Sialadenitis

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Sialadenitis

Sialadenitis – inflammation of the salivary glands, often leading to the formation of stones in the salivary ducts (calculous sialadenitis, sialolithiasis, salivary stone disease); in the aftermath, obstruction of the duct may occur with subsequent inflammation and intermittent painful swelling of the gland. Stones are most often found in the submandibular glands. Etiology

    • Oral bacteria are the most common cause
    • Parotitis
    • Actinomycosis
    • Tuberculosis
    • Syphilis
    • Cytomegalovirus infection
    • Cat scratch disease. Risk factors
    • Dehydration
    • Fever
    • Hypercalcemia. Pathomorphology
    • Dilatation of the duct with delayed salivation
    • Gross atrophy or thickened and edematous mucosa
    • Purulent or serous-purulent exudate inside the duct
    • Replacement of glandular tissue with fibrous
    • Leukocyte infiltration.

Clinical picture

    • Enlarged painful salivary gland
    • On palpation from the opening of the duct, pus is likely to be released
    • Hyperemic painful opening of the duct
    • Fever
    • Dry mouth (xerostomia)
    • Decreased secretion of saliva (aptalism).

Research methods

    • X-ray examination (detect shadows of calculi in calculous sialadenitis)
    • Sialogram with the introduction of a contrast agent into the drained duct (the area of ​​obstruction is revealed). The method is effective for x-ray negative stones.

Differential Diagnosis

    • Taking certain drugs (TAD, phenothiazine derivatives, anticholinergics)
    • Myxedema
    • Plummer-Vinson disease
    • pernicious anemia
    • Mikulich’s disease
    • Malignant neoplasms (epidermal carcinoma, neurofibroma, fibrosarcoma, melanoma).

Drug therapy

    • Antibiotics, eg penicillins, erythromycin, cephaloridine
    • Analgesics. Surgery
    • For sialadenitis without stone formation
    • If the sialogram shows a stricture in the distal duct, it should be dilated
    • If symptoms persist for a long time, the gland can be removed
    • With calculous sialadenitis
    • When the stone is located within the outer opening of the duct, the calculus is removed through the oral cavity
    • If the stone lies deep in the iron,

it can be removed through an external incision

    • With multiple stones and recurrent pain, the entire gland should be removed.

Current and forecast. Complete recovery and good prognosis. ICD

  • K11.2 Sialoadenitis
  • KH.5 Sialolithiasis