Inflamed salivary gland under the tongue. Basic methods of treatment. Inflammation of the salivary gland, description, types

866 02/13/2019 5 min.

There are a lot of reasons for pain under the tongue - the problem can be in a damaged frenulum, an inflammatory process in the oral cavity, muscle and soft tissue injuries. That is exact reason only the doctor will call according to the results of the examination, and you should contact him as soon as possible. As for treatment, it depends on the underlying cause of the symptom and includes both medication and topical treatment of the affected tissues. More details regarding the causes and elimination of pain under the tongue later in the article.

Causes

The cause of the tumor under the tongue can be both damage to the frenulum and inflammation of the salivary glands. Only a specialist can correctly determine the cause.

The main causes of inflammation under the tongue:

Bridle injury. The short frenulum is more often injured, but the usual one can be easily damaged during a conversation, such an infectious disease of the oral cavity as stomatitis (usually accompanied by wounds and ulcers) has a negative effect on its condition. Gently move your toothbrush during hygiene procedures.
Angina- accompanied by active reproduction harmful microorganisms on the oral mucosa. The infectious focus may grow, and the inflammation will begin to move into the sublingual zone. Especially dangerous is acute tonsillitis, in which it is difficult to chew, swallow, and even just stick out your tongue.
Dental diseases– dental problems need to be treated on time, because even the usual can eventually develop into serious pathology, including soft tissues oral cavity.
or phlegmon- pus accumulates in the area of inflammation (especially often - in the area of \u200b\u200bthe tongue). The main causes of the purulent process are acute periostitis, periodontitis.
Inflammation of the salivary gland. Under the tongue is a large gland that produces saliva. If an infection gets into it, pain appears.
Violation of the symmetry of the hyoid bone- most often it congenital anomaly, but the symmetry can also change as a result of traumatic impact.
Allergy- some allergic reactions develop instantly and are very dangerous to health (for example, Quincke's edema). Edema progresses very quickly, without proper medical care a person can die. The pain is strong.
Injuries- vessels, nerves and tissues are damaged, blood accumulates between muscle fibers, nerve fibers are injured, severe pain appears. Similar symptoms can be observed with.

If you not only have pain under your tongue, but also develop severe swelling, seek medical help immediately.

Symptoms

While the pain syndrome is not very pronounced, it is difficult to determine the problem. The following symptoms should alert you:

A swelling appears under the tongue, which then begins to gradually turn into edema.
Sensitivity of the swollen place develops.
Pus, cloudy saliva is released from the duct.
Body temperature rises - up to 40 ° C.

When the swelling increases, there are problems with chewing food, speech activity. The doctor must conduct an examination, take tests from the patient and make a diagnosis, accurately determining the cause of the disease. And remember that the longer you delay visiting a specialist, the worse the consequences can be.

How to identify inflammation of the salivary glands

The sublingual glands are among the largest glands in the oral cavity (along with the parotid and submandibular glands). Soreness in the area under the tongue can occur if something is wrong with them. The salivary glands are affected against the background of a closed excretory duct for saliva, as a result of which saliva accumulates in the tissues, penetrates into the ducts and provokes the development of infectious lesions. The main causes of blockage of the ducts are typhus, influenza, pneumonia, operations on the oral cavity, blockage by a stone.

As you can see, both the causes and the consequences are very serious, so you should consult a doctor immediately. If measures are not taken in time, phlegmon or abscess may develop. The characteristic symptoms of inflammation of the salivary glands are swelling, pain, bright red color and a pronounced shine of the affected area. Muddy saliva with pus may accumulate in the sublingual zone. Soreness and intensity of the pathological process will constantly increase.

If the excretory duct is closed due to blockage by a stone, surgery is required.

Treatment

When anxiety symptoms contact a doctor who will conduct a comprehensive diagnosis and establish the cause of the pathology. Treatment is prescribed only after the factors that caused the disease are determined.

In case of inflammation and injuries of the frenulum, rinses with antiseptics are prescribed, which remove pathogenic bacteria from the oral cavity and stop the inflammatory process. The simplest options are a solution of soda and furatsilin. You can use special medicines:

stomatofit-10 ml of tincture dilute in 50 ml of water;

Romazulan- concentrated infusion chamomile. For 1 liter of water, take 2 tablespoons. The drug is suitable for children;
Chlorophyllipt – alcohol tincture eucalyptus. For rinsing, take a tablespoon of the product in 300 ml of water. Children can use. Note that it is often used;
Calamus tincture- Dilute 5 ml of alcohol tincture in 100 ml of water;
Stomatidin, Geksoral- medicinal preparations of plant origin to hexidine. Strong antibacterial, antiseptic agents that do not need to be diluted. Efficiency is high;
Iodinol or blue- ready-to-use solution, which is prescribed for wiping the oral mucosa. This drug is also often used in the treatment of stomatitis. Read more details on how to apply silk for stomatitis.

Rinse your mouth every time after eating, since the solutions can be toxic, you can not swallow them. You can't eat or drink for half an hour after the procedure. You can replace pharmacy remedies with folk remedies - for example, a solution of salt and soda, cabbage juice (diluted with water 1: 1), parsley juice (wipe the inflamed area).

The most dangerous pain under the tongue is on the left or right. It most often indicates a purulent inflammatory process.

If everything is fine with the frenulum, but there is pain or swelling, contact your dentist for a diagnosis. Possible reasons inflammation - problems with teeth, destructive processes in the salivary gland, lymph nodes purulent processes. Do not self-medicate, because you can only aggravate the situation and waste time.

Possible Complications

Most severe complications develop as a result of progressive inflammation of the salivary glands. The pathological process can affect the submandibular, sublingual, parotid glands. Do not ignore it - the inflammation itself rarely goes away, and over time it can cause severe complications - neuritis, nephritis, myocarditis, meningitis, pancreatitis, encephalitis. In some cases, one or more teeth may become numb. For more details on why teeth go numb, see.

Take good care of your health early stages any pathology is easier to identify and cure without unnecessary complications. Otherwise, pain in the area of the tongue simply significantly worsens the quality of life - it interferes with normal speaking and chewing, and causes a lot of purely physical inconvenience.

Preventive measures

It is much easier to prevent inflammation of the sublingual zone than to treat it later (especially in advanced cases). Regular check-ups at the dentist, refuse too hard food, rinse your mouth after eating. An elementary set of rules for oral care is not difficult to follow and will protect you from many problems in the future. Read more about ways to prevent dental caries.

Bad habits - smoking and regular alcohol consumption - have a negative impact on the condition of the oral mucosa. But eating more spices and just chewing citrus slices is very useful.

Treat in a timely manner dental diseases- because even a banal caries over time can lead to very unpleasant consequences.

Video

For more useful information regarding the symptoms and treatment of inflammation of the salivary glands, see the video.

Conclusion

Inflammation of the sublingual region can occur as a result of injuries of the frenulum, tonsillitis, dental diseases, phlegmon or abscess, dynamically progressing allergic reaction, violation of the symmetry of the hyoid bone, problems with the salivary gland. The sooner you start treatment, the simpler, faster and more effective it will be. Therapy should be prescribed by a doctor, taking into account the causes that caused the pathology. You may also be interested in learning about treatments.

During the scan of the gland, the accumulated saliva in the ducts is determined as a moving mass.

When chewing food, salivation is stimulated, which makes the symptoms worse. Since the ducts are blocked, saliva cannot be completely expelled and thus compresses the area of inflammation, swelling and pain increase. It turns out a vicious circle.

Signs of chronic sialadenitis

Nonspecific chronic sialoadenitis is often secondary to ductal obstruction. In elderly patients, decreased salivary secretion and retrograde infections may lead to gradual diffuse dilation of the salivary glands. This is often seen after radiation therapy,.

