What Is the Treatment for Blocked Salivary Glands?

salivary gland diseases

Salivary gland disease

Salivary glands, also called salivary glands, come in two sizes. There are three pairs: the parotid, submandibular, and sublingual glands, each with a catheter opening in the mouth; the smaller ones are distributed in the lamina propria and submucosa of the lips, tongue, cheeks, palate, and molars.

Introduction to Salivary Gland Diseases

salivary gland diseases

Common salivary gland diseases include the following: Salivary gallstone disease. The most common submandibular duct stones. Main symptoms: pain and swelling of the submandibular glands when eating. Can lead to stones in the catheter. X-ray pictures can show positive stones. Treatment: Surgical removal of stones. Salivary adenitis. Mainly caused by salivary gland stones and infections such as pyogenic bacteria, viruses, and tuberculosis. Clinical manifestations: redness, swelling and pain in salivary glands, fever all over the body. Salivary ductal lipstick in purulent patients can squeeze out pus; saliva in the ductal ducts of viral patients is clear; salivary ductal lymphadenitis is normal. Treatment: antibacterial and anti-inflammatory. Miguelitz's disease, Sjogren's syndrome (dry mouth syndrome). Autoimmune disease of the salivary glands. Lymphocytes infiltrate and replace acinar. Clinical manifestations: dry mouth, dry eyes, enlarged salivary glands, joint disease, etc. Salivary gland angiography, isotope scanning, and biopsy pathological examination have diagnostic value. There is no cure, and can be treated with Chinese and Western medicine to improve saliva secretion. Benign hypertrophy of salivary glands. Compensatory or degenerative lesions of salivary glands. Responses to salivary glands such as malnutrition, hepatitis, and diabetes. Clinical manifestations: soft swelling of salivary glands without discomfort. The salivary glands were benign hypertrophy. Generally does not require treatment. Salivary gland tumor (see Maxillofacial tumor).

Salivary Gland Disease Factors

Salivary stone disease can occur in any salivary gland. Because of the length of the submandibular gland duct, the duct mouth is located at the bottom of the mouth. Submandibular gland sialolith is the most common, followed by the parotid gland. It can occur in one or more glands, and salivary stones can also be one or more, sometimes accompanied by stones in other organs. The etiology is not very clear, but it is related to the following factors: saliva retention, concentration, chemical composition changes, and inorganic salts deposited on the ducts; foreign bodies such as toothbrush hairs, wheat ears, exfoliated epithelial cells, protein degradation products, or bacteria Can form the core of calcium salt deposition; systemic factors, such as the close relationship between the metabolism of inorganic salts and the colloidal state of saliva.

Main manifestations of salivary gland disease

Symptoms due to obstruction of salivary glands, swelling and pain of salivary glands. When eating, especially when eating acid, severe swelling and pain, called salivary colic, gradually subsided after eating. It is also often accompanied by chronic inflammation of salivary glands, showing enlarged and hardened glands, mild tenderness, redness and swelling of the catheter, and a small amount of pus in the catheter. According to the medical history and X-ray examination, a positive sialolith (good calcification and can absorb X-rays) is not difficult to diagnose. For negative salivary stones (those who do not absorb X-rays), an organic iodine aqueous solution needs to be injected from the catheter into the gland to show the catheter system and fill a little acinar, called salivary gland radiography, and negative salivary stones can be seen in the catheter. For circular or oval-shaped contrast agent defects, care should be taken to avoid gas from entering to avoid confusion. If it is completely blocked, it can be seen that the contrast agent is blocking it; if it is not completely blocked, it can be seen that the distal end (catheter opening is centered) of the catheter and glands are damaged by inflammation. The salivary stone is removed surgically or the glands with inflammation are removed at the same time.

