The sialadenitis submandibular salivary gland: symptoms
Inflammation of the major salivary glands, depending on the nature of the flow can be acute and chronic. Acute sialadenitis is divided into viral and bacterial, chronic – interstitial, parenchymatous, and calculous (salivary stone disease). Each form has characteristic clinic and particularly in treatment.
This disease is caused by paramyxovirus and is the most typical manifestation of sialadenitis in children. The first affects the parotid gland, but then involved in the process of sublingual and submandibular. Due to swelling of the parotid areas, the sick person becomes rounded, and the ears are bent forward because of these changes in appearance of the patient, its called «piggy».
The symptoms of mumps
A few days before the appearance of the characteristic signs of the disease manifest the common symptoms of viral infection: General weakness, headache, fever. Then they are joined by a swelling and soreness in the salivary glands, dry mouth. Favourite localization of viral sialadenitis – parotid salivary gland. Swelling increases, reaching a maximum on the 3rd day from the onset of the disease, then within 7 days, gradually fading away. The increase in body temperature is noted within 4 to 7 days with a tendency to gradual decrease. The emergence of a new wave of fever for 4-5 days, especially in children, indicates the development of complications.
Complications of viral parotitis
Mumps is not terrible in itself, but dangerous possible complications. In children it is primarily meningitis, the frequency of which amounts to 10% of cases. In addition to the new wave of fever, there is severe headache and vomiting, not bringing relief. The treatment is carried out in the neurology Department of hospital for infectious diseases.
In adult men mumps is complicated by the inflammation of the testicle – orchitis is a possible complication in children. Patients who were not on bed rest, it is found 3 times more often than those who have limited movement. Against the background of increasing temperature, there is pain in the testicle and swelling of the scrotum. Required corticosteroid treatment to reduce the likelihood of atrophy of the organ.
It is also possible the inflammation of the pancreas, pancreatitis (severe abdominal pain, persistent vomiting, not bringing relief), the defeat of the middle and inner ear (ringing in the ears, dizziness, impaired coordination) and inflammation of the joints.
Diagnosis and treatment.
To confirm the diagnosis using the technique of isolation of the virus from biological material and determination of the titer of antibodies to its antigens. Treatment of uncomplicated forms of viral sialadenitis of the parotid gland in children and adults is held in the home. It is recommended to stay in bed for 10 days, drink plenty of fluids and diet. To prevent pancreatitis and reduce the amount of white bread, eliminate fatty and fried foods, limit raw fruits and vegetables. With the development of complications, especially in children, may require hospitalization.
Acute bacterial sialadenitis
Bacterial sialadenitis is more common in adults, and in most cases is the worsening of chronic. In children this disease occurs in severe weakening of the immune system and exhaustion. There are two forms of bacterial sialadenitis: serous and purulent.
The symptoms of bacterial sialadenitis
The serous form is manifested by painful swelling of the affected salivary gland, increasing in volume and pain on palpation. When massaging the gland from the duct, a small quantity of turbid thick saliva without any inclusions. The mucous membrane in the region of the excretory duct is red and swollen (of the parotid gland is the cheek at the level of the sixth upper teeth, submandibular and sublingual – submandibular roller).
Symptoms of sialadenitis in the suppurative stage: swelling, sharp pain, redness of the skin over the gland, palpation can feel a buildup of fluid in the tissues. When massaging the gland from the duct of saliva mixed with pus or pus in pure form
Treatment of bacterial sialadenitis
Acute serous bacterial sialadenitis can be treated conservatively with antibiotics and rational physical therapy. With timely start of treatment and proper surgical intervention is not required. Antibiotics, anti-inflammatory and antihistamines, it is recommended that self-massage of the prostate and konohana diet.
Acute suppurative sialadenitis is a collection of pus inside the gland. In rare cases it can be evacuated through a natural duct, prevent swelling and soreness, which does not perform an adequate massage. If 2 days of starting antibiotic therapy, the condition does not improve, the physician performs an incision of the skin or mucous membranes, which ensures the outflow of pus. In this case the pain and restores the function of the gland.
The chronic form of inflammation of the major salivary glands occurs most often in adults as an independent disease or a symptom of systemic lesions of connective tissue, the latter is possible in children. Depending on what tissue is damaged glandular cells or connective tissue matrix — isolated parenchymatous and interstitial forms of inflammation, and chronic calculous sialadenitis.
The nature of the disease is not completely understood, traced the role of genetic, hormonal and autoimmune factors. When this becomes inflamed the connective tissue constituting the frame of a gland. It thickens and grows, eventually blocking ducts and causing secondary lesions of the glandular tissue.
In this case, the first symptom will be an increase in the salivary glands, and other symptoms like dry mouth or burning sensation in the region of the glands when eating appear later. To confirm the diagnosis is sialography – contrast radiography. The treatment is complex involving immunologist, rheumatologist and endocrinologist
In this case actually inflamed glandular tissue and secretory cells and ducts. The first function is suffering, the patient begins to complain of dry mouth, notes the need to wash down the food, swelling of glands in the cold period may not be during a flare-up pattern corresponds to acute bacterial sialadenitis. Treatment is complex.
Salivary stone disease
The reason for the formation of stones in the salivary gland is not known. It is considered that this stems from the characteristics of mineral metabolism, changes in the composition of saliva, the anatomy and function of the salivary ducts. A stone formed in the duct or body of the gland may not show itself until, until he will block the release of saliva and causes inflammation.
This condition, a manifestation similar to acute bacterial inflammation is considered to exacerbate salivary stone disease. Often affects the submandibular and sublingual glands, rarely parotid.
Treatment of salivary stone disease during exacerbation
The main goal of surgical treatment – evacuation of purulent exudate. Under local anesthesia the surgeon makes the incision in the course of the ductless glands and pushes the underlying tissues to give the outflow of pus and to detect calculus. After decrease in acute inflammation, a validation study of the salivary gland, if more stones there – there is no need for further treatment. If the stone during the operation have not been removed or in the gland are more stones needed for the second stage of surgical treatment.
Surgical treatment in remission
Surgical treatment of sialadenitis, accompanied by the formation of stones in the gland is routinely. The volume of the operation depends on the number and location of calculi:
- a single stone in the main duct of the submandibular or parotid gland – removal of calculus;
- chronic calculous sialadenitis with stone formation in submandibular salivary gland – removal of the prostate gland;
- stones in the body of the parotid gland – partial or Subtotal resection of her. In this case, conservative treatment should be as long as possible and proceed to the surgical stage, just making sure its full of failure. Surgery on the parotid gland are considered to be technically difficult because of the risk of damage to the facial nerve and paralysis of facial muscles.