Sialocele

Cyst – the pathological cavity in various fabrics and bodies having a wall and contents.

What is a sialocele?

Sialocele or retentsionny sialocele – cystous education which forms owing to difficulty or complete cessation of outflow of a secret from gland, disturbance of passability of the output channel of gland caused by its obstruction, an injury, the stopper created by the condensed secret. Disturbance of passability of a channel of a sialaden can be also caused by the tumor making the squeezing impact on a channel or the hem significantly narrowing the channel. The cavity at the same time is formed by the collected secret stretching a channel or a ferruterous segment. The wall of a retentsionny sialocele is covered by the flattened epithelium.

The sialocele can have various localization. Depending on type of the sialaden struck with cystous education distinguish:

• Retentsionny cyst of a small sialaden;
• Ranulu (hypoglossal cyst of retentsionny character);
• Cyst of a submaxillary sialaden;
• Cyst of a parotid sialaden (OKZh).

The sialocele most often forms on a mucous membrane of lips, cheeks. Regardless of type of the struck sialaden, cysts in most cases form asymptomatically. Cysts of small sialadens are most often formed, cysts of a parotid sialaden form less often that in particular is caused by localization of glands and probability of their mechanical damage.

Cyst of a small sialaden: origins, symptomatology, diagnosis

The cyst of a small sialaden – the cystous education forming in most cases on an internal surface of an under lip is closer to a mouth corner. Also can strike front sites of a mucous membrane of cheeks. Localization of the cysts affecting small sialadens is caused by the increased risk of mechanical damage of these sites of an oral cavity in the course of meal, a conversation. A cyst of a small sialaden – the small formation of rounded shape which is gradually increasing in the diameter. In most cases the sialocele does not cause disturbance to the patient. In rare instances patients complain of painful feelings at mechanical impact on area of a cyst: at a conversation, meal, a palpation. Usually the cysts affecting small sialadens do not deform a face form.

At inspection the roundish education filled with translucent liquid, the having 2 cm in the diameter is found. The sialocele well acts over a cover mucosal surface. Sialoceles are accurately limited from surrounding fabrics, have a dense elastic consistence, are mobile, painless. Painful feelings can arise at inflammatory process. In most cases the single-chamber cyst on a channel of a small sialaden is found. The multichamber sialocele is in rare instances diagnosed. Sometimes there is a spontaneous opening of the cysts which are formed on a small sialaden at disturbance of integrity of its cover to any effluence of contents in an oral cavity.

At diagnosis of a cyst of a small sialaden education needs to be differentiated with other tumoral new growths of an oral cavity for the choice of the correct treatment.

The following methods are applied to diagnosis of the cyst formed on a channel of a small sialaden:

• Survey;
• Puncture.

Cyst of a parotid sialaden: origins, symptomatology, diagnosis

Cyst of a parotid sialaden – locally limited formation of elastic, rather dense consistence, painless, forming on a channel of a parotid sialaden. This type of cysts of sialadens meets extremely seldom. The cysts forming on a parotid sialaden happen inborn, formed as a result of malformations, and also retentsionny or acquired, forming under the influence of certain external and internal factors. The reasons of formation of a cyst of OKZh can become:

• Obstruction of an interlobular channel of gland;
• Its mechanical damage and, as a result, scarring;
• Chronic inflammation of gland.

The cyst affecting channels of a parotid sialaden is characterized by an elastic consistence and fluctuation. Fluctuation is not defined at a deep arrangement of a sialocele.

At formation of a cyst of a parotid sialaden in a lower part the tendency to distribution of its capsule inside is observed that is caused by an anatomic structure of an oral cavity, than diagnosis and treatment also becomes complicated. Simultaneous defeat of two parotid glands is in rare instances observed.

The cyst of a parotid sialaden is also characterized by asymptomatic development. Painful feelings are observed at formation of abscess. At irregular shapes formation of a cyst can be followed by restriction of an opportunity to open a mouth, a dermahemia.

The cyst of OKZh demands differential diagnosis for an exception of other new growths of a parotid sialaden: lymphadenites, lipomas, bronchial cysts.

Standard diagnostic methods of the cysts affecting sialadens are:

• ULTRASONOGRAPHY;
• Computer tomography or magnetic and resonant tomography in the contrast mode;
• Puncture;
• Aspiration biopsy.

Sialocele: treatment, prevention

When diagnosing a sialocele, treatment assumes surgical removal of education. Depending on localization of a sialocele surgical intervention is made or vnturirotovy access (a cyst of a small sialaden), or extraoral (open access). The second technique is applied during removal of the cyst forming on a parotid sialaden. Removal of a sialocele is carried out under local anesthesia. Respect for hygiene of an oral cavity is the cornerstone of prevention of formation of cysts of sialadens.

At any form of a sialocele, treatment by conservative techniques is not provided.

After removal of various sialoceles to the place of the excised education stitches are put. Within 1-3 days puffiness of the operated area can be observed.

Removal of a sialocele: risk factors

Removal of a sialocele is full-fledged surgical intervention as manipulation assumes full separation of adjacent fabrics and directly removal of the cyst. The main risk during removal of a sialocele consists in possible communication of a cyst with branches of a facial nerve which integrity disturbance inevitably involves paralysis of mimic muscles and distortion of the person. Removal of various sialoceles formed on the surface of a lip or cheek involves smaller risks owing to easier access and superficial localization of a cyst. During removal of a sialocele full removal of its cover in order to avoid a recurrence is important.