SU1223892A1 - Method of treatment of chronic parotitis - Google Patents

Description

FIELD OF THE INVENTION The invention relates to medicine, in particular to oral and maxillofacial surgery.

The purpose of the invention is the prevention of relapse by interfering with the external part of the parotid duct.

The method is carried out as follows.

The operation is performed under local anesthesia. A polyethylene catheter, selected according to the diameter of the duct lumen, is introduced into the parotid duct to a depth of 1-1.5 cm. 2.0 ml of 2% is injected through a catheter using a syringe with a metal needle attached to the parotid duct. solution of novocaine, which achieves anesthesia of the duct wall. Additionally, infiltration anesthesia of the soft tissues surrounding the duct is carried out with a 0.25-0.05% m solution of novocaine in the amount of 10-15.0 ml.

The incision of the buccal mucosa 3-4 cm long is made parallel to the jaw line, near the mouth of the duct. The duct preparation is carried out in a blunt and sharp way, separating it from the surrounding soft tissues, cheek muscles, fatty lump of the cheek and cheek branches of the facial nerve. If there is an additional share of the parotid gland, it is also extirpated together with the duct. In the area of entry of the extra-iron parotid duct into the parenchyma of the gland, the duct is cut to a transverse size. The wound is sewn up with knotty catgut sutures, applied in two layers: on the cheek muscle and on the mucous membrane of the cheek.

For the purpose of chemical denervation of the VIUHO-temporal nerve, 1.0 ml of a 2 ° / a-1 solution of novocaine in 80 ° ethanol was used to inject a syringe into the jawbone between the upper edge of the trestle of the yiu shell and the posterior surface of the myeloid process of the lower jaw. 1.5-2 cm, depending on the degree of development of subcutaneous adipose tissue.

A pressure dressing is applied to the operative area for 24 hours. In the postoperative period, a 0.1% solution of atropine sulfate is administered orally for 6–8 drops 20-30 minutes before meals 3 times a day for 7 days, as well as a liquid, non-stimulating salivation diet.

Example. Patient Sh., 49 years old, was admitted with complaints of recurrent swelling of the right parotid gland with a high temperature, purulent saliva from the right parotid duct. Anamnesis of the disease. Sick since 1981, when suddenly, for no apparent reason, swelling of the right parotid gland was caused. Treatment with outpatient warming compresses for suspected mumps. The swelling soon disappeared, but far away

five

five

ABOUT

0

0

0

that 6 times there was a recurrence of inflammation. Treatment in the maxillofacial inpatient hospital at the place of residence on the occasion of established chronic recurrent parotitis. Antibacterial, desensitizing therapy was performed, the gland was washed through the parotid duct with antibiotic and antiseptic solutions, and physiotherapy was prescribed. The treatment gave only a temporary effect. The history of the disease - without features.

General status. A patient of medium height, hypersthenic physique, increased nutrition (obesity, 1 st.). The skin and visible mucous membranes of the norm. Regional lymph nodes are not palpable. There is no visible deformation of the musculoskeletal system, movement in the joints is not limited. A lung pulmonary sound, vesicular breathing, is determined by the lungs by the percussion. Faces of 1, heart is normal, tones are clean, pulse is 72 per 1 min, satisfactory filling and voltage, HELL 245/85. The abdomen is soft, painless on palpation. The liver does not protrude from the edge of the costal arch, the kidneys and spleen are not palpable. Symptom Pasternatsky negative.

Local status. The face is symmetrical, the skin is of normal color. The parotid and submandibular glands are visually and palpatorically not enlarged, painless. The mouth of the right parotid duct is distended, zet. When massaging the right parotid gland, about 3-4 ml of thick saliva was secreted, initially turbid and then transparent; from the left duct, a drop of transparent saliva. The mucous membrane of the oral cavity is pale pink in color, pormal regional lymph nodes are punctured. Biochemical analysis, analyzes without deviations from the normal moisture content, the blood and common urine and feces are not we.

Sialometry about ppih glands. In the morning, the secretory function of the parotid glands was examined on an empty stomach with the aid of polyethylene catheters inserted separately into the parotid ducts. Unstimulated saliva collected in 1 hour. Results: left parotid gland - 1.0 ml; rights - About ml. Stimulation of secretion was produced by giving 8 drops of a 1% solution of salt 1 of pilocarpine oxide inwards. In the study after 20. Min after administration of pilocarpine stimulated secretion 0.5 ml of saliva was obtained from the left parotid duct within 20 minutes, from the right one - O ml.

Sialography of the right gland. In the right parotid duct through a polyethylene catheter is injected under a manometrically controlled pressure of 160

180 mmHg Art. 1.5 ml of a 60% aqueous solution of urografin. X-rays were taken 15 seconds, 1 minute after the radiopaque substance entered the gland and 2 minutes after stopping its supply and removing the catheter from the duct.

On sialograms, the deformation of the extra-iron tract with the dilatation alternating with constrictions is determined. The function of the gland is impaired.

Sialography of the left parotid gland. Under technical conditions similar to the right gland, 2.0 ml of a 60% vérografin solution is injected into the circulating duct. No abnormal changes were found on the sialograms. Function

qi gland is not disturbed. Diagnosis: sialo-dichitis of the right gland with severe disruption of the glandular secretory function. The operation is performed - the extirpation of the right near the duct by the intrarocary canal with chemical denervation of the gum-temporal nerve. The postoperative period is uneventful, the wound is clamped by primary tension. Sick discharged home.

At the control examination, the patient does not complain. The rights of the peripheral gland are not enlarged, painless. In the thickness of the soft tissues of the right buccal region, a small, painless infiltration is palpable. The right parotid gland is not enlarged, the infiltrate is not palpable.

Claims (1)

METHOD FOR TREATING CHRONIC PAROTITIS by separating the extra-iron part of the duct of the parotid gland, characterized in that, in order to prevent relapse, an extra-iron part of the parotid duct is extirpated and the ear-temporal nerve is denervated. yo yo qo SO y