Below is a photo of inflammation of the sublingual salivary gland

In chronic cases of inflammation, the glands become fibrous (the glandular tissue is mixed with connective tissue) and dense.

Signs of acute sialadenitis

Acute sialadenitis begins with acute pain in the sublingual region, which is aggravated after chewing movements. Deterioration develops rapidly and is characterized by:

dry mouth;
sharp pain;
fever.

During the examination, all signs of inflammation are diagnosed as a rapid swelling of the soft tissues in the affected area.

When pressing at the angle of the lower jaw, there is a sharp pain, which is one of the pathognomonic (characteristic) symptoms of the disease. When examining the mucous membrane, the second characteristic feature of acute sialoadenitis appears - tension and congestion (cyanosis, redness and swelling).

Inflammation of the sublingual salivary gland: treatment

An important goal of diagnosis is to combat the main signs, and only then - with secondary ones. If inflammation of the sublingual gland is associated with bacterial infection antibiotic therapy is recommended. Painkillers and anti-inflammatory drugs are taken if the disease was caused by viruses. At viral nature diseases, an antiviral treatment regimen and a salivary diet are prescribed.

Good oral hygiene speeds up healing. Thanks to the so-called salivary stimulants, an increased secretion can be obtained, which is a good way to cleanse the salivary glands. In addition, the stones present on the way can be washed away. Classically, acidified drinks, chewing gum, and hard candies are thought to have a salivary effect.

Treatment of calculous sialadenitis on initial stage most often performed with gland massage or extracorporeal shock wave lithotripsy. Ultrasonic waves are directed at the salivary stones, as a result of which they break up and it becomes easier for them to come out. If a ultrasound therapy is only partially successful, large remnants of stones must be removed endoscopically or surgically.

When diagnosing a malignant cyst or tumor, the only treatment option is to remove the neoplasm and nearby affected tissues.

Treatment with home remedies

In some cases, it is possible to avoid medical treatment of the salivary gland under the tongue. Some lifestyle changes may be helpful folk remedies. The basic rules of therapy include the following tips:

to drink a lot of water;
stimulate the flow of saliva by drinking lemon juice, chewing gum or using lozenges;
apply warm compresses to the inflamed areas;
rinse your mouth with warm salt water, three times a day - useful for relieving pain and swelling;

To prepare the rinse solution, pour hot water into a glass and then add ½ teaspoon of salt. After that, wait for the salt to dissolve completely and use the solution for its intended purpose.

stop smoking;
massage the inflamed gland, which will help improve the outflow and salivation.

At the same time, the chronic type of the disease is difficult to treat, and the percentage of complete recovery does not exceed 25%. All of the treatments used for the chronic type of inflammation are largely used to prevent further development complications.

Salivary glands in humans are not so small. Two parotid (one at each ear), two submandibular (on each side under the lower edge of the jaw) and two sublingual. In addition, there are many different small glands in the sky, cheeks, tongue, lips, mucous and submucosal of the mouth.

And each of these salivary glands one far from perfect day can become inflamed, bringing a lot of trouble to its owner. This condition will be called sialadenitis. BUT special case inflammation of the parotid salivary gland is called mumps. We will talk about inflammation of the salivary glands, symptoms and treatment of sialadenitis further.

Why do they get inflamed

The culprits of inflammatory changes are most often:

When an infectious agent enters the salivary gland, the mucosa swells, the duct that excretes saliva narrows, a clear or purulent fluid accumulates in it, and salivation becomes difficult. With the continued existence of such a situation, the gland gradually atrophies or scars, ceasing to produce and secrete a sufficient amount of saliva.

The infection most often penetrates through the mouth of the duct, less often with the flow of blood, lymph:

on the background respiratory infections pharynx, trachea, periodontitis, skin boils
or by contact from nearby areas (with purulent diffuse inflammation of soft tissues).

The causes of inflammation of the salivary glands in 30% of cases are mumps viruses (or mumps).
In addition to the infectious process, gland damage can be included in the program of rheumatic diseases (Sjögren's syndrome)
and radiation damage.
Up to 40% of all inflammations are due to dentistry.

Acute sialadenitis is often infectious.

Chronic inflammation involves the gland tissue itself (parenchymal), its connective capsule (interstitial) or duct in the process. In this case, the disease lasts more than 3 months with periods of peak and remission of inflammation.

What can be seen

The acute process is characterized by the following manifestations:

Edema appears at the location of the inflamed gland,
It is painful and tight when pressed.
If you massage the gland, pus may be released from its duct.
The mouth dries out due to a small amount of saliva, or vice versa, saliva flows all the time.
The temperature may rise.

The pain that the patient feels is located in the projection of the affected gland, can be given to the ear, neck, lower jaw, oral cavity (damage to the submandibular salivary glands). They are oppressive, bursting in nature.

Factors contributing to sialadenitis:

dehydration,
high calcium content in the blood (stones of the ducts of the glands can form, clogging them).

The chronic form of the disease often leads to scarring and atrophy of the glandular tissue, due to which the production of saliva drops significantly, swallowing and speech become difficult.

Interstitial sialadenitis is characterized by painless swelling of the gland. They are more likely to affect people over 40 with immunity errors (diabetes mellitus, hypothyroidism). At the beginning of the process (the process is often symmetrical), the glands are densely elastic, then they become denser. Dry mouth may appear, a drop in efficiency. In exacerbation, pain appears, aggravated by cold.
The parenchymal variant is more often congenital. There is also periodic swelling, salivation with an admixture of pus, with a gradual drop in the level of saliva production.
The ductal variant develops both against the background of a wider congenital duct, and as a result of its acquired expansion (in trumpeters, glassblowers), usually in old age. Do not discount and foreign bodies in the duct, which often give symptoms of inflammation of the submandibular salivary gland. Usually the disease begins suddenly with bursting pain and its increase, more often after eating. When pressed, a secret is released. When the bacterial flora is attached, the temperature rises, swelling increases, and pus is released.

Most formidable complication such a pathology is abscess formation (the formation of a limited abscess at the site of the gland) and sepsis.

Under this soulful name flows acute inflammation parotid salivary gland (mumps). The disease is caused by a virus transmitted by airborne droplets from a person who is contagious up to the ninth day from the onset of the disease. Children and unvaccinated adults are more likely to get sick. Since the virus has an affinity for glandular tissue, other salivary glands can also be affected, as well as the pancreas and testicles in men or boys, and the ovaries in women.

The virus does not tolerate the external environment well, is sensitive to antiseptics and ultraviolet radiation, but tolerates low temperatures and freezing. After the introduction of its RNA into the cells of an infected person, about 18 days pass before the development of the clinic.

Symptoms of unilateral inflammation of the salivary gland: swelling, pain near the ear, salivation, muscle and headaches, fever.

Diagnostic search

With complaints to children, a pediatrician is called, adults themselves come to a therapist, an infectious disease specialist, a dentist, less often a surgeon or a venereologist.

The diagnosis is suspected on the basis of complaints, examination, palpation of the gland.

Ultrasound and radiography are methods for visualizing the glands.
To clarify the nature of inflammation, serological blood tests are performed (if a viral infection is suspected): looking for immunoglobulins to virus antigens. For example, with parotitis, during the incubation period, immunoglobulins may not yet be present or their titer is low (repeat the analysis after a couple of days). From the moment the symptoms appear, there are immunoglobulins M in the blood, with an advanced disease - M and G. After its resolution - G (they also provide immunity after the illness).
For bacterial and viral infections universal way diagnostics with maximum sensitivity remains polymerase chain reaction(for blood or secreted glands). It can also be used as an express diagnostic.
Bacterial agents make it possible to perform a more complex and time-consuming culture of the separated gland with the growth of bacterial colonies and the determination of their sensitivity to antibiotics.
A biopsy may be required in cases of suspicion of an autoimmune process or for differential diagnosis.

