Sialadenitis

Description:

Sialadenitis (sialadenitis)  - an inflammation of any sialaden. The sialadenitis can be primary (an independent disease) or is more often secondary (a complication or display of other disease).

In process it can be involved one iron or at the same time two symmetrized; there can sometimes be a multiple adenosis. The sialadenitis flows sharply or chronically, quite often with aggravations.

Sialadenitis reasons:

Development of a sialadenitis is connected, as a rule, with an infection.
Primary sialadenitis presented by epidemic parotitis and a cytomegaly is connected with a viral infection.

Secondary sialadenites cause various bacteria, mushrooms.

Ways of penetration of an infection to gland are various: stomatogenny (through channels of glands), hematogenous, lymphogenous, contact. The noninfectious nature sialadenites develop at poisoning with salts of heavy metals (at their removal with saliva).

The disease is connected with functional disturbance of salivation. Often accompanies a sialolithic disease. Communication salivary and gonads (an orchitis and parotitis) is described.

The disease arises at infectious diseases (flu, etc.), after operations in an abdominal cavity. In these cases the parotid sialaden is surprised more often. At influence of the local reasons (foreign bodys, stomatitises, etc.) process is localized in submaxillary, hypoglossal sialadens.

Pathogeny:

The acute sialadenitis can be serous, purulent (focal or diffusion), is rare - gangrenous. Chronic sialadenitis, as a rule, interstitial productive. The special type of a chronic sialadenitis with the expressed lymphocytic infiltration of a stroma is observed at a dry syndrome of Shegren and Mikulich's disease at which unlike a dry syndrome arthritis is absent.

Sialadenitis symptoms:

Sialadenitis acute purulent (parotitis not epidemic) - a unilateral disease. The shooting pains in the field of gland, irradiruyushchy in an ear, a swelling, temperature increase to 39 C, a lockjaw, the complicated swallowing and even breath are characteristic. Integuments over gland are hyperemic, lose mobility, at a palpation dense painful infiltrate is groped. Because of sharp decrease in salivation are felt dryness in a mouth, a hearing impairment.

At massage of gland from the mouth of channels it is possible to receive muddy, and then purulent liquid.

Treatment of a sialadenitis:

Treatment in initial stages conservative: dry heat, соллюкс, a diet for increase in salivation, antibiotics, in 1% hydrochloride Pilocarpinum solution on 6-8 drops 2-3 times a day. Penicillinic and novocainic blockade of hypodermic cellulose of parotid chewing area (40-50 ml of 0,5% of solution of novocaine and 200 000 PIECES of penicillin), and also infiltration of a submucosal layer on the course of a channel of gland.

At suppurations treatment operational: cuts at an angle jaws, on the channel course. It is necessary to remember a possibility of damage of a facial nerve.

Complications and outcomes.  The acute sialadenitis comes to an end with recovery or transition to chronic. The sclerosis (cirrhosis) of gland to an atrophy of acinar departments, lipomatozy stromas, to decrease or loss of function happens an outcome of a chronic sialadenitis that is especially dangerous at systemic lesion of glands (Shegren's syndrome) as it conducts to a xerostomia.