Salivary gland cancer is a rare oncological disease characterized by the development of malignant tumors in the large salivary glands (submandibular, parotid, sublingual) or small (lingual, labial, palatal, buccal, molar). This disease is characterized by slow dynamics and hematogenous metastasis.
Confirmation of the diagnosis at the Yusupov Hospital occurs after a thorough examination by an oncologist using additional types of diagnostics - CT, PET-CT, MRI, and tissue biopsy. Treatment is prescribed on an individual basis based on the patient’s examination results.
General information
Sialadenitis is an inflammatory process in the salivary glands. In humans, there are three pairs of salivary glands in the oral cavity, which secrete saliva and discharge them into the oral cavity through special ducts, thereby ensuring a normal digestive process. These are the parotid , submandibular and sublingual glands.
The main functions of saliva are to soften food and also facilitate the process of swallowing it. During the inflammatory process, the production of saliva becomes difficult, and during the process of eating a person feels significant inconvenience. During the development of the disease, pain, swelling of the face, etc. are noted. If the process progresses, a purulent cavity or tumor may form. The disease develops in both young children and adults. Damage to the salivary glands requires consulting a doctor and carrying out the prescribed treatment. The ICD-10 code for sialadenitis is K11.2. How inflammatory diseases of the salivary glands manifest themselves, what treatment is most effective in such cases - this will be discussed in the article.
Treatment of chronic sialadenitis
Treatment of chronic sialadenitis is aimed at preventing changes in gland tissue, normalizing saliva secretion and eliminating the inflammatory process.
During an exacerbation, the dentist prescribes a course of broad-spectrum antibiotics. In the absence of a bacterial infection, therapy may be limited to antiseptic rinses and the administration of a vitamin complex to support immunity. In complex therapy, it is possible to carry out physiotherapeutic procedures, such as electrophoresis or magnetic laser therapy. In rare cases, if conservative treatment is ineffective and the gland loses function, surgical intervention is possible.
Pathogenesis
There are three pairs of major salivary glands in the human mouth. The parotids are located under the auricle in front and are the largest. The submandibular muscles are located under the lower jaw. Accordingly, sublingual - under the mucous membrane of the floor of the oral cavity on both sides of the tongue. These glands produce saliva, which is produced through ducts located in the oral cavity. Saliva ensures normal digestion by softening solid foods.
Reactive-dystrophic pathological processes occur in stages. At the initial stage , there are no symptoms of the inflammatory process, but the lymph stagnates near the blood vessels and ducts. The vessels become overfilled with blood, the lymph around the gland ducts stagnates, and the connective tissue loosens. The acini (terminal sections of the salivary gland) are completely preserved, and mucopolysaccharides and mucin accumulate in them.
The second stage of the disease is characterized by the presence of signs of an obvious chronic inflammatory process. There are signs of atrophic changes in the end parts of the gland, infiltrates are detected in the sclerotic stroma. Fibrous tissue appears near the excretory ducts of the gland. Lymphocytes and epithelial cells accumulate in the lumen of the ducts.
At the third stage, almost complete atrophy of the gland parenchyma occurs, and it is replaced by connective tissue. Blood vessels dilate, the ducts of the gland dilate or narrow if they are compressed by connective tissue.
Neoplasm of the parotid salivary gland - symptoms
A tumor of the parotid gland in the initial stages can be practically asymptomatic. The first witnesses of the disease may be causeless dry mouth or, on the contrary, excessive salivation. Further dynamics of the disease are often characterized by the following clinical manifestations:
- numbness of the face or part of it in the area of the salivary glands;
- swelling, painful lump in the neck, mouth or jaw;
- pain while swallowing;
- increased body temperature;
- dizziness;
- discomfort when opening the mouth;
- muscle pain or weakness (paresis) in a certain area of the face.
However, these symptoms may also indicate the occurrence of other benign neoplasms, for example, a salivary gland cyst. If you experience one or more of the above symptoms, you should consult a qualified physician for a diagnosis. Oncologists at the Yusupov Hospital, thanks to their professionalism and extensive experience working with patients of different ages, will competently prescribe treatment and all the necessary diagnostic measures.
Classification
Taking into account the peculiarities of the process, acute and chronic sialadenitis are distinguished.
According to nosological independence, two forms of the disease are distinguished:
- Primary is an independent disease.
