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慢性复发性非特异性腮腺炎:病例报告与文献复习

Chronic Recurrent Non-specific Parotitis: A Case Report and Review.

作者信息

Mahalakshmi Saibaba, Kandula Srinivas, Shilpa Patil, Kokila Ganganna

机构信息

Department of Oral Medicine and Radiology, Sri Siddhartha Dental College & Hospital, Sri Siddhartha Academy of Higher Education, Tumkur.

Department of Oral Medicine and Radiology, Kalinga Institute of Dental Science, KIIT University, Bhubneshwar.

出版信息

Ethiop J Health Sci. 2017 Jan;27(1):95-100. doi: 10.4314/ejhs.v27i1.13.

Abstract

BACKGROUND

Chronic recurrent non-specific parotitis is characterized by recurrent episodes of swelling and pain of unknown etiology in the parotid gland. Sialography is a hallmark in the diagnosis of salivary gland disorders; newer imaging modalities like CT-Sialography, sialoendoscopy and MRI can be used. Various treatment modalities have been tried, from conservative approach to surgical excision depending on the recurrence rate and severity of the condition. Although symptomatic treatment with antibiotics and analgesic, injection of intraductal medicament, aggressive treatment like duct ligation or excision of gland are some of the treatment modalities, there is no established algorithm as to which treatment method should be opted in such clinical situation.

CASE DETAIL

A 20 years old male patient reported with pain and salty taste in the mouth that had began before a week. Examination revealed an elevated right parotid papilla; ropy, cloudy appearing saliva was oozing out on milking the gland. Unstimulated and stimulated whole salivary flow rate was assessed using drooling method. Sialography was used as a diagnostic and a therapeutic aid. In our case, sialography as a treatment showed a good response with no recurrence after two years of follow-up. We highlighted the role of sialography as a therapeutic aid.

CONCLUSION

Recurrent attacks significantly affect the quality of life and also lead to progressive gland destruction. Preventing or reducing the frequency of recurrence remains the goal of therapeutic procedure. Hence, conventional sialography is useful in the diagnosis and also effective as a therapeutic aid in recurrent parotitis.

摘要

背景

慢性复发性非特异性腮腺炎的特征是腮腺反复出现肿胀和疼痛,病因不明。唾液腺造影是诊断唾液腺疾病的一项标志性检查;也可使用计算机断层扫描唾液腺造影、唾液腺内镜检查和磁共振成像等更新的成像方式。根据病情的复发率和严重程度,已经尝试了从保守治疗到手术切除等各种治疗方式。尽管使用抗生素和镇痛药进行对症治疗、导管内药物注射、导管结扎或腺体切除等积极治疗是一些治疗方式,但对于在这种临床情况下应选择哪种治疗方法,尚无既定的算法。

病例详情

一名20岁男性患者报告称,一周前开始出现口腔疼痛和咸味。检查发现右侧腮腺乳头抬高;挤压腺体时,有黏稠、浑浊的唾液渗出。使用流涎法评估非刺激性和刺激性全唾液流速。唾液腺造影被用作诊断和治疗辅助手段。在我们的病例中,唾液腺造影作为一种治疗方法显示出良好的效果,随访两年后无复发。我们强调了唾液腺造影作为治疗辅助手段的作用。

结论

反复发作会显著影响生活质量,还会导致腺体进行性破坏。预防或减少复发频率仍然是治疗的目标。因此,传统的唾液腺造影在诊断中有用,在复发性腮腺炎的治疗辅助中也有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c8e/5390234/b16b51a34e37/EJHS2701-0095Fig1.jpg

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