How to treat

The patient is placed in protective mode. Treatment of inflammation of the salivary glands at the initial stage is outpatient. Shown milk-vegetarian diet, plentiful drink, rinsing the mouth with acidified (lemon juice) solutions or Kaposol.

Local treatment options:
- With mumps - warming alcohol compresses on the parotid region, a blue lamp (sollux), in a polyclinic - UHF, electrophoresis.
- With inflammation of the glands of the oral cavity - rinsing with antiseptics (Miramistin, Furacillin solution: 2 tablets per glass of water), solutions baking soda: a teaspoon per glass of water.
Antiviral drugs are used more often for mumps, but their effectiveness is poorly proven today.
If carried out antibiotic treatment, what antibiotics to choose? The choice is based on the high resistance of the oral flora to antibiotics. The first-line drugs are Amoxicillin (Ospamox, Amosin) and Amoxicillin clavulanate (Amoxiclav, Flemoclav, Augmentin), the second is Cefixime (Zinnat, Suprax) or Josamycin (Vilprafen).
Paracetamol, Ibuprofen (up to three times a day) can be used to reduce pain, intoxication and fever.
A chronic process in the acute stage requires antimicrobial therapy, anesthesia. In the stage of remission - resolving therapy or replacement of saliva deficiency (rinsing with Kaposol). The same tactics are followed for Sjögren's syndrome and radiation injuries glands.
The surgical stage may be required for suppuration of the glands, duct stones. Stones can be removed during duct bougienage, lithotripsy, lithoextraction.

Prevention

For mumps - vaccinations in childhood, non-specific quarantine measures in children's groups during epidemics, sanitization premises, personal protective measures for healthy adults caring for the sick (masks, hand washing).

It is also worth paying attention to the state of the immune response (eat well, correct hormonal pathologies, do not take uncontrolled drugs that reduce immunity, beware of radiation).

Paradoxically, barrier contraceptive measures (condoms, latex wipes) protect against specific inflammation of the salivary glands against the background of genital infections.

Timely and preventive visits to the dentist, adequate care of the teeth and oral cavity prevents the development of odentogenic sialadenitis.

Treatment of the inflammatory process in the salivary gland - an overview of methods

Swelling in the maxillofacial or cervical area may be a sign of such insidious disease, as sialoadenitis is an inflammation of the salivary gland, the treatment of which is so variable that it is quite difficult for a non-specialist to figure out all the possible ways on their own.

So, what is the treatment of sialadenitis, read on.

Symptomatic treatment

If sialoadenitis occurs in a mild primary or chronic form, then, as a rule, to eliminate it, it is enough to stop the inflammatory process with drugs, rinse your mouth with saturated soda (saline) solution and regularly massage the affected area to increase salivation.

Symptomatic treatment performs several important functions:

eliminates congestion and swelling in the glands;
stimulates the movement of lymph and blood in the affected area;
reduces the effects of intoxication of the body;
stops pain.

Treatment of symptoms does not always help: very often inflammation of the salivary glands develops against the background of serious viral, infectious or fungal diseases, in this case it is necessary to act on the problem in a complex manner, eliminating not only the consequences, but also the very cause of the pathology.

Dieting

To prevent blockage of the salivary glands and prevent their re-inflammation, during the treatment period and for some time (depending on the body's regenerative capabilities) after the symptoms have been eliminated, the doctor may recommend a special diet that will stimulate a constant outflow of saliva.

Basic rules of the salivary diet:

it is necessary to dissolve a small slice of lemon before each meal, which, depending on individual preferences, can be replaced with other natural food that has a pronounced sour taste (sauerkraut, cranberries, lime);
for a while, stop using foods that can cause mechanical (nuts, seeds, bony fish, shell seafood, meat with small bones, waffles, cookies) or chemical (vinegar, artificial colors, stabilizers, etc.) injuries to the oral mucosa ;
include in daily diet fruits and vegetables (paprika, cabbage, kiwi, rose hips, currants, pears) rich in vitamin C, which is useful for local and general immunity of the body;
be sure to rinse your mouth with a weakly concentrated one (1 tsp of soda per 200 ml warm water) soda solution after each meal to neutralize the remaining acids and disinfect the oral cavity;
if it is difficult or painful for the patient to swallow, then when compiling the menu, food with a softer texture (cereals, soups, mashed potatoes, stewed vegetables or any other finely chopped dishes) should be preferred.

Such a diet avoids stagnation of saliva in the glands and helps to remove dead cells and bacteria from them.

If there is an urgent need to increase salivary outflow, and the diet does not help, then the doctor prescribes a course of drugs that stimulate salivation (saliva production), for example, a 1% solution of pilocarpine hydrochloride (4-5 times a day, 5-6 drops).

Rinsing with antiseptics

For rinsing the throat and mouth, agents with antimicrobial and anti-inflammatory properties are used, which can be safely used to treat the skin and mucous membranes:

Chlorhexidine solution 0.05-0.1% - does not require dilution with water;
Furacilin 20 mg tablets - 2 tablets (40 mg) per 200 ml of water;
water tincture of calendula 10% - 20 ml of tincture per 250 ml of water;
Septisol (concentrate) - 5 ml of solution per 250 ml of water;
alcohol tincture of propolis 10% - 10 ml of tincture per 200 ml of water.

Procedure rules:

temperature ready solution-38-40°C;
the frequency of rinsing - from 5 to 7 times a day;
liquid retention time in the mouth - at least 30 seconds;
duration of the course - from 5 days or more (if necessary).

In one approach, it is necessary to use up the entire resulting solution, because during storage it loses its medicinal properties. Improvement with this method of treatment occurs within the first two days. Regardless of the chosen means, any of them, in accordance with the instructions, is forbidden to be swallowed, therefore, the procedures must be carried out with the utmost care.

Due to the impossibility of full control, this method is not recommended for the treatment of children under 6 years of age. If the need to use antiseptics still arises, you can pour the solution into a spray bottle and irrigate the affected area of the child yourself in a strictly metered volume.

The use of painkillers

To reduce body temperature (if it exceeds 38.5 ° C) and reduce the intensity of the pain syndrome, it is allowed to take non-steroidal anti-inflammatory drugs (Analgin, Baralgin, Ibuprofen, Pentalgin, Tempalgin), which have antipyretic, analgesic and anti-inflammatory effects.

In severe cases, for stopping very severe attacks pain, which is often accompanied by spasms of the salivary ducts, a temporary shutdown of innervation (sensitivity nerve endings) on the affected area of the face or neck by novocaine blockade. This procedure is carried out only in a hospital setting.

Application antihistamines(Suprastin, Loratadine) is required in case of a concomitant allergic reaction: additional edema in this situation can lead to severe consequences, up to the onset of involuntary asphyxia (suffocation).

Physiotherapy

Physiotherapeutic methods of treatment are used in parallel with drug therapy.

Local hardware impact on the neck and maxillofacial zone is aimed at eliminating the very cause of the development of sialoadenitis and restoring the functional activity of the affected gland.

Physiotherapy can be prescribed even in the acute phase of the disease, if at the same time the possibility of the natural passage of saliva through the excretory duct is preserved.

The physiotherapy treatment plan for sialadenitis includes three stages:

elimination of the focus of inflammation;
removal of edema from tissues;
reduction of pain sensations.

The most effective anti-inflammatory treatments:

UV therapy - irradiation of the affected area with an ultraviolet lamp is carried out in a course of 4 to 5 procedures every two days;
fluctuorization - the course of therapeutic effects of pulsed current on the gland is 8-10 daily sessions.

