Sialoadenita (Sialolitiaza)

Sialoadenita (Sialolitiaza)

    * Introduction
    * Signs and symptoms
    * Diagnosis
    * Treatment
Sialoadenita salivary gland infection is usually secondary to obstruction or hiposecretia salivary lithiasis. Sialoadenita usually occurs after hiposecretia or salivary duct blockage, but it can develop without an obvious cause. Major salivary glands are the parotid, the submandibular and sublingual.
Sialoadenita is more common in parotid and occurs in patients after 50-60 years, those with xerotomie with Sjogren's syndrome and after radiation therapy of oral cavity. Teenagers and adults with anorexia are also prone to this disease. The main causative organism is Staphylococcus aureus infection, pathogens include other streptococci, coliform bacteria and other anaerobic bacteria. Mumps mumps often cause. Patients with HIV infection often have swelling secondary to cysts limfoepiteliali parotids. Zgirieturii cat disease by infection with Bartonella often invade lymph nodes and can infect the parotid periparotidieni by contiguity. Although the disease is self-limited cat zgirieturii needed antibiotics and incision drainage if abscess is installed. Atypical mycobacterial infections of the tonsils (tonsils) or teeth may spread by contiguity to the major salivary glands.
Signs and symptoms include fever, chills, pain and swelling unilateral submandibular or parotid area (the lower external ear and lateral mandibular angle). The gland is firm and sensitive diffuse erythema and edema of the skin with superjacent. Pus can often be expressed by the compression gland duct affected, requiring bacterial culture. Suggest focal enlargement of an abscess formation.
Initial treatment is antibiotics against Staphylococcus aureus (dicloxacillin, a generation I or clindamycin cafalosporina, according to the antibiogram and bacterial culture results. Because of the rising prevalence of methicillin-resistant staphylococci, especially among older patients who are hospitalized in foster care , vancomycin remains the last resort. And hydration are important agents sialogogi (lemon juice, hard candy or other substances that trigger saliva, hot compresses, massage of the gland and good oral hygiene. Abscesses require drainage. Sometimes it takes parotidectomie superficial or excision for patients with submandibular gland chronic relapse.
Pathogenesis
Anatomy and the role of salivary glands.
Saliva is produced by three pairs of major glands:
Parotid glands are found in the ear canal between the mandible and the vertical ram prcesul mastoid, parotid gland ducts open masseter and crosses through a small papilla on the buccal membrane cooranei opposite the upper second molar, shows an intimate relationship with the facial nerve, which divides into its branches and crosses the gland.
Submandibular glands are the size of a peanut and is located in front of the mandibular angle, covering the posterior edge of the muscle miohiloidian; ducts emerge from the mouth floor side bridle the tongue.
Sublingual glands are under the tongue and open through several ducts in the mouth floor.
There are a number of minor salivary glands 600-1000 distributed in oral mucosa, palate, uvula, floor of mouth, posterior tongue, retromolara and peritonsillar area, pharynx, larynx and paranasal sinuses.
Pathophysiology saliva. Salivary glands serve many functions, including lubrication, enzymatic degradation of food, production of hormones, antibodies and other blood-reactive substances, media taste and antimicrobial protection. Regular flow of saliva is mainly controlled by the autonomic system and mainly parasympathetic. If this is mediated glsandei glanglionul submandibular submandibular. Presynaptic fibers derived from superior salivary nucleus and are trensportate by tympanic nerve cord, which joins the lingual nerve crossing the node. Postsynaptic fibers extend from the ganglion and the gland.
Saliva is produced in glandular subunit. The fluid component of saliva is derived from perfused blood vessels near the gland, while the macromolecular components derived from the secretory granules of acinar cells. Saliva is produced by salivary acinii. Along the periphery of acini are located mioepiteliale cells containing contractile elements. By their contraction saliva is secreted in the ductal system.
Mucus concentration is higher in submandibular gland secretion due to its viscous nature than other salivary glands. This high viscosity and cluttered secondary salivary flow contributes to the propensity for salivary calculi and stasis in certain circumstances.
Causes and Risk Factors
Sialoadenita acute can be caused by: - Staphylococcus aureus, Streptococcus viridans, Haemophilus influenzae, Streptococcus pyogenes, Escherichia coli. -Associated risk factors are immunosuppression, diabetes, HIV / AIDS, organ transplantation, chemotherapy Newborns, and children were identified prepubertari streptococci and Pseudomonas aeruginosa -Viral infections include mumps, HIV, coxsachie virus, parainfluenza type I and II, influenza A and herpes.
Autoimmune Sialoadenita:-Sjogren syndrome.