Salivary gland disease

Generally differentiated purulent, specific (tuberculosis, actinomycosis) and viral (mumps). Virality is discussed in epidemics. Tuberculosis is mostly infected from the lymphatic tract. Because there are real lymph nodes in the parotid gland, there are more people who have disease in the parotid gland and very few salivary gland diseases caused by actinomycetes. Acute suppurative mumps is now rare. In the past, hematogenous spread was considered to be the main route of infection for chronic suppurative mumps when suffering from severe systemic diseases. However, it is currently considered to be an infection caused by bacteria retrograde to the glands along the salivary gland ducts. Toxic mumps caused by heavy metals such as mercury, lead, arsenic, and bismuth are also rare. There are various symptoms of parotid inflammation, local swelling and pain, salty liquid flowing out of the catheter mouth, and the presence of salivary stones coexist, the symptoms of obstruction are more obvious, and a thick, cord-like duct can be scooped under the skin. Submandibular glanditis is often associated with obstruction and is often accompanied by salivary stones, causing repeated swelling and pain in the glands.

In addition to clinical symptoms and signs, salivary angiography is very helpful for diagnosis. The angiography shows that the main duct is dilated and has a sausage shape and extends to the branch duct. It is called obstructive salivary glanditis (tubitis). There is no change in the main duct and branch ducts, and only those with a little punctate and spherical expansion of the peripheral acinus are called non-obstructive salivary adenitis (adenitis), which is found in the parotid gland (recurrent mumps in adults); chronic recurrent mumps also occur In children, there is often a history of mumps, repeated swelling and pain in one or both parotid glands, and the salivary angiography image is similar to adenitis. Children and adults with recurrent mumps have a tendency to heal themselves and can be treated conservatively.

Salivary Gland Disease Treatment

Submandibular gland disease can be performed for submandibular gland disease. Treatment of mumps: inject antibacterial drugs into the catheter, but the effect can not last; use the main catheter ligation after the infusion of antibacterial drugs to control the infection to gradually shrink the parotid glands and stop secretion; Salivary gland cysts and tumor cysts are caused by obstruction of salivary gland ducts. Mucinous gland cysts are located under the mucosa and are caused by obstruction of the small salivary glands, which can be removed surgically. Sublingual gland cysts are formed by obstruction of a duct (there are multiple ducts in the sublingual gland) or rupture of the duct, and the secretion fluid leaks out. Its appearance is similar to the pharyngeal sac that bulges when a frog tweets. Pathological studies have shown that the cyst wall of the sublingual gland cyst is fibrous tissue or granulation tissue with occasional epithelium. Simply removing the cyst can not accurately remove the obstruction and extravasation of the sublingual gland, which will inevitably cause recurrence. Therefore, the cyst and the associated Sublingual glands.

Salivary gland tumors have a higher incidence in tumors of the oral and maxillofacial regions, with parotid gland tumors having the highest incidence. Salivary gland tumors are classified as benign, low-grade, and malignant. Mixed tumors (also known as polymorphous adenomas) are the most common. Although they are benign, they can also be malignant. A benign tumor is a slow-growing painless mass with activity, no adhesion, and no dysfunction; malignant tumors often show pain, grow faster, show invasive growth, have adhesions to surrounding tissues, and even infiltrate nerve tissues and cause facial paralysis. 3. Tongue muscle paralysis; some low-grade malignant tumors may look like benign tumors at an early stage, but have a longer course.

Salivary gland tumors are generally not recommended for biopsy, because the invasion of the capsule can cause the tumor to spread and easily recur and metastasize. Histopathology is often performed on frozen sections during surgery. However, this prolongs the operation time, and sometimes frozen sections cannot be confirmed. Therefore, in addition to salivary gland angiography, scholars at home and abroad are exploring new diagnostic methods, such as CT, ultrasound, isotope, and fine needle aspiration to improve the understanding of tumor properties before surgery. Due to the incompleteness of some tumor capsules, a simple method of peeling along the capsule often relapses. Therefore, most of the glands or whole glands are removed from the normal parotid gland during surgery to preserve the facial nerve. Malignant tumors are not only used for total gland resection, but sometimes the normal tissues outside the mass need to be removed, and the facial nerve is sacrificed if necessary.