Ways to eliminate pathological infiltration (accumulation biological fluid) and relieve puffiness:

IR therapy - complete resorption of a liquid formation takes at least 12 procedures;
Ultrasound therapy - daily ultrasound treatment continues for 1 to 2 weeks;
electrophoresis - this method of drug delivery (potassium iodide 3%) into the deep layers of the skin can be used up to 10-12 days in a row.

The option (focused or defocused) of radiation exposure is selected individually in each case, the course is from 8 to 10 daily sessions.

Advantage laser method is that in addition it also has an anti-allergic effect: this allows you to exclude or limit the use of antihistamines.

Compresses with Dimexide

Dimethyl sulfoxide (Dimexide) is a widely used drug with anti-inflammatory and analgesic effects.

With sialadenitis, it is used in the form of local applications (compresses) to relieve spasm of the salivary gland duct, eliminate the inflammatory process and reduce pain.

Warm gauze compresses with a 30% solution of Dimexide should be applied to the affected gland from the outside for 30-40 minutes. This procedure can be repeated no more than twice a day.

With this treatment regimen, the drug penetrates well deep into the skin, where it reaches the focus of inflammation and affects the microbial flora, helping to cope with pain.

Antibacterial therapy, antiviral and antifungal drugs

Traditional conservative treatment involves eliminating the root cause of sialoadenitis by taking medications, the choice of which depends on the type of pathogen:

antibacterial drugs, including antibiotics (Azithromycin, Norfloxacin, Cifran, Oxacillin) - are prescribed for destruction pathogenic microorganisms if the cause of the inflammation is an infection;
antiviral drugs (Interferon, Kagocel, Amiksin, Arbidol) - are used in case of development of pathology of the salivary glands against the background of a decrease in immunity during viral infection;
antifungal agents (Levorin, Pimafucin, Mycozoral, Fluconazole) - have antimycotic properties that suppress mycoses ( fungal infections) and clear the salivary ducts from them, restoring normal patency.

If a positive effect is observed from taking prescribed medications, but it is not enough for a full recovery, then antibiotics (Penicillin, Gentamicin) and antiseptics (Dioxidin, potassium furaginate) are additionally injected into the inflamed duct directly through the catheter.

If this does not give the expected result within the next 2-3 days, then the patient is placed under the supervision of doctors in a hospital and a dropper is installed with the addition of Kontrykal or Atropine, which quickly relieves swelling and inflammation. After that (depending on the situation), doctors decide whether to continue conservative treatment or transfer the patient to the surgical department.

Surgery

Surgery is the most last resort the fight against sialoadenitis, which is prescribed only in emergency situations:

complete absence of positive dynamics in conservative treatment within 5-7 days;
the threat of rupture of the gland due to the very large volume of pus accumulated in it;
deposition of large stones in the parenchyma of the salivary glands or in their ducts (extensive calculosis);
necrotic process in the gland or adjacent area (gangrenous form of the disease);
chronic severe inflammation.

In the conditions of a surgical hospital, an opening of the festering cavity of the salivary gland with its outer side, after which it is drained (dehydrated) by installing a catheter. In this case, directly into the affected organ are introduced antibacterial drugs, which will prevent the further spread of infection throughout the body and will not allow pus to re-accumulate in the gland itself.

Operational removal stones at calculous form inflammation is necessary only in the case of the formation of large solid formations that cause a regular exacerbation of sialadenitis.

If they have an unformed appearance, a loose structure, a high degree of fragmentation (dispersion), then in this case the treatment is observational in nature, since there is a high probability of dissolution of small particles spontaneously or under the influence of medications.

In the presence of several large stones, the damaged salivary gland to be completely removed.

The gangrenous form of the disease is the basis for urgent hospitalization and carrying out an unscheduled operation, since such a condition is a direct threat to the life of the patient. Excision of dead tissue is carried out through an external incision under general anesthesia.

A safer alternative is cryotherapy. Exposure to cold inhibits the development of the inflammatory process and enhances the swallowing reflex, which allows you to restore the function of the natural outflow of saliva.

In order not to face the need for a long and difficult treatment sialoadenitis, it is necessary to control the condition of the oral cavity: compliance with the rules of personal hygiene, timely elimination dental problems, prevention of viral and infectious diseases in most cases, they avoid inflammation of the salivary gland or, in case of illness, do without surgical intervention.

Why the cheek is swollen, or inflammation of the salivary glands: how to diagnose and treat?

Inflammation of the salivary gland in medicine is called sialadenitis and is a disease of the salivary glands of an inflammatory nature with acute or chronic course. Most often, the parotid salivary glands are affected by the inflammatory process.

Sialoadenitis is equally common in both adults and children. Also, the incidence of this disease is at the same level in men and women.

Inflammation of the salivary glands: causes

In acute inflammation of the salivary glands, the cause is almost always the penetration of pathogenic microorganisms into the gland. Depending on the type of pathogen, the following forms of acute sialadenitis are distinguished:

viral etiology, which is most often caused by the mumps virus, since this virus is tropic to the glandular epithelium. The main route of transmission of the disease is airborne. Entrance gate to this case the mucous membranes of the mouth and throat protrude. The reproduction of the virus occurs in the glandular epithelium of the parotid salivary gland. In boys, there is also glandular tissue in the testicles, to which tropene virus mumps, so they can also be affected, which in some cases leads to infertility;
bacterial etiology. This form sialadenitis develops both with exogenous and endogenous penetration of bacteria into the salivary glands.

The main causative agents of acute sialadenitis are representatives normal microflora oral cavity. The following factors contribute to the development of the inflammatory process:

non-compliance with oral hygiene;
reactive narrowing of the ducts of the salivary glands. This state occurs against the background of general exhaustion of the body due to extensive surgical interventions on the organs abdominal cavity, cancer intoxication, chronic diseases of organs digestive tract, stress, errors in the diet or diabetes. The narrowing of the duct of the salivary gland leads to stagnation of saliva, which creates fertile ground for the life and reproduction of pathogenic microbes;
obstruction of the duct of the salivary gland. Obstruction of the duct is most often carried out by a calculus or a foreign body. In this case, the outflow of saliva from the gland is also disturbed, and optimal conditions are created for the reproduction of pathogenic bacteria.

Besides, acute sialadenitis can be triggered by the penetration of infection into the salivary gland by the hematogenous route in severe diseases infectious nature(typhoid fever, scarlet fever). Also, some patients were diagnosed with lymphogenous spread of infection from purulent foci, which were localized in the face or neck (boils, purulent wounds, chronic tonsillitis, gum disease, etc.).

Chronic inflammation of the salivary glands is almost always a primary process, that is, it does not occur against the background of acute sialadenitis. This feature is explained by the fact that the salivary glands in a patient with chronic sialoadenitis are initially predisposed to this disease.

Contribute to the development of chronic inflammation of the salivary glands such factors as:

hereditary tendency;
autoimmune diseases;
diseases of internal organs;
psycho-emotional shock;
local or general hypothermia;
trauma;
depletion of the body;
elderly age;
vascular atherosclerosis.

Inflammation of the salivary glands: photos and symptoms

With inflammation of the salivary gland, the symptoms directly depend on which gland is inflamed. Therefore, we propose to consider the signs of inflammation of the salivary glands of different localization.

Inflammation of the parotid salivary gland

Since epidemiological infectious disease, then after infection with the virus, an incubation period begins, which lasts from 11 to 23 days. Patients in this period do not have any signs of the disease, but, nevertheless, they can already infect others.

At the end incubation period Patients with mumps have the following symptoms:

increase in body temperature;
aches in the joints;
muscle pain;
headache;
general weakness;
loss of appetite;
pain in the parotid region and ear;
dry mouth;
swelling of tissues in the parotid region.

Also, the mumps virus can lead to inflammation of the salivary glands under the tongue and under the jaw.

