Sialadenitis

A sialadenitis (also Sialoadenitis, σίαλον of Greek, sialon, saliva ἀδεν, aden, gland and ίτις, -itis, inflammation) is an inflammation ( adenitis ) of the salivary glands.

There are infectious and distinguish non-infectious causes. Pain and swelling dominate the clinical picture. The diagnosis can often be made ​​at first glance. Treatment depends on the cause and may include the administration of antibiotics, surgical or symptom-oriented measures.

Causes

Acute purulent infections are often caused by bacteria such as staphylococci or streptococci. They are - mainly in the parotid gland - by a reduced flow of saliva or - mainly in the submandibular gland - favored by salivary stones ( Sialolithiasis ).

Viral pathogens of sialadenitis among other mumps virus ( Mumps pathogens ), influenza virus, coxsackie virus, and cytomegalovirus.

A radiation-induced inflammation can occur with radiation therapy in the head and neck region or at a radioiodine therapy.

Certain autoimmune diseases, such as Sjögren's syndrome can cause inflammation of the salivary glands. With a chronic recurrent parotitis Often, no cause can be identified.

Clinical manifestations

Typically, a swelling of the affected gland, which is also painful. Depending on the cause, in addition there are general symptoms, such as malaise or fever.

In salivary calculi or chronic recurrent inflammation of the patient's complaints are often one-sided, usually bilateral mumps during or Sjogren's syndrome.

Research methods and findings

Is often possible to make the diagnosis with the first glimpse of the patients ( " visual diagnosis ").

In the area of ​​the mouth of the efferent duct of the affected gland in the oral mucosa often finds a swelling and redness. Explore voiding pus indicates a bacterial infection, clear secretions to a viral infection.

Medical ultrasonography can support the diagnosis in doubtful cases. The Sialografie can provide valuable information for the differential diagnosis of chronic cases. In a chronic recurrent sialadenitis a picture, just like in a " leafy tree". In contrast, many glandular ducts are destroyed in a Sjögren's syndrome ( " rarefied " ) so that the image of a " leafless tree " results. In an acute inflammation of the salivary glands Sialografie is contraindicated.

Treatment

Treatment depends on the cause. In bacterial infection, antibiotics are given. Occasionally a Abszessspaltung and drainage is necessary. For viral inflammation is treated symptomatically ( wet compresses, pasty food).

An acute sialadenitis, which occurs under a radioactive iodine treatment, can be relieve with mostly good cooling and anti-inflammatory medications such as nonsteroidal anti-inflammatory drugs or glucocorticoids. The complaints sound but even without treatment within a few days.

In Sjögren's syndrome, the treatment of the underlying disease is paramount. The dryness of the mouth occurs in this disease and in radiation- induced sialadenitis is mitigated with artificial saliva.

In severe chronic recurrent bleeding, removal of the affected salivary gland may be necessary ( Sialadenektomie, for example parotidectomy ).

Case of a blocking stone in a salivary duct of a salivary gland, the duct can be extended by a simple operation. The stone is mostly washed away. Here, the transition is usually cut with scissors. In addition, much is recommended to drink, where appropriate, to chew gum for saliva flow is stimulated.

Cure views

The viral inflammation of the salivary glands heal with overcoming the infection. In particular, the mumps but complications can arise (see # mumps complications).

The chronic recurrent sialadenitis often heals after puberty.