RU2182501C2 - Method for treating large salivary gland inflammation diseases - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves introducing blunt injection needle 40-50 mm in depth into the large salivary gland duct in lying position. Light guide connected to laser device is introduced through the needle. Red light laser radiation treatment in red bandwidth is applied for 2 min at 0.63 mcm wavelength and 4.5-5 mW power once a day. The total treatment course is 5 procedures long. EFFECT: enhanced effectiveness of radiation treatment.

Description

 The invention relates to medicine, namely to dentistry, and can be used to treat inflammatory diseases of the large salivary glands.

 For the treatment of inflammatory diseases of the large salivary glands, antibacterial, anti-inflammatory, desensitizing agents are used [3]. These measures are combined with laser treatment of the salivary gland by the contact method along the anatomical borders from the outside (extraoral) side. Non-contact intraoral irradiation with defocused laser radiation is also carried out (pulse power 3 W, frequency 1500 Hz, exposure 60-85 s). The course of treatment 3-5 sessions [1].

 The existing method of laser exposure to gland tissue has several disadvantages.

 With the passage of low-intensity laser light into the thickness of the glandular tissue, part of the energy is lost. This is due to the high resistance of the skin and subcutaneous tissue, the genetically determined purpose of which is the absorption of light and, as a consequence, the protection of deep-lying structures from external influences. Loss of energy leads to a decrease in the therapeutic effect.

 Increasing the radiation power leads to a shift of the focus of maximum energy to the level of the skin and subcutaneous tissue. Given the anatomical features of the skin structure and the severity of the subcutaneous fat layer in each individual patient, it seems difficult to calculate the parameters of the cutaneous laser exposure necessary to achieve the maximum therapeutic effect directly at the gland level.

 Given the projection area of the parotid salivary gland on the skin, it becomes obvious that the effect must be carried out in several stages, after dividing the entire surface into small sections that should correspond to the cross-sectional area of the light beam. In this case, the number of fields will be equal to the number of single exposures. The total amount of impacts per session is limited and should not exceed the permissible limits, which are six fields per session [2]. All this ultimately leads to an uneven, focal effect, which is unacceptable in conditions of generalized inflammation of the gland.

 Inpatient treatment of inflammatory diseases of the large salivary glands, including a course of antibiotic therapy, gland sanitation, a course of physiotherapeutic treatment, takes an average of 14 days [3].

 The purpose of this invention is to reduce the treatment time for inflammatory diseases of the large salivary glands.

 This goal is achieved by the fact that a patient in a prone position, a blunt injection needle is inserted into the duct of the large salivary gland. The depth of needle insertion is up to 50 millimeters for the duct of the parotid salivary gland, and up to 40 millimeters for the duct of the submandibular and sublingual salivary glands.

 After that, an OS-2 optical fiber connected to a laser apparatus is drawn into the needle, and monochromatic polarized radiation is irradiated in the red spectral region with a wavelength of 0.63 μm and a power of 4.5-5 mW. Irradiation is carried out for 2 minutes with a repeat of the irradiation session after 24 hours. The course of treatment consists of 5 procedures.

 Example 1. Patient K., 60 years old, was admitted to treatment at the ChLH department of the Voronezh Regional Clinical Hospital with complaints of swelling and aching pain of low intensity in the area of the right parotid gland.

 Objectively: facial contours are changed due to swelling in the right parotid chewing area. On palpation of the right parotid gland, sharp pain is noted, the gland is dense, with a tuberous surface. The mucous membrane of the oral cavity is pale pink, in the area of the mouth of the right Stenon duct hyperemic. When massaging a gland, a small amount of a thick, cloudy secretion is secreted from the duct. On the sialogram of the right parotid salivary gland, multiple cavities up to 5 mm in diameter are noted, ducts of the I-V orders are narrowed, not determined in places.

 Diagnosis: "Exacerbation of chronic parenchymal mumps on the right."

 The treatment, including antibiotic therapy, gland atropination, gland instillation with a sanitizing 5% aminocaproic acid solution, was combined with a course of intraductal laser therapy. Irradiation was carried out with monochromatic polarized radiation in the red spectral region with a wavelength of 0.63 μm and a power of 4.5 mW. Irradiation was carried out for 2 minutes with a repeat of the irradiation session after 24 hours.

 As a result of the treatment, a decrease in the volume of the gland tissue to normal sizes, the disappearance of pain, the normalization of passage and the consistency of saliva are noted.

 When examined after six months, there was no need for a second course of treatment.

 Example 2. Patient Ch., 40 years old, with clinical and radiological confirmation of the diagnosis: "Exacerbation of chronic sialadenitis of the left submandibular salivary gland."

 A course of intraductal irradiation with red laser light from five procedures was carried out. The parameters of daily irradiation sessions were: power 4.5 mW, session time 2 minutes.

 Laser therapeutic effects were combined with antibacterial therapy and instillations of 5% aminocaproic acid through the duct.

 On the second day of the treatment, normalization of the color and consistency of the secretion of the gland was noted. On the third day of treatment, pain in the gland disappeared. On the fourth day, gland tissue softened and its volume decreased.

 Complete normalization of gland function occurred on the fifth day of treatment.

 The proposed method allows to reduce the treatment time for patients with inflammatory diseases of the large salivary glands in comparison with known methods of treatment by an average of 50%.

Sources of information
1. Builin V.A. Low-intensity laser therapy in dentistry. M .: Aspect Press, 1995, p. 34.

 2. Builin V.A. Low-intensity laser therapy in dentistry. M .: Aspect Press, 1995, p. 37.

 3. Romacheva I.F., Yudin L.A., Afanasyev V.V., Morozov A.N. Diseases and injuries of the salivary glands. - M.: Medicine, 1987, p. 156-160.

Claims (1)

 A method of treating inflammatory diseases of the large salivary glands, including laser irradiation of the gland tissue, characterized in that the patient in a prone position, a blunt injection needle is inserted into the duct of the large salivary gland to a depth of 40-50 mm, into which an OS-2 light guide connected to a laser apparatus, and irradiation with monochromatic radiation in the red region of the spectrum with a wavelength of 0.63 μm, a power of 4.5-5 mW for 2 min, once a day, a course of treatment of five procedures is carried out.