In adults, inflammatory phenomena in epidparotitis are local in nature. The child, except parotid gland, the soft tissues under the chin also become inflamed, making swallowing and chewing painful.

On palpation, the swelling of the gland is soft and has no clear boundaries.

In rare cases, there is parotitis, which occurs due to obstruction of the duct of the salivary gland with a calculus, a foreign body, or due to injury. The causative agent of the disease is mainly pathogenic bacteria that cause purulent inflammation.

Symptoms of non-epidemic parotitis are the same as with viral infection salivary gland. The difference lies in the fact that pus is formed inside the gland, which is released from the duct into the oral cavity.

Inflammation of the sublingual salivary gland

The sublingual salivary gland is located under the tongue and has two ducts that open near the root in the sublingual region.

Most often, the sublingual salivary gland becomes inflamed in patients with tonsillitis, tonsillitis, acute respiratory infections, stomatitis, caries or sinusitis.

With inflammation of the salivary gland under the tongue, patients complain of the following symptoms:

dry mouth or hypersalivation (excess saliva);
pain when chewing;
pain when opening the mouth;
unpleasant taste in the mouth;
taste change;
increase in body temperature.

Inflammation of the submandibular salivary gland

The submandibular gland has round shape and is located in the submandibular triangle.

In patients with an inflamed submandibular salivary gland, the following symptoms are most often observed:

dry mouth due to decreased salivation;
unpleasant taste in the mouth;
taste change;
bad breath;
pain under the jaw, which increases in the process of chewing food or when opening the mouth;
redness of the mucous membrane under the tongue;
stomatitis;
increase in body temperature;
general weakness;
decrease in working capacity;
loss of appetite.

Diagnosis of sialadenitis

If we talk about what diagnostic methods are used for inflammation of the salivary glands, then the most common and informative are sialography and ultrasound procedure.

In the acute course of the disease, an experienced specialist will have enough complaints from the patient and objective data that can be obtained during examination and palpation of the gland. To clarify the prevalence of the process or differential diagnosis, ultrasound, computed or magnetic resonance imaging can be used.

With sialoadenitis with a chronic course, sialography is performed, the essence of which is the introduction of contrast into the duct of the gland and the performance of an x-ray. At this study signs of inflammation of the salivary gland may be narrowing of the ducts, the presence of stones or cysts.

How to treat inflammation of the salivary gland?

In the acute course of sialoadenitis, patients are most often referred for inpatient treatment in a hospital. It should also be noted that uncomplicated inflammation of the salivary glands is treated with conservative methods, but with the development purulent complications surgery will be needed.

In acute nonspecific sialadenitis in the treatment, specialists are guided by the following principles:

diet. Health food is that patients are advised to consume foods that increase salivation. These products include sauerkraut, crackers, cranberries, lemon;
the appointment of a 1% solution of hydrochloric acid pilocarpine, which is taken orally 4-5 drops. This drug helps to reduce smooth muscle salivary gland duct, which also increases salivation;
antibiotic therapy. The use of antibiotics for inflammation of the salivary glands is indicated if the disease is bacterial in nature. The drug of choice in this case may be Penicillin or Gentamicin, which is injected directly into the duct of the salivary gland, and when severe course taken orally or administered parenterally. Antiseptics are also used, such as Dioxidin and potassium furaginate, which wash the ducts of the glands;
physiotherapy. In the treatment of sialoadenitis, UHF and electrophoresis can be used;
novocaine-penicillin blockade. This procedure effectively eliminates swelling and inflammation in the area of the gland and surrounding tissues;
local therapy. Locally, compresses with a 30% solution of dimexide are used, which are applied to the parotid region once a day for 20-30 minutes. This procedure is used only when the parotid salivary gland is inflamed.

With suppuration of the salivary gland, an abscess is opened and drained. Sick with gangrenous form sialadenitis shows complete removal of the gland.

In acute epidparotitis, all patients must be prescribed etiotropic therapy using antiviral drugs (Viferon, Laferon, Interferon and others). As symptomatic therapy antipyretic, analgesic and anti-inflammatory drugs (Ibuprofen, Paracetamol, Nimesulide and others) are used.

Exacerbation of chronic inflammation of the salivary glands is also treated according to the principles described above.

During the period of remission, patients with chronic sialadenitis may be prescribed the following procedures:

massage of the ducts of the salivary gland;
the introduction of antibiotics into the duct of the gland;
novocaine blockade in the region of the gland;
electrophoresis with galantamine;
galvanization;
injections into the gland area of Iodolipol 3-4 times a year;
diet.

It is also important to follow the rules of oral hygiene (brush your teeth twice a day, rinse your mouth after meals, use dental floss, etc.).

At frequent relapses an operation is indicated, during which the affected salivary gland is removed, since it is almost impossible to cure chronic sialadenitis conservatively.

Folk methods of treatment

Treatment at home can be carried out using compresses, ointments, infusions, tinctures and decoctions prepared on the basis of natural ingredients. To your attention the most effective and safe folk remedies for the treatment of sialadenitis.

Compress with tincture of celandine and yarrow. One glass of crushed celandine roots and 5 tablespoons of flowers must be passed through a meat grinder, then poured with three glasses of high-quality vodka and let it brew for 7 days in a dark, cool place. A piece of gauze folded in 5-6 layers is soaked in tincture, placed on the parotid area, covered with wax paper and left for 15-20 minutes. The procedure is carried out once a day.
Ointment based on birch tar. One tablespoon of petroleum jelly is thoroughly mixed with ten tablespoons of tar until a homogeneous consistency is formed. The finished ointment is applied to the skin over the affected gland twice a day.
Propolis and mummy. In case of inflammation of the sublingual salivary gland, a piece of mummy the size of a pea is placed under the tongue three times a day. The course of treatment is 6 weeks, after which three times a day for one month you need to chew and swallow ½ teaspoon of propolis.
Rinse your mouth with a solution of baking soda. In 200 ml of warm boiled water, you need to dilute one tablespoon of baking soda. Rinse the mouth with the resulting solution 2-3 times a day.
Echinacea tincture. This medicine can be purchased at a pharmacy. Take tincture three times a day, 30 drops for one month. Also, this natural medicine can be used for compresses.

We have analyzed what constitutes inflammation of the salivary glands, symptoms and treatment in humans, but pets can also get sick with this disease. Therefore, we propose to briefly consider how sialoadenitis proceeds in dogs and cats.

Inflammation of the salivary gland in dogs and cats: causes, symptoms and treatment

The salivary glands in dogs and cats can become inflamed for several reasons, namely:

mechanical injury;
penetration of pathogenic microorganisms into the gland;
poisoning with various poisons.

The disease can also be acute or chronic.

Suspect sialadenitis in pet possible for the following symptoms:

dense swelling in the region of the posterior edge of the lower jaw;
local hyperthermia in the affected area of the salivary gland;
when probing the affected gland, the animal feels pain, so be careful, otherwise the pet will bite you;
the secretion of saliva is sharply reduced or completely absent;
the animal cannot move its head in full, as this is prevented by swelling and soreness of the tissues;
the animal has a reduced appetite, or it completely refuses to eat;
fever;
the ear from the side of inflammation is displaced down;
palpable cervical lymph nodes;
after opening the abscess, there is a discharge of pus with bad smell from fistulas;
with inflammation of the sublingual and submandibular salivary glands in the animal, the tongue increases and thickens, which disrupts swallowing, chewing, and hypersalivation is also present.

In the treatment of sialadenitis in dogs and cats, alcohol compresses, blockades with novocaine, antibiotic therapy, UHF, electrophoresis, ointments are used. With the formation of abscesses, opening, drainage and washing with antiseptics are shown.

