, an urgent operation is performed under general anesthesia. If there is a stone, it is removed, because. otherwise, the process will repeatedly escalate.

Chronic sialadenitis

During the period of exacerbation, treatment is carried out in the same way as in acute sialadenitis. Out of exacerbation, the following activities are shown:

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

Prevention of inflammation

There is no specific prevention (vaccination) against sialadenitis, except for mumps. In the latter case, a three-component vaccine is administered that is effective against measles, mumps and rubella. She is live inactivated. Children are vaccinated at the age of 1.5 years.

Strong immunity is preserved in 96% of children.

Non-specific prevention includes the following activities:

• standard oral hygiene;
• sanitation of foci of infection in the mouth;
• prevention of stagnation of saliva and reproduction of infection in common infectious diseases, by taking pilocarpine orally, rinsing the mouth with solutions of furacilin, potassium permanganate, rivanol and other antiseptics.

Which doctor should I contact?

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

These specialists will promptly refer the patient to an infectious disease specialist, who is engaged in the treatment of mumps.