- Secondary – a complication in the development of other diseases ( flu , sore throat , etc.).
Taking into account the causes of the development of the disease, the following are distinguished:
- Traumatic – a consequence of injuries and the influence of external factors.
- Radiation – a consequence of irradiation.
- Toxic – a consequence of chemical influence.
- Infectious – develops after infection.
- Allergic.
- Autoimmune.
- Obstructive - a consequence of blockage of the excretory duct by a foreign body or cicatricial narrowing of the duct.
According to the location of the lesion there are:
- Inflammation of the sublingual salivary gland - the inflammatory process of the sublingual gland is also called sublingual gland.
- Inflammation of the parotid salivary gland - in this case, the cheeks swell and there are signs of general intoxication. Sialadenitis of the parotid gland is also called mumps .
- Sialadenitis of the submandibular salivary gland is an inflammatory process of the submandibular salivary gland. When this gland is damaged, calculous sialadenitis , which is characterized by the development of stones in the ducts of the salivary glands or in their parenchyma.
Taking into account the condition of the parenchyma, the following forms of the disease are distinguished:
- interstitial sialadenitis - only stromal damage occurs.
- parenchymal sialadenitis - in addition to the stroma, the parenchyma is also affected.
Depending on the nature of the inflammatory process, the following forms of sialadenitis are distinguished:
- Purulent.
- Serous.
- Hemorrhagic.
- Connective tissue.
- Destructive.
- Granulomatous.
- Fibroplastic.
- Sialadenitis without deformation of the gland.
- Sialadenitis with scarring of the gland.
There are also epidemic and non-epidemic sialadenitis.
- The epidemic form of the disease develops against the background of viral diseases and infections.
- Non-epidemic form - diagnosed if there is a blockage of the salivary gland. Such blockage can develop as a result of injuries, salivary stones, or foreign bodies entering the ducts.
Causes
There are a number of factors that provoke the development of sialadenitis:
- Wrong approach to oral hygiene.
- Diseases in which the composition and viscosity of saliva changes.
- Postponed surgeries.
- Infectious diseases - influenza, encephalitis , herpes , ARVI , etc.
- Oral diseases – caries , pulpitis , periodontitis , etc.
- Dry mouth.
- Treatment with chemotherapy , radiation therapy .
- Diabetes.
- Disorders of mineral metabolism leading to stone formation.
The epidemic type of the disease develops as a result of infectious processes. Most often, this condition develops with mumps (mumps) . This virus is transmitted from infected people through airborne droplets.
The non-epidemic form of the disease is usually associated with blockage of the glands. This happens with injuries or exposure to foreign bodies. Also the cause of the development of this form of the disease is the so-called salivary stone disease ( sialolithiasis ). If a person develops sialolithiasis of the submandibular salivary gland, the resulting stones may block the ducts.
Tumor of the parotid salivary gland - causes of development
The causes of salivary gland cancer have not yet been precisely established. The main factors of occurrence are considered to be adverse environmental effects, excessive insolation, infectious and inflammatory diseases of the salivary gland, certain eating habits, and smoking. The factor that has the most negative effect is radiation in any of its manifestations - radiation therapy, repeated x-ray examinations, living in an area of high radiation, etc. There is also a connection with the professional type of activity of a person, since a tumor of the salivary gland most often appears in asbestos workers mines, metallurgical enterprises, automobile and woodworking plants. This is due to the constant contact of people in these professions with dangerous carcinogens - lead, chromium compounds, silicon, asbestos, etc. A high likelihood of developing cancer also exists in patients who have had mumps in the past. The factor of smoking today is controversial, since some scientists believe that it affects the development of certain types of cancer of the salivary glands, while others deny the connection of this bad habit with tumors of the salivary glands. Eating behavior can negatively affect the development of cancer processes in the human body if there is insufficient consumption of plant fiber, yellow and red fruits and vegetables, herbs and excessive consumption of cholesterol.
Symptoms of salivary gland inflammation
The signs that inflammation manifests largely depend on where exactly the pathological process is localized.
submandibular sialadenitis develops , symptoms may be as follows:
- Pain in the submandibular area, which becomes worse when chewing.
- Swelling in the area of the salivary gland, which may increase.
- Temperature increase.
- Taste of salt or pus.
- Swelling of the face.