An untimely appeal to a veterinarian with inflammation of the salivary glands in cats and dogs threatens to form scars, which make it difficult to move the head, as well as hearing loss.

Inflammation of the salivary gland - symptoms, treatment, photo

All photos from the article

The inflammatory process in the salivary gland, usually parotid, occurs in both adults and children. Based on the reasons that caused it, as well as the age of the patient, the course of the disease is accompanied different symptoms and requires appropriate treatment. The scientific purpose of inflammation of the salivary gland is sialadenitis (in some editions, sialadenitis). The disease rarely affects the submandibular and sublingual glands, in its course it is chronic and acute.

The main reason that causes inflammation of the salivary gland is the action of the infectious microenvironment that has entered its cavity. Pathogens are diverse, based on their type, the disease is:

Viral, developing with mumps or in a simple "mumps". This microenvironment is well transmitted through the air and causes high sensitivity salivary glands, therefore, when it enters through the respiratory tract, the virus quickly penetrates the parotid gland, begins to multiply in it, which causes inflammation. The pathogen poses an additional threat to children - boys. Since its abundant reproduction can lead to damage to the structure of the testicles, which will be reflected in infertility in adulthood.

Photo 1. Location of the parotid salivary gland

bacterial, otherwise called non-specific. In this case, the microflora is introduced through the oral cavity or by entering it into the blood. The main causes of infection bacterial type sialadenitis is:

Poor oral hygiene
Reactive obturation, when obstruction of the abdominal organs is observed, for example, as a result of surgery, the development of a malignant tumor, diseases of the gastrointestinal tract, stress, malnutrition, or exposure to diabetes mellitus. As a result of obstruction, the ducts narrow reflexively, due to which the volume of saliva secreted decreases and it accumulates at the place of production. All this creates favorable environment in order for microorganisms from the oral cavity to take root and begin to multiply in the parotid gland
Mechanical obturation, when the duct is blocked by a foreign object, such as a calculus. The result here is the same as with reactive blockage - the development of inflammation.

Infection through the blood is a rarer phenomenon, which is facilitated by the disease typhoid fever and scarlet fever. In addition, sialadenitis can occur when a person has symptoms of pharyngeal inflammation, lesions on the mucous membrane in the mouth, signs of furunculosis, tonsillitis, periodontitis. These pathologies should not be ignored, if they are present, it is important to carry out qualified treatment in order to avoid complications.

Inflammation of the salivary gland is characterized by a rare phenomenon when chronic form this is not a sequel to acute. Sialoadenitis is primarily a chronic disease, because. the salivary gland in its structure is prone to a gradual change in the tissue structure. The main reasons why it becomes inflamed in some people and not in others is:

genetic features
Autoimmune abnormalities
Situations of high stress
hypothermia
Getting injured
Weakness of the body against the background of a serious illness

In older adults chronic inflammation more common than in children and young adults. This is due to atherosclerotic phenomena, due to which the blood supply and nutrition of the salivary gland deteriorates. Atherosclerosis occurs as a result of the aging of the body, when the vessels and arteries slowly wear out and lose their tone.

Symptoms and photos

The initial stages of inflammation of the salivary gland are manifested by very acute manifestations, most often in a person, the temperature rises sharply to values over 39 gr. The main external symptom is swelling in the area near the ears, which manifests itself symmetrically, which is accompanied by pain with increased chewing. Gradually, the swelling increases, and the swelling, spreading outward, becomes more expressive. More informative symptoms are presented in the photo.

Photo 2. Inflamed salivary glands in the mouth

With the development of the disease or if adequate treatment is absent, then the disease also moves to the salivary glands under the tongue and lower jaw.

The presence of additional symptoms will depend on the type of inflammatory process, and if the disease is not treated, then it goes through several stages in turn:

At serous form of sialadenitis, in addition to swelling in the parotid area, there is dryness in the mouth. Pain sensations tend to increase when eating food or even when looking at it, when saliva is reflexively released. The skin in the parotid zone is not changed, if you press a little on the salivary gland, then there is almost no salivation.

Photo 3. external symptoms inflammation

If there was a transition to purulent stage the pain becomes very severe. A person cannot sleep and eat normally, the temperature is stable, its value is >38 degrees. There are symptoms of restriction when opening the mouth, swelling is noticeable in the temples, cheeks and lower jaw. If you press on the area of swelling, which to the touch has a dense structure with a red skin tone and pain when touched, then a certain volume of purulent contents is released into the oral cavity.

Gangrenous form is very active and pronounced. The main symptoms are high fever, partial damage to the skin over the inflamed salivary gland, through which the dead parts of the organ are gradually released.

In some cases, the disease turns into the death of the patient, when the infection spreads uncontrollably, leading to sepsis in different parts organism. Another reason lethal outcome this is heavy bleeding arising from damage cervical vessels. Thus, despite the small size of the salivary gland, the inflammatory process in it can result in the most serious consequences, so the disease must be treated. At the same time, amateur performance is not allowed, all treatment must take place within the framework of a medical institution.

If it has been inflamed submandibular salivary gland, then swelling occurs at its location. When palpating, an increase in size, tuberosity and severe pain are diagnosed. The progression of the disease causes pain when swallowing due to an increase in the area of edema. In the sublingual zone, redness and signs of swelling are noticeable, pus is sometimes released from the iron ducts.

Disease submandibular glands are often referred to as calculous. "Calculous" means a foreign object that overlaps something. In such conditions, small pebbles can block the salivary ducts. This is usually due to an increase in calcium levels. The calculous inflammatory process has symptoms:

A sharp stabbing sensation of pain that increases when taking food
Impaired salivation
Dryness in the mouth
Swelling and tuberosity in the submandibular area
Purulent discharge from under the tongue
An increase in the volume of the salivary gland during periods of eating, which is expressed by discomfort, and sometimes even does not allow you to eat normally

The sublingual salivary gland becomes inflamed in rare cases, most often it occurs against the background of an abscess or lesions of the teeth.

Chronic sialadenitis

Chronic disease takes many forms.

At chronic interstitial form parotid salivary gland is affected. Pathology is more typical for older people, especially for women. For a long period, any signs and manifestations are absent, as inflammation develops slowly, causing constriction of the ducts along the way.

A sharp increase in symptoms happens suddenly, its first sign is a dry mouth. The gland itself becomes enlarged, becomes painful and smooth to the touch. After the exacerbation has passed, the size of the organ does not return to normal, remaining several times larger.

Chronic parenchymal inflammation almost in all cases concerns exclusively the parotid gland. In women, the risk of development is also higher than in men, there are no pronounced age groups susceptible to the disease, it occurs both in an infant and a very old man over 60-70 years old. Often there are no symptoms at all for many years.

The exacerbation resembles acute sialadenitis, when at the initial stage only very big selection salty mucus when pressed on the salivary gland. Without treatment, a feeling of heaviness develops further and increased density glands, there are no symptoms of limited mouth opening. On the late stages the surface becomes bumpy, there are no pain sensations, saliva is secreted with purulent phenomena, sometimes dry mouth is present.

Sialodochit call the state when the pathological process has touched only the ducts that are expanding. The disease is characteristic of both men. So are older women. The main symptom is increased excretion saliva while eating or talking skin surface swells around the mouth. During an exacerbation, the salivary gland swells strongly, pus is released from it.

Diagnostics

Identification of an acute form of inflammation occurs during examination and questioning. Previously, sialography was practiced, implying the input contrast medium. However, later this diagnostic method was abandoned, since during acute course it enhances the inflammatory process, which sharply increases soreness.

Sialography is used in the diagnosis chronic sialadenitis. If the disease is present, then x-ray narrowing of the ducts will be detected and not a large number of contrast. A feature of the parenchymal form is big number cavities with a diameter of 6-9 mm, which in total include a large amount of contrast.

