#sialadenitis

[mcatmemoranda]

[delicatemagazinedreamer]

Global Bacterial Sialadenitis Market Is Estimated To Witness High Growth Owing To Rising Cases of Oral Infections

The global Bacterial Sialadenitis market is estimated to be valued at US$ 1.90 billion in 2023 and is expected to exhibit a CAGR of 5.6% over the forecast period, as highlighted in a new report published by Coherent Market Insights. Market Overview: Bacterial Sialadenitis is an infection of the salivary glands caused by bacteria. The market offers various products for the diagnosis and treatment of this condition. These products include antibiotics, pain relievers, saliva stimulants, and surgical interventions. The demand for these products is driven by the rising cases of oral infections and the need for effective treatment options. Market Key Trends: One key trend in the Bacterial Sialadenitis market is the increasing adoption of minimally invasive surgical interventions. Minimally invasive procedures offer several advantages such as shorter recovery time, reduced pain, and minimal scarring. These procedures are becoming popular among patients and healthcare providers alike. For example, endoscopic sialadenectomy is a minimally invasive surgical procedure used for the removal of salivary gland stones, which is a common complication of bacterial sialadenitis. PEST Analysis: - Political: The regulatory landscape and government policies regarding healthcare infrastructure and infectious diseases impact the market growth. - Economic: Economic factors such as healthcare expenditure, insurance coverage, and affordability of treatment options influence market growth. - Social: Changing lifestyles, increased awareness about oral health, and better access to healthcare facilities contribute to the market growth. - Technological: Advancements in diagnostic techniques and surgical technologies drive market growth by providing more accurate and efficient treatment options. Key Takeaways: In terms of market size, the global Bacterial Sialadenitis market is expected to witness high growth, exhibiting a CAGR of 5.6% over the forecast period. This growth is fueled by the increasing cases of oral infections and the need for effective treatment options. For example, the rising incidence of salivary gland stones, a complication of bacterial sialadenitis, drives demand for surgical interventions. Regionally, North America is anticipated to be the fastest-growing and dominating region in the global Bacterial Sialadenitis Market Growth. This can be attributed to the well-established healthcare infrastructure, high healthcare expenditure, and a large patient population. Key players operating in the global Bacterial Sialadenitis market include Pfizer Inc., Merck & Co., Inc., GlaxoSmithKline plc, Novartis AG, Sanofi S.A., Johnson & Johnson, Abbott Laboratories, Eli Lilly and Company, AstraZeneca plc, Bayer AG, Bristol-Myers Squibb Company, Roche Holding AG, Teva Pharmaceutical Industries Ltd., Mylan N.V., and Allergan plc. These companies are focusing on research and development activities to introduce innovative products and strengthen their market position. The global Bacterial Sialadenitis market is expected to witness significant growth due to the increasing cases of oral infections. The market trends suggest a shift towards minimally invasive surgical interventions, and the PEST analysis highlights the impact of political, economic, social, and technological factors on market growth. Overall, the market presents lucrative opportunities for key players in this industry.

[groupwest]

grrrr so frustrated. dr took one look at my mouth/throat and decided i have sialadenitis and not tonsil stones. which is just wrong. i know they are tonsilloliths for starters they r on my fucking tonsils and not my glands. they don’t cause me pain, they cause EXESS saliva not a dry mouth. and they smell. hopefully the antibiotics i got will help with them as well it just would have been nice for him to listen to me and look at my throat for more than five seconds. he thought my fever could’ve been from my wisdom tooth or the gum being infected rather than a flu or something but idk i felt so awful that day i woke up with a fever. ugh what an annoying day i had to reschedule this appointment like three times and he only spoke to me for like hardly even five minutes. in the parking lot.

[jyothsnarajan]

  The Submandibular Gland: Structure, Function, and Clinical Significance

Introduction

The submandibular gland is one of the major salivary glands located in the human oral cavity. It plays a vital role in the process of digestion and maintaining oral health. This article provides an overview of the submandibular gland, discussing its structure, function, and clinical significance, including treatment options available in Warangal, Hanumakonda, Kukatpally, and Hyderabad.

Anatomy of the Submandibular Gland

The submandibular gland, also known as the submaxillary gland, is a paired exocrine gland located beneath the floor of the mouth, on either side of the mandible, hence its name. It is the second-largest salivary gland in the human body, following the parotid gland. The gland has a roughly almond-shaped structure and is composed of both serous and mucous acini (secretory units). It is connected to the oral cavity through a duct called Wharton's duct.

Function of the Submandibular Gland

Saliva Production: The primary function of the submandibular gland is to produce saliva. Saliva is essential for various processes in the oral cavity, including digestion, speech, and maintaining oral hygiene.

Enzyme Secretion: The serous acini of the submandibular gland secrete saliva rich in enzymes, such as amylase, which helps break down starches in food during the initial stages of digestion.

Lubrication: Saliva produced by the submandibular gland aids in the lubrication of food, making it easier to swallow.

Antibacterial Properties: Saliva contains enzymes and antimicrobial proteins that help protect the oral cavity from harmful bacteria.

Clinical Significance and Treatment Options

Salivary Stones: One common issue associated with the submandibular gland is the formation of salivary stones, also known as sialolithiasis. These stones can block the duct, causing pain and swelling in the gland. Treatment, including submandibular gland swelling treatment in Warangal and Hanumakonda, may involve removal of the stone or managing symptoms.

Infections: Infections of the submandibular gland can occur, resulting in conditions like sialadenitis. These infections may be bacterial or viral in origin and require appropriate antibiotic treatment. Seek submandibular gland swelling treatment in Warangal for prompt care.

Tumors: Tumors, both benign and malignant, can develop in the submandibular gland. These can lead to swelling, pain, and changes in saliva production. Diagnosis and submandibular gland surgery in Hanumakonda or Kukatpally may be necessary, and further treatment options like salivary gland removal surgery in Kukatpally and Hyderabad may be considered based on the type and stage of the tumor.

Sjögren's Syndrome: This autoimmune disorder can affect the submandibular gland and other salivary glands, leading to reduced saliva production and dry mouth. Management may involve medications and submandibular gland removal in Hyderabad in severe cases.

Conclusion

The submandibular gland is a crucial component of the human oral cavity, responsible for saliva production, enzyme secretion, and maintaining oral health. Understanding its anatomy and functions is essential for diagnosing and managing various clinical conditions associated with this gland. If you are in Warangal, Hanumakonda, Kukatpally, or Hyderabad and require treatment for submandibular gland-related issues, it is important to consult with a qualified healthcare professional who can provide appropriate care and guidance tailored to your specific needs.

About

Dr. Gouda Ramesh is a seasoned ENT surgeon in Hyderabad with more than 18 years of experience. He is an expert in performing complex ENT surgeries and adept in coblator assisted adeo- tonsillectomy, endoscopic laser tympano-mastoidectomy, micro-debrider assisted sinus surgeries (FESS), radiofrequency, laser micro-laryngeal surgeries, and thyroid surgeries, bronchoscopy. He has successfully performed more than 10000 surgeries and treated more than 200000 patient. Gouda ENT is the best ENT hospital in hyderabad.

[jcrmhscasereports]

Pediatric Case of Ludwig’s Angina (LA), Pakistan by Dr. Rafia Jabbar in Journal of Clinical Case Reports Medical Images and Health Sciences 

ABSTRACT

Ludwig’s Angina (LA) is a severe form of infection which spread rapidly, effecting submandibular, sub lingual and sub maxillary spaces resulting state of emergency. We report a case of Ludwig’s angina in a 12-month-old female with a literature review and presentation, etiology, management, and potential complications of this in pediatric cases.

INTRODUCTION

Ludwig’s angina is a potentially life-threatening cellulitis of floor of mouth and tongue which rapidly progresses and becomes hard and inflexible. Ludwig’s angina, is named after German physician Wilhelm Fredrick von Ludwig who first described this in 1836. Due to the possible complications associated with Ludwig’s angina immediate identification and management is required. (1)

CASE REPORT

We report a case of a previously healthy well-nourished and vaccinated 12-month-old female brought to pediatric Emergency department with complain of left sided submandibular swelling which was observed 8 days back along with fever and cough, swelling rapidly progressed to submental area in a day (figure-1). There is no history of drooling, odynophagia, shortness of breath, cyanosis. Child was partially vaccinated with proper dentition. On physical examination child was febrile (38 ° C), heart rate was 120 beats/min, respiratory rate 30 breaths /min. oxygen saturation was 99% at room air. Examination of neck revealed midline swelling extending to the left submandibular region fluctuation was positive, oral cavity examination was normal. On the basis of this history and physical examination, diagnosis of Ludwig’s angina was made. Hemoglobin was 9.5g /dl, white blood cell count was 25,000 cells/mm3. Incision and drainage were done and around 15ml puss was drained. Intubation wasn’t required. Injectable antibiotic ceftriaxone was given, pus culture was suggestive of methicillin resistant staphylococcus aureus growth so antibiotics were escalated to vancomycin and patient was discharged 5 days later (figure:2), After 7 days of follow up visit wound site was healed there wasn’t any complain of pain

Figure 1 : Patient At Presentation

Figure 2 : Patient recovered after incision and drainage

DISCUSSION

Ludwig's angina, first define by Wilhelm Fredrick von Ludwig in 1836, is a serious and potentially lethal rapidly expanding cellulitis of soft tissue of the neck and floor of mouth (2)with approximately 10% to 17% mortality from this infection in the pediatric population (3).Mortality rate reported previously as high as 54% to 60% (4)  due to airway obstruction, that is the most fatal complication cause by inflexible fast growing indurated swelling  displacing anatomical structures of oral cavity and oropharynx. The delay in diagnosis and management can lead to difficult airway especially in children due to high position of  the larynx in the neck and like in adult patients we cannot do  technique of choice i.e. blind nasal intubation or awake fiberoptic (5). It is still a nightmare for an anesthesiologist as life-threatening acute airway obstruction despite marked reduction in mortality have been observed with early recognition, efficient antibiotics and modern dental care. (5)

LA mostly affects adult population with poor dentition while incidence of LA in the pediatric population 27-30%. LA with identified odontogenic source only 50% of the cases in children but in adults incidence of odontogenic cause 70% to 90%.   LA is two to three times more prevalent in boys (6). As many as 1 in 3 to 4 cases of Ludwig’s angina are reported to occur in children (3) . Oral mucosa lacerations, submandibular sialadenitis (7) and mandibular fractures are other etiologic sources in children.11 children with systemic diseases, Tetralogy of Fallot herpetic gingivostomatitis, (8)tongue piercing and lymphatic vascular malformation superinfection as causative factors of LA have been reported. It can also occur without any predisposing or precipitating cause (6).

It is essential to know about the complex anatomy of head and neck for better understanding of the disease progression within the potential spaces of neck form by facial layers attachment to neck structures. The submandibular space, that is the primary site of LA is located above the hyoid bone. The superior border is formed by the mucosa of floor of mouth. It is divided superiorly into the sublingual space which is located between the geniohyoid and mylohyoid muscles and inferiorly into the submaxillary space located between the mylohyoid muscle and the superficial fascia and skin. Ludwig’s angina most frequently originates from the second or third mandibular molars (3) and extends into submaxillary space through extension below mylohyoid line. Involvement of floor of mouth displaces tongue posteriorly resulting in life threatening airway obstruction but due to hyoid bone it does not spread inferiorly but can present as on the anterior aspects of the neck resulting in bull neck. The infection spreads along the facial planes with tendency to involve parapharyngeal, retropharyngeal space, superior mediastinum and not via the lymphatic system (3).

Clinical presentation of LA can vary from focal to systemic signs and symptoms which include tongue, throat pain, dysphagia, trismus, dysphonia, drooling from mouth with fever, chills, malaise, decreased oral intake causing dehydration and toxic appearance. Usually have progressive bilateral submandibular and submental neck swelling which on local physical examination can be soft to firm, with or without fluctuation, warm, tender induration of the floor of the mouth and late presentation causes posterior and superior displacement of the tongue obstructing the airway with or without trismus (9). Severe Airway compromise can lead to respiratory symptoms like dyspnea, cyanosis, stridor, altered levels of consciousness, labored breathing and oxygen desaturation. LA mostly diagnosed clinically as in our case. If a child comes with firm edematous tongue or floor of the mouth with neck swelling below the mandible than pediatrician must suspect LA as these are the cardinal signs of  progression to airway obstruction.  (10)

Variations of clinical features and severity with time of presentation, atypical cases without predisposing cause can delay the diagnosis and increase mortality. Mostly fever and neck swelling with bilateral submandibular swelling and elevation of the tongue are the presenting complains (10)  like in our case. Plain neck-and-chest  radiographs can help in diagnosis showing swelling, airway compression. Unstable or patient unable to lie supine point-of-care sonographs give the details of collection while computed tomography (CT) scan is recommended before surgical intervention in stable patient which will give information about the extent of soft-tissue inflammation and the infected spaces with respective anatomical location (7)

Organisms isolated from bacterial cultures after surgical drainage of Ludwig’s abscesses usually showed mixed growth of both aerobic and anaerobic bacteria, including streptococcus, staphylococcus, and Bacteroides. The predominant microorganisms isolated from the discharge after Incision and drainage in pediatric Ludwig’s angina cases most commonly is Streptococcus species (10) which is reported  40%  (3). In our case MRSA was isolated. Other isolates include gram-negative rods 25% and anaerobes were found 20% of cases while 35% of blood cultures in same patient series came positive. Septic shock can develop after the surgical drainage which was not seen in our case and few Patients may require a second operation to improve the drainage. (10)  Admission with close monitoring is important as sequelae of sepsis and progression in severity can develop in any patient.

Emergency and timely consultation is of prime importance for the management of Ludwig’s angina, immediate initiation of medical therapy is crucial. Early airway establishment via endotracheal tube or tracheostomy is recommended in case of detoriation or signs of airway obstruction(3).Although changes in anatomy of airway and mobility of tissue creates difficulty in intubation, in certain cases there are chances of complete airway obstruction with the induction of general anesthesia. (11). Team of emergency tracheostomy must always be present during intubation process.

Depending upon the causative organism antibiotic is indicated, severely immunocompromised patients should be treated against methicillin-resistant S. Aureus and resistant gram-negative bacterias. Commonly used antibiotics are high-dose penicillin G, along with metronidazole. In patients who are allergic to penicillin , an alternate is clindamycin hydrochloride. (10)The role of steroids has been reviewed in a study using dexamethasone , even then surgery was required in 27 out of 31 patient cases. (12).

CONCLUSION

Ludwig’s angina can be a lethal disease with its rare occurrence leading to inadequate emergency department experience. It can progress to rapid airway obstruction so in order to prevent Ludwig’s angina early recognition and immediate treatment by pediatric emergency, anesthetic and otolaryngology team is required.

Declaration of patient consent

The authors certify that they have obtained all appropriate consent forms from patients’ attendant. In the form the patient(s) attendant has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The parents understand that their child’s names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

For more information: https://jmedcasereportsimages.org/about-us/

For more submission : https://jmedcasereportsimages.org/

[mcatmemoranda]

I have a pt who was admitted for sialadenitis after she had a root canal. She was treated outpt with clindamycin and Cephalexin. Here she is getting IV ampicillin.

From UpToDate:

If secondary infection is suspected because of increasing pain, fever, or purulent drainage from the duct, antistaphylococcal antibiotics such as dicloxacillin 500 mg four times a day or cephalexin 500 mg four times a day should be administered for 7 to 10 days. If there is not an improvement in the pain, fever, or purulent drainage within five to seven days, a culture of any duct discharge should be obtained and the antibiotic coverage broadened by substituting amoxicillin/clavulanate or clindamycin until culture results are available. In addition to broadening antimicrobial coverage, we also obtain imaging with ultrasound or computed tomography (CT) with contrast if there are signs suggestive of an abscess, such as fluctuance with overlying erythema and warmth.

Genera regarded to be generally susceptible to ampicillin and amoxicillin are Staphylococcus, Streptococcus, Corynebacterium, Clostridium, Escherichia, Klebsiella, Shigella, Salmonella, Proteus and Pasteurella, although many of these bacteria have acquired resistance.

[alphasurgical]

Parotidectomy Understanding the Procedure, Indications, and Recovery

The parotid gland, one of the major salivary glands, plays a crucial role in saliva production and oral health. However, when benign or malignant tumors, infections, or other medical conditions affect the parotid gland, a surgical procedure called parotidectomy may become necessary. In this blog, we'll delve into the details of parotidectomy, its indications, the process, and recovery, with a focus on the expertise of Alpha Surgical Group.

What is Parotidectomy?

Parotidectomy is a surgical procedure designed to remove all or part of the parotid gland, which is located near the ears. The parotid gland is responsible for secreting saliva, aiding in digestion, and keeping the mouth healthy. When conditions such as tumors, infections, or chronic inflammation develop in the parotid gland, a parotidectomy may be recommended to address these issues.

Alpha Surgical Group: Your Expert Parotidectomy Partner

Alpha Surgical Group is a renowned medical group known for its expertise in performing parotidectomy procedures and other surgical interventions. Their team of highly trained surgeons, nurses, and medical staff is committed to providing exceptional care and support to patients throughout their surgical journey.

Indications for Parotidectomy

1.            Tumors: Both benign and malignant tumors can develop in the parotid gland. A parotidectomy may be required to remove these tumors, with the extent of surgery depending on the tumor's type and size.

2.            Infections: Severe or recurrent infections of the parotid gland can necessitate surgical removal to prevent further complications.

3.            Chronic Inflammation: Conditions like chronic sialadenitis, characterized by recurrent inflammation and blockage of the salivary ducts, may require parotidectomy to resolve.

The Parotidectomy Procedure

Parotidectomy is performed under general anesthesia, and the surgical approach can vary based on the location and extent of the problem. The two main types of parotidectomy are:

1.            Superficial Parotidectomy: In this procedure, the outer portion of the parotid gland is removed, while preserving the facial nerve, which is responsible for facial movements and expressions.

2.            Total Parotidectomy: This more extensive surgery involves the removal of the entire parotid gland, including the deep lobe, when necessary.

Recovery and Aftercare

Recovery after a parotidectomy procedure may involve:

•              Hospital Stay: Depending on the complexity of the surgery, patients may need to stay in the hospital for a short period.

•              Pain Management: Pain and discomfort are common after surgery, and pain management techniques will be provided.

•              Diet: Initially, a soft diet may be recommended to avoid straining the surgical site and to promote healing.

•              Follow-up Care: Regular follow-up appointments with the surgical team are crucial to monitor recovery and ensure there are no complications.

Alpha Surgical Group's commitment to patient care includes post-operative support, ensuring that patients have the best chance at a successful recovery.

Conclusion Parotidectomy is a surgical procedure designed to address various conditions affecting the parotid gland. Alpha Surgical Group, with its experienced medical team and commitment to patient care, is an ideal partner for those in need of a parotidectomy procedure. If you are facing parotid gland issues, consider consulting with Alpha Surgical Group to receive top-notch care and expertise throughout your surgical journey. Contact them at (310)-657-2253 or visit their website at https://www.alphasurg.com/ for more information.

[ashleighmontford-blog]

Living with a chronic illness is a lesson that test one's character, being, confidence, and spirituality just to name a few arenas. Especially an illness that is not visible to the eye, people think I’m just being dramatic.

You can’t feel what I feel.

You can’t sense what I sense.

“Ashleigh you’re always sick.”

I’ve learned that love is complicated and it takes a toll on people who care. But that doesn’t mean it’s impossible or that I am incapable or do not deserve love. Love is the very unit that constructs the base of our lives.

I’ve learned that my openness can be an encouragement to others. It’s not fair for me to hold in all that I am when there are other people who can benefit from my struggles and victories in relation to my chronic illness.

I’ve learned that I am not entirely my chronic illness. It does not define me but I define it. I am not solely a sick being who seeks to find a cure, but I am a creative, a person who has the potential for more greatness that she even realizes. The future is female.

I’ve learned that I have what it takes to have control over myself to a certain extent. I know how I need to eat, drink, exercise, mentally take care of myself and all of this. I cannot leave all of my health up to date and other people.

I will not be defined by my illness. I am strong, resilient, powerful, evolutionary, amazing, female.

No matter what your chronic illness is, you are amazing. You are everything you need to be and more. Don’t give up, but keep on fighting. People are rooting for you, I am cheering for you.

You are loved,

Queen 👑

[jmgrimes-robison78]

Yet again I am sick sorry for the lack of #themoreyouknow facts in my last few post I feel a little better right now besides my Face being 2x it’s normal size lol so i have a infection called #sialadenitis of the #parotid super painful so of course I tortured myself by googling it..... that was the wrong thing to do because (and I am pretty sure everyone does this) you look at the worst case scenario. So of course with my new found #education I went to the doctor only to have him look at me and say “ You do realize that the worst case scenario and only happens in Third World countries that don’t have antibiotics” so ya! No more web MD for me that brings me to today’s the more you know post A brief history of @webmd; WebMD is an American corporation known primarily as an online publisher of news and information pertaining to #fiorellafloraldesign humanhealth and well-being. It was founded in 1996 by internet #entrepreneur Jeff Arnold. In early 1999 it was part of a three way merger with Sapient Health Network (SHN) and Direct Medical Knowledge (DMK). SHN began in Portland, OR in 1996 by Jim Kean, Bill Kelly, and Kris Nybakken, who worked together at a CD-ROM publishing firm, Creative Multimedia. Later in 1999, WebMD merged with Healtheon, founded by Netscape Communications founder Jim Clark. The company reported $705 million in revenue for the year 2016. In 2017, private equity company Kohlberg Kravis Roberts (K.K.R.) agreed to purchase WebMD Health Corporation for approximately $2.8 billion 😮 so remember don’t freak out until you see the Really doctor 😆 #funfact #funfacts #history #learnsomething #learnsomethingnew #weirdfacts #funfactswithjenice #mythandlegend #historyablastfromthepast #historyfacts #foodforthought #neverstoplearning #weirdstories #weirdhistory #think #learn #brainbasedfitness and I always #blameitonthebuttercat #onlinemedicine #webmd #sick (at Queen Creek, Arizona) https://www.instagram.com/p/BwWvSarByRl/?utm_source=ig_tumblr_share&igshid=kdghbaqkzst4

[biomedres]

Küttner’s Tumour - Chronic Sclerosing Sialadenitis of the Submandibular Gland

Küttner’s Tumour - Chronic Sclerosing Sialadenitis of the Submandibular Gland by CM Bowe in Biomedical Journal of Scientific & