Ibhekene nokukhishwa kwamathe, kunezinhlobo ezimbili zezindlala zamathe: izindlala eziyinhloko zamathe kanye nezinsimbi ezitholakala kumathe. Zingaba indawo yokutheleleka kwebhaktheriya noma igciwane, i-lithiasis, izicubu ezinobungozi noma, ngokungajwayelekile, izimila ezimbi. Umdlavuza wezindlala zamathe ngempela umdlavuza oyivelakancane.

Kunezinhlobo ezimbili ze-salivary glands:

• izindlala ezitholakalayo, ezitholakala olwelweni lwesikhala somlomo nolimi. Mancane ngosayizi futhi alula ngesakhiwo;
• izindlala eziyinhloko zamathe, ezitholakala ngaphandle kodonga lomgodi womlomo. Okukhudlwana, kuyizitho ezizimele ezinesakhiwo esiyinkimbinkimbi. Zakhiwa amayunithi secretory nabanye, excretory.

Phakathi kwezindlala eziyinhloko zamathe singahlukanisa:

• izindlala ze-parotid ezitholakala phambi kwendlebe, esihlathini. Ngakho-ke kukhona ezimbili. Umsele wabo uvuleka ebusweni obungaphakathi besihlathi, ezingeni le-molar;
• izindlala ezingaphansi komhlaba zingaphansi komhlathi. Umsele wabo uvuleka eduze kwe-frenulum yolimi;
• izindlala ezingaphansi kolimi zitholakala ngaphansi kolimi. Umsele wabo uphinde uvule eduze ne-frenulum yolimi.

Izindlala zamathe zikhiqiza amathe. Njengesikhumbuzo, amathe ayingxube yamanzi, ama-electrolyte, amangqamuzana e-desquamated kanye ne-serous secretions, kuhlanganise nama-enzyme. Amathe enza imisebenzi ehlukene: agcina ukugeleza kwamanzi emlonyeni, abambe iqhaza ezigabeni zokuqala zokugaya ngenxa yama-enzyme, aqinisekise indima elwa namagciwane ngenxa yamasosha omzimba.

Izindlala zamathe eziyinhloko zikhipha amathe ekuphenduleni izisusa kuyilapho izindlala zamathe ezitholakalayo ziphumela ngaphandle ngokuqhubekayo.

i-salivary gland lithiasis (sialolithiasis)

Amatshe angakheka emiseleni yamathe yesinye sezindlala ze-submandibular kaningi. Avimba ukugeleza kwamathe, abangele ukuvuvukala okungenabuhlungu kwendlala yamathe. Kuyi-benign pathology.

Ukutheleleka kwamagciwane

Lapho amathe emile endlaleni ngenxa yesithiyo ekuphumeni kwayo (i-lithiasis, ukuncipha komgudu), ingangenwa igciwane. Lokhu kubizwa nge-sialitis noma ukutheleleka okuyindlala, i-parotitis lapho indlala ye-parotid ithinteka ne-submandibulitis uma kukhulunywa ngendlala ye-submandibular. Idlalade libe selivuvukala, lishubile, libuhlungu. Ubomvu bungase buvele, kanye nomkhuhlane.

I-parotitis ephindaphindiwe yentsha

Uhlobo oluthile lwe-parotitis oluthinta izingane kanye nentsha, ziyizifo eziphindaphindiwe ze-bacterial eyodwa noma zombili izindlala ze-parotid. Ingcuphe, ngokuhamba kwesikhathi, ukubhujiswa kwe-parenchyma eyindlala (amaseli akha izicubu eziyimfihlo).

Ukutheleleka ngegciwane

Amagciwane amaningi angafinyelela ezindlaleni zamathe, ikakhulukazi izindlala ze-parotid. Okwaziwa kakhulu ukuthi umvukuzane, i-paramyxovirus eyaziwa ngokuthi igciwane elithi “mumps” elisakazwa kalula ngamathe. Ama-mumps abonakaliswa ukuvuvukala okubuhlungu kwesinye noma zombili izindlala ze-parotid, ubuhlungu bendlebe, ubuhlungu bomphimbo, imfiva, nokukhathala okukhulu. Imvamisa imnene ezinganeni, lesi sifo singaholela ezinkingeni ezinganeni, kubantu abadala nakwabesifazane abakhulelwe: i-meningitis, ukulahlekelwa ukuzwa, i-pancreatitis, ukulimala kwamasende okungaholela ekungazali. Umuthi wokugomela i-MMR uyindlela engcono kakhulu yokuvimbela umvukuzane.

I-Pseudo-allergic sialitis

Okungaziwa kancane futhi okuvamise ukuholela ekuzuleni kokwelapha, i-pseudo-allergic sialitis izibonakalisa ngokuvuvukala kwesinye isikhathi okubuhlungu kwendlala yamathe eyodwa noma ngaphezulu ngesikhathi sokudla noma ukugqugquzeleka noma ukuhogela, okuhambisana nokulunywa okukhulu. Izimbangela zalesi sifo azikaziwa nanamuhla.

Izimila ze-Benign

Izimila eziningi ze-salivary gland azilungile. Ngokuvamile zithinta izindlala ze-parotid. Zivela njengeqhubu elizimele, eliqinile, elihambayo nelingenabuhlungu elikhula kancane.

Isimila esivame kakhulu yi-pleomorphic adenoma. Ingadlulela kwisimila esibi, kepha kuphela eminyakeni eyi-15 kuye kwengu-20 ngemuva kokuvela kwayo. Ezinye izimila ezinobungozi zikhona: i-monomorphic adenoma, i-oncocytoma ne-cystadenolymphoma (isimila sika-Warthin).

Izimila ezimbi - umdlavuza wezindlala zamathe

Izimila zendlala yamathe eziyingozi zibonakala njengesisindo esiqinile, esinamaqhuqhuva, ngokuvamile anamathela esiculweni esiseduze, esinohlaka olungachazwanga kahle. Lawa amathumba angavamile (isigameko esingaphansi kuka-1/100), amelela ngaphansi kuka-000% wamathumba ekhanda nentamo. Ukuvela kwe-metastatic kubonakala cishe ku-5% yamacala.

Kunezinhlobo ezahlukene zezimila ezinomdlavuza wezindlala zamathe. Ukuhlukaniswa kwakamuva kwe-World Health Organization (2005) ngaleyo ndlela kuqaphela izinhlobo ezingu-24 ezihlukene zamathumba e-epithelial ezimbi kanye nezinhlobo ezingu-12 ze-benign epithelial tumors. Nazi eziyinhloko:

• i-mucoepidermoid carcinoma umdlavuza ovame kakhulu wezindlala zamathe. Ngokuvamile kuthinta indlala ye-parotid, okungavamile kakhulu indlala ye-submandibular noma indlala encane yamathe yolwanga;
• I-Adenoid cystic carcinoma uhlobo lwesibili oluvame kakhulu lwesimila. Ngokuvamile kuthinta izindlala ze-salivary ezitholakalayo futhi kungasakazeka ezinzwa ebusweni. Ngokuya ngesimo samangqamuzana omdlavuza, kwenziwa umehluko phakathi kwe-cribriform adenoid cystic carcinoma (evame kakhulu), i-adenoid cystic carcinoma eqinile kanye ne-tuberous adenoid cystic carcinoma;
• i-salivary duct carcinoma ivame ukuthinta indlala ye-parotid. Ikhula ngokushesha futhi inolaka kakhulu, isakazeka kalula kuma-lymph nodes;
• i-acinar cell carcinoma ngokuvamile ithinta indlala ye-parotid, ngezinye izikhathi kokubili;
• i-lymphomas eyinhloko yezindlala zamathe ayivamile.

Ezinye izinhlobo zezimila ze-salivary gland zikhona, kodwa zingavamile kakhulu.

Ukutheleleka kwamagciwane

Ukwelashwa ngama-antibiotic kunqunyiwe. Ukuhlolwa kwe-ultrasound kwenziwa ukuze kuqinisekiswe ukuphulukiswa okuphelele kwendlala.

Ukutheleleka ngegciwane

Izindlebe zivame ukuphola ngokuzenzekelayo zingakapheli izinsuku eziyishumi. Njengoba ukutheleleka kuyigciwane, awekho ama-antibiotic adingekayo. Ukushisa nobuhlungu kuphela kungelashwa ngama-antipyretics noma ama-analgesics.

Ukutheleleka ngegciwane kwezindlala zamathe kungaba okwesibili kukutheleleka ngebhaktheriya. Ngemuva kwalokho izodinga ukwelashwa ngama-antibiotic.

I-lithiasis yamathe

Amatshe e-salivary ngokuvamile ahamba ngosizo lokubhucungwa okuvamile kwe-salivary gland. Uma ziphikelela, i-sialendoscopy (i-endoscopy yamapayipi nezindlala zamathe) ingenziwa. Enye indlela, ebizwa ngokuthi i-extracorporeal lithotripsy, ihlanganisa ukuhlukanisa amatshe ngamagagasi athuthumela angaphandle.

I-Sialectomy (isenzo sokuhlinzwa esihlanganisa ukuvula ipayipi lamathe ukuze kukhishwe isibali) senziwe kancane kancane kusukela ekuthuthukisweni kwalezi zindlela ezimbili.

I-Pseudo-allergic sialitis

Ukuphatha kuqala ngokwelashwa kokuhlasela kwamaviki ama-2 okuhlanganisa i-bi-antibiotic therapy, i-corticosteroid therapy, i-antispasmodics, i-antiallergic kanye ne-benzodiazepine. Ukwelashwa kwesikhathi eside okusekelwe ku-corticosteroids ebuthakathaka kanye ne-antiallergic kuyabe kunqunywe.

Izimila ze-Benign

Ukwelashwa kwezimila ezinhle ukuhlinza. Kufanele iphelele futhi ibe nomkhawulo wokuphepha ukuze kukhawulwe ingcuphe yokuphinda iphindeke.

Izicubu zomdlavuza

Ukwelashwa kwezimila eziyingozi zendlala yamathe ukuhlinzwa okunesilinganiso esikhulu sokuphepha, ngezinye izikhathi kulandelwa i-radiotherapy yomdlavuza othile. Ngokuya ngokusabalala, ama-lymph node entanyeni kwesinye isikhathi asuswa. I-Chemotherapy ayikhonjisiwe, ngaphandle kwezimo ezingavamile.

I-prognosis iyahlukahluka kuye ngokuthi uhlobo lomdlavuza, ukusabalala kwawo, isigaba sokukhula kanye nempumelelo yokuhlinzwa.

Ngokuvamile ukuba khona kwenqwaba okuholela isiguli ukuthi sibonane nodokotela waso ojwayelekile noma udokotela we-ENT. Lapho ubhekene nesigaxa ku-salivary gland, kungase kunqunywe ukuhlolwa okuhlukahlukene:

• ukuhlolwa komtholampilo ukuze kuhlolwe izilinganiso zesilonda, isandiso sendawo nesifunda ngokusesha i-lymphadenopathy yomlomo wesibeletho (ama-lymph nodes);
• i-x-ray ikhombisa amatshe;
• i-sialography ihlanganisa ukujova umkhiqizo ohlukile endlaleni yamathe ukuze ivuleke. isetshenziselwa ikakhulukazi ukuhlola izifo ezithathelwanayo zezindlala zamathe;
• ukuhlolwa kwe-anatomo-pathological yesampula uma kwenzeka izimila; ukuze uqinisekise ukutholakala kwe-neoplasia eyingozi, ucacise uhlobo lwayo lwe-histological futhi uma kungenzeka izinga layo;
• i-MRI, noma ukwehluleka ukuthi i-ultrasound noma i-CT scan;
• i-CT scan yentamo kanye ne-thorax ukuze ubheke ukubandakanyeka okungenzeka kwe-metastatic.