Treatment of inflammation of the salivary gland

If the patient has signs of acute inflammation, then the treatment is carried out in a hospital. The main therapy is conservative, surgery is resorted to only in a situation of purulent manifestations.

How to treat acute sialadenitis

At mumps treatment is prescribed based on the symptoms present. Interferon agents are mainly used, and the patient is also shown to be treated with antipyretic and analgesic drugs.

If revealed acute nonspecific inflammation salivary gland, then the treatment is aimed at eliminating the inflammatory reaction and returning the standard functionality of saliva secretion. The main therapy is:

The use of a salivary diet to train the muscular structure of the ducts through which saliva is excreted. Diet products include everything sour, such as lemon, cranberries, and crackers.
The introduction of antibiotics and antiseptics into the cavity of the duct, for example, penicillin and gentamicin, dioxidine and potassium furaginate.
The use of an anti-inflammatory compress based on a Dimexide solution, which anesthetizes and suppresses the progression of the disease.
Physiotherapy using UHF and warming.
Blockades based on novocaine and penicillin with severe swelling and a sharp increase in inflammation.
Reception systemic antibiotics. Which antibiotics to choose the doctor decides after studying the bacterial environment.
Intravenous injections.

Surgery as a treatment is used in the purulent course of the disease. The gangrenous course is the most severe, it requires an urgent operation under general anesthesia. If the cause of the pathology is a calculus, then it must be removed, otherwise relapses will be repeated again.

How is a chronic condition treated?

For exacerbations, treatment is the same as for acute form. In periods when there is no exacerbation, the chronic form is treated:

Massages of the ducts, when an antibiotic is additionally introduced into their cavity to combat purulent phenomena
Novocaine blockades, electrophoresis, which increase secretion
Daily galvanization course
The introduction of solutions that prevent the development of exacerbations
X-ray therapy, due to which the inflammation of the salivary gland is well stopped
Removal of the gland, the restoration of the functionality of which is impossible.

Which doctor treats

Profile doctors who treat sialadenitis are dentist or surgeon specializing in the facial and jaw area. When a person has symptoms of mumps, then for children the profile doctor is a pediatrician, and for adults - a therapist. The task of these broad specialists is to conduct an initial examination and refer to more narrow doctor, for example, to an infectious disease specialist who conducts therapy for mumps.

Preventive measures

To prevent the occurrence of inflammation of the salivary gland, there are no special measures vaccine-related prevention. The only exception is mumps, when a special vaccine is used, which is also used to protect against measles and rubella. This method of prevention is used for children, they are vaccinated at the age of about 18 months. The effectiveness of such vaccination is kept at the level of 95% and allows you to almost completely eliminate the occurrence of the disease.

to the standard curative prevention include:

Compliance with oral hygiene
Timely cleansing of infectious foci in the mouth, often associated with caries and other dental lesions
Tracking congestion in salivation and preventing them by taking special medications (pilocarpine), rinsing with furacilin, rivanol and other antiseptics.

And each of these salivary glands one far from perfect day can become inflamed, bringing a lot of trouble to its owner. This condition will be called sialadenitis. A special case of inflammation of the parotid salivary gland is called parotitis. We will talk about inflammation of the salivary glands, symptoms and treatment of sialadenitis further.

Why do they get inflamed

The culprits of inflammatory changes are most often:

The infection most often penetrates through the mouth of the duct, less often with the flow of blood, lymph:

against the background of respiratory infections of the pharynx, trachea, periodontitis, skin boils
or by contact from nearby areas (with purulent diffuse inflammation of soft tissues).

Main reasons:

The causes of inflammation of the salivary glands in 30% of cases are viruses).
In addition to the infectious process, gland damage can be included in the program of rheumatic diseases ()
and radiation damage.
Up to 40% of all inflammations are due to dentistry.

Acute sialadenitis often infectious.

What can be seen

The acute process is characterized by the following manifestations:

Edema appears at the location of the inflamed gland,
It is painful and tight when pressed.
If you massage the gland, pus may be released from its duct.
The mouth dries out due to a small amount of saliva, or vice versa, saliva flows all the time.
The temperature may rise.

Factors contributing to sialadenitis:

dehydration,
high calcium content in the blood (stones of the ducts of the glands can form, clogging them).

The chronic form of the disease often leads to scarring and atrophy of the glandular tissue, due to which the production of saliva drops significantly, swallowing and speech become difficult.

Interstitial sialadenitis is characterized by painless swelling of the gland. They are more likely to affect people over 40 with immunity errors (diabetes mellitus, hypothyroidism). At the beginning of the process (the process is often symmetrical), the glands are densely elastic, then they become denser. May appear, a drop in performance. In exacerbation, pain appears, aggravated by cold.
The parenchymal variant is more often congenital. There is also periodic swelling, salivation with an admixture of pus, with a gradual drop in the level of saliva production.
The ductal variant develops both against the background of a wider congenital duct, and as a result of its acquired expansion (in trumpeters, glassblowers), usually in old age. Do not discount the foreign bodies in the duct, which often give symptoms of inflammation of the submandibular salivary gland. Usually the disease begins suddenly with bursting pain and its increase, more often after eating. When pressed, a secret is released. When the bacterial flora is attached, the temperature rises, swelling increases, and pus is released.

The most formidable complication of such a pathology is abscess formation (the formation of a limited abscess at the site of the gland) and sepsis.

Piggy

Under this spiritual name, acute inflammation of the parotid salivary gland (mumps) occurs. The disease is caused by a virus transmitted by airborne droplets from a person, which is contagious up to the ninth day from the onset of the disease. Children and unvaccinated adults are more likely to get sick. Since the virus has an affinity for glandular tissue, other salivary glands can also be affected, as well as the pancreas and testicles in men or boys, and the ovaries in women.

The virus does not tolerate the environment well, is sensitive to antiseptics and ultraviolet radiation, but tolerates low temperatures and freezing. After the introduction of its RNA into the cells of an infected person, about 18 days pass before the development of the clinic.

Symptoms of unilateral inflammation of the salivary gland: swelling, pain near the ear, salivation, muscle and headaches, fever.

Diagnostic search

With complaints to children, a pediatrician is called, adults themselves come to a therapist, an infectious disease specialist, a dentist, less often a surgeon or a venereologist.

The diagnosis is suspected on the basis of complaints, examination, palpation of the gland.

Ultrasound and radiography are methods for visualizing the glands.
To clarify the nature of inflammation, serological blood tests are performed (if a viral infection is suspected): looking for immunoglobulins to virus antigens. For example, with parotitis, during the incubation period, immunoglobulins may not yet be present or their titer is low (repeat the analysis after a couple of days). From the moment the symptoms appear, there are immunoglobulins M in the blood, with an advanced disease - M and G. After its resolution - G (they also provide immunity after the illness).
For bacterial and viral infections, the polymerase chain reaction (for blood or secreted glands) remains a universal diagnostic method with maximum sensitivity. It can also be used as an express diagnostic.
Bacterial agents make it possible to perform a more complex and time-consuming culture of the separated gland with the growth of bacterial colonies and the determination of their sensitivity to antibiotics.
A biopsy may be required in cases of suspicion of an autoimmune process or for differential diagnosis.

How to treat

The patient is placed in protective mode. Treatment of inflammation of the salivary glands at the initial stage is outpatient. Shown milk-vegetarian diet, drinking plenty of water, rinsing the mouth with acidified (lemon juice) solutions or Kaposol.

Local treatment options:
- With mumps - warming alcohol compresses on the parotid region, a blue lamp (sollux), in a polyclinic - UHF, electrophoresis.
- In case of inflammation of the glands of the oral cavity - rinsing with antiseptics (Miramistin, Furacillin solution: 2 tablets per glass of water), baking soda solutions: a teaspoon per glass of water.
Antiviral drugs are used more often for mumps, but their effectiveness is poorly proven today.
If antibiotics are being treated, which antibiotics should be used? The choice is based on the high resistance of the oral flora to antibiotics. The first line drugs are Amoxicillin (Ospamox, Amosin) and Amoxicillin clavulanate (Amoxiclav, Flemoclav, Augmentin), the second is Cefixime (Zinnat, Suprax) or Josamycin (Vilprafen).
To reduce pain, intoxication and fever, can be used (up to three times a day).
A chronic process in the acute stage requires antimicrobial therapy, anesthesia. In the stage of remission - resolving therapy or replacement of saliva deficiency (rinsing with Kaposol). The same tactics are followed for radiation damage to the glands.
The surgical stage may be required for suppuration of the glands, duct stones. Stones can be removed during duct bougienage, lithotripsy, lithoextraction.

Prevention

For mumps - vaccinations in childhood, non-specific quarantine measures in children's groups during epidemics, sanitization of premises, personal protective measures for healthy adults caring for the sick (masks, hand washing).

It is also worth paying attention to the state of the immune response (eat well, correct hormonal pathologies, do not take uncontrolled drugs that reduce immunity, beware of radiation).

Paradoxically, barrier contraceptive measures (condoms, latex wipes) protect against specific inflammation of the salivary glands against the background of genital infections.

Timely and preventive visits to the dentist, adequate care of the teeth and oral cavity prevents the development of odentogenic sialadenitis.

Inflammation of the salivary gland can occur in any age group and bring many inconveniences and complications to the patient.

Salivary glandular organs, their functions

The photo shows where the salivary glands in humans are located.

In the oral cavity and beyond, there are a large number of glands that produce a special secret - saliva. The largest of them are paired salivary glands: submandibular, sublingual and parotid. Smaller ones are represented by the buccal glands, lingual, labial, etc.

The parotid salivary gland is located behind the jaw, in front of the ear. Passes through its tissue facial nerve responsible for mimic muscles and major artery with veins. The duct, through which the secret from the glands enters the oral cavity, opens on the inner surface of the cheek in the region of the upper large molars.

The sublingual gland, according to its name, is located under the lingual muscle. It feeds on blood through the lingual arteries.

The submandibular salivary gland is located within the boundaries of the submandibular triangle. A small section of the upper edge is located near the parotid.

Functions of the salivary glands

affect perception. palatability food consumed.
They have an important effect on articulation.
Enzymes (amylase, peroxidase and others) are necessary to start the process of digestion of food already in the oral cavity. Then the food with them enters the stomach.
Production of a special secret that contains mucin, enzymes, lysozyme, immunoglobulin A:

Mucin, in turn, envelops food, so the formed food bolus easily passes through the esophagus.
Lysozyme has an antibacterial effect, thanks to which it protects the surface of the teeth from the formation of caries and demineralization.
Immunoglobulin A (secretory protein) performs a local protective function, destroying bacteria and viruses.

Causes of the disease

Inflammation of the salivary gland, or otherwise - sialadenitis, implies the development of inflammatory processes in the thickness of this organ. Sialadenitis downstream can be acute and chronic.

The main causes of inflammatory processes in the organs that produce saliva:

Symptoms of the disease

To general clinical signs inflammation of the salivary glands include: sudden sharp pain in place of the affected gland, which becomes more intense during eating; dry mouth due to impaired saliva production; swelling and roughness of the surface of the glandular organ.

Symptoms of inflammation of the parotid gland

Acute onset of the disease with fever, weakness, headache.
Later, manifestations of acute damage to the tissue of the organ join: swelling of the parotid region, soreness when pressing on the swelling and on the tragus of the ear, the color of the skin over the enlarged gland does not change.
Feeling of dryness in the mouth, pain when opening the mouth.
Important diagnostic features: bilateral lesion and Mursu's symptom (inflammatory ridge around the opening of the excretory duct at the level of 1-2 molars of the upper jaw).
Contact with a patient with parotitis.
Sometimes the process spreads to neighboring structures, complicated by pancreatitis, orchitis (inflammation of the glandular structures of the testicles), adnexitis (ovarian damage), which can lead to a decrease in reproductive function up to infertility.

With inflammation of the sublingual gland (sublinguitis), in addition to intoxication and common features, there is an unpleasant aftertaste in the mouth, pain when chewing food, a feeling of an inflammatory roller under the tongue. Submandibulitis, or inflammation of the submandibular gland, has similar manifestations. Diagnostic criterion - an increase in the neck on the side of the lesion.

Symptoms of non-specific inflammation

At nonspecific inflammation symptoms directly depend on the stage and type of inflammation:

With serous sialadenitis there is pain and swelling of the salivary gland, a feeling of dryness in the mouth, elevation of the earlobe. Pain syndrome increases during meals, after the reflex production of salivary fluid at the sight of food. The body temperature is normal or slightly elevated, the color of the skin over the gland is not changed. When pressing on the excretory duct, the discharge is insignificant or absent altogether.
In case of purulent sialadenitis the pain is sharp, which can disturb sleep. There is difficulty in opening the mouth, pus is released from the duct. The body temperature rises intensively (more than 38 C). The tissue of the organ itself is dense, the skin above it is shiny and acquires a bright red color. Edema may extend to the lower jaw, temporal region and cheek.
Gangrenous sialadenitis manifested by skin necrosis, rapid course, severe intoxication. Such pathological condition can lead to the spread of infection and the development of a septic condition (massive entry of bacteria, toxins and decay products into the bloodstream).

Elderly people may develop isolated inflammation salivary duct, or sialodochit. Manifested in excessive salivation during eating and talking, angular stomatitis (jamming in the corners of the mouth).

Diagnosis of the disease

If the above symptoms are found, it is necessary to contact an infectious disease specialist or a surgeon in order to find out the cause of the disease.

To diagnose inflammation of the salivary glands in a child and an adult, the doctor conducts a survey, a general examination of the patient, prescribes general analysis blood (to determine the nature of inflammation), in some cases, ultrasound, contrast sialography is performed.

Treatment tactics

Treatment of inflammation of the parotid salivary glands (with parotitis) consists in prescribing a sparing diet, bed rest for 5-7 days, taking antiviral drugs, frequent rinsing of the mouth and dry heat on the affected area. At high temperature - antipyretic drugs (paracetamol, ibuprofen).

General approaches in the treatment of diseases of the salivary glands:

The appointment of drugs that enhance the production of saliva (a solution of pilocarpine or potassium iodide).
Careful oral hygiene. Teeth should be brushed not only in the morning and evening, but also after each meal.
Take crushed, soft and not coarse food, so as not to injure the inflamed ducts and the inner lining of the oral cavity.
Give up smoking and alcohol.
Physiotherapeutic treatment has a good effect: UHF, dry warm bandages on the diseased gland, semi-alcohol compresses.
With microbial infections of the salivary glands, the use of antibacterial and anti-inflammatory drugs (penicillins, cephalosporins, etc.) is indicated.
In the event of purulent or gangrenous sialoadenitis, it is performed, first of all, surgical intervention by excision of the affected tissue of the organ, drainage of the wound for the outflow of pus and the introduction of local antibiotics. After the operation is carried out infusion therapy using saline and colloidal solutions.

In the treatment of inflammation of the salivary glands at home, you can use a variety of antiseptic solutions for rinsing the mouth (furatsilin, rotokan chamomile, saline solution). To reduce pain, it is recommended to gently self-massage in the area of edema, or with alcohol.

It is important to remember that inflammatory processes in the salivary glands and their consequences can greatly complicate the life of the patient, contribute to the development of caries and diseases of the gastrointestinal tract.