- Redness and swelling in the mouth.
If sialadenitis of the sublingual salivary gland , similar symptoms develop. The mouth of the exit ducts of the gland turns red and swelling develops. The pain may be more severe than with submandibular sialadenitis .
With parotid sialadenitis, more pronounced symptoms appear. There is marked swelling and asymmetry of the face, redness of the skin. The patient is bothered by dry mouth. The pain intensifies when palpating the affected area. The temperature rises and the general condition worsens. Shortness of breath may bother you . Palpation of the parotid salivary gland leads to the appearance of cloudy saliva mixed with pus.
Symptoms of salivary stone disease can manifest themselves in a similar way. I am concerned about soreness and dry mouth. At the same time, it is difficult for a person to open and close his mouth.
Symptoms of chronic sialadenitis
At the initial stage of parenchymal sialadenitis , symptoms are usually absent. The main complaints are related to a feeling of dry mouth. In the future, there may be a painful swelling in the neck, an unpleasant taste in the mouth, and nagging pain. Without treatment, the surface of the salivary gland becomes lumpy, and saliva separation is difficult.
With interstitial sialadenitis, a separate area of the inflamed gland may bother you. Complaints of hearing loss are rarely observed. With increasing inflammation, the salivary gland increases in size; upon palpation, the unevenness of its surface is felt, and the secretion of saliva is impaired.
Ductal sialadenitis affects people of advanced age or with weakened immune systems. Inflammation is accompanied by an obsessive salty taste in the mouth. When pressing on the mouth of the duct, cloudy saliva is released. The mouth of the excretory duct itself is noticeably thickened.
Tests and diagnosis of sialadenitis
Diagnosis of sialadenitis is carried out using clinical, instrumental and laboratory methods.
The essence of clinical methods is the collection of complaints and anamnesis. The doctor also examines the patient.
Laboratory methods - a general blood and urine test, a biochemical blood test are performed. A study of saliva is also carried out, in which, during the inflammatory process, leukocytes and an admixture of pus are found.
Hardware methods - diagnosis of diseases of the salivary glands involves, first of all, sialography with contrast, that is, x-rays of the gland. With the help of such a study, stones, narrowing of the lumen of the excretory duct, as well as other obstacles to the normal secretion of saliva are determined.
CT, MRI - it is advisable to carry out if the presence of stones is suspected.
Ultrasound - allows you to determine the structure of the gland and the characteristics of the inflammatory process.
Thermosialography – the temperature of the gland is measured.
Salivary gland biopsy - performed under ultrasound guidance.
Sialendoscopy.
Treatment with folk remedies
Traditional methods in the treatment process can only be used as auxiliary ones. It is advisable to use the following methods of traditional treatment:
- Rinsing the mouth - for this purpose, a solution of soda and salt can be used (1 teaspoon of salt and soda for 1 glass of water). It is also recommended to rinse the mouth with infusions of herbs - sage, oak bark, calendula, chamomile. To prepare the infusion for rinsing, 2 tbsp. l. raw materials should be poured into 3 liters. boiling water Leave for an hour and rinse your mouth several times a day. In case of purulent processes, rinsing is contraindicated.
- To stimulate salivation, it is recommended to consume lemon juice, cranberry juice, and chewing candies.
- 5 tbsp. l. pine needles pour 1 liter of water, bring to a boil, leave and take 50 ml 2 times a day.
Diet
Diet to boost immunity
- Efficacy: therapeutic effect after 3 weeks
- Terms: 1-3 months or more
- Cost of products: 1600-1800 rubles. in Week
During the treatment period, it is recommended to eat properly to strengthen the immune system. Sometimes doctors advise sticking to the so-called salivary diet. However, if a patient is diagnosed with calculous sialadenitis, then in this case it is necessary to carry out mechanical removal of stones, since nutritional correction will not help cure the calculous type of disease.
The salivary diet involves introducing the following products into the menu:
- Sauerkraut, sour berry fruit drinks, lemon juice, pickles.
- Citrus.
- Sour lollipops.
- Fresh vegetables.
- Juices from cabbage, carrots.
- Rose hip decoction.
You need to exclude from your diet foods that contribute to the formation of stones:
- Cheeses, cottage cheese.
- Tofu.
- Almonds, sesame.
- Fish.
- Milk.