Salivary gland diseases Mikulich's disease, Sjogren's syndrome and Sjogren's syndrome

A group of autoimmune diseases that occur in the salivary glands. Pathology showed that a large number of lymphocytes infiltrated the glands and replaced acinar cells, showing symptoms such as dry mouth and glandular enlargement. One or more, unilateral or symmetrical bilateral salivary glands and lacrimal glands are progressively enlarged (parotid glands are enlarged, submandibular glands, sublingual glands, other small salivary glands can also be enlarged), and there are no other symptoms except swelling , Called Mikulich's disease. Two of the three are dry mouth, dry eyes, and connective tissue disease (most commonly rheumatoid arthritis), which are called Sjogren's syndrome. Only dry mouth and dry eyes are called Sjogren's syndrome. In some cases, the swelling of the parotid gland or submandibular gland can touch the pseudotumor formed by infiltration of lymphocytes, which is clinically called tumor type or nodular type. Those with dry mouth are susceptible to infection and the disease can be malignant.

In addition to clinical manifestations, salivary gland angiography can assist diagnosis, because secretory acinars are replaced by infiltration of lymphocytes and lose the ability to empty normally, so the contrast agent is particularly slow to be discharged. Isotope 99mTC scans are also valuable for diagnosis. Salivary glands tend to concentrate nuclide. At this time, acinars are destroyed and replaced by lymphocyte infiltration, so the intake is reduced. Labial biopsy can reflect salivary gland changes to a certain extent, so it can be used as a reference for diagnosis. Symptomatic treatments such as artificial tears and gargle with water containing glycerin can make the mouth lubricate; surgical treatment is suitable for tumor or nodular types of single glandular lesions, which can remove part of the autoantigen, prevent the development of the disease, and prevent malignant changes . For patients with extensive and severe disease, immunosuppressive therapy can be tried.

Salivary gland disease

Glandular fistula (exudation of salivary extravasation from the gland) or tube fistula (exudation at the salivary autonomous catheter) due to trauma, infection, or incorrect surgical incision in the salivary glands and their catheters. Clinically refers to external salivary fistula, saliva flows to the cheek, while internal salivary fistula saliva flows into the oral cavity, which is not a big hindrance. The salivary fistula mostly occurs in the parotid gland and its duct. The position of the parotid gland is superficial. Its duct runs under the skin and passes through the upper side of the chewing muscle to the front edge of the chewing muscle. It passes through the buccal muscle opening to the oral mucosa. When a glandular fistula occurs, a spot-shaped fistula can be seen on the skin of the parotid gland, a small amount of transparent liquid flows out, and it increases when eating; the tube fistula is located in the buccal muscle or the chewing muscle in the back. There are also transparent or turbid liquid flowing from the fistula to the cheek, which increases when eating, and over time, the skin may be stimulated by saliva, and there may be eczema-like skin lesions. In addition to clinical manifestations, salivary gland angiography is helpful for the choice of diagnosis and surgical treatment. The angiographic image shows that the intact catheter system is the glandular fistula; the main catheter is interrupted, and the contrast agent overflow is the duct fistula. The manifestation of inflammation. Glandular fistula is treated with local flap rotation repair. Tube fistula needs to observe the distance between the fistula opening and the glandular door displayed by the contrast agent. If the distance is long, it is estimated that the length of the catheter can enter the mouth through the chewing muscle, peel the fistula and catheter, and sew the fistula opening on the oral mucosa. It is called internal fistula. If the distance is very short, it indicates that the remaining catheter is very short, and the buccal mucosal flap needs to be used to form a new catheter to coincide with the broken end. If the newly isolated duct fistula is not defective, the catheter can be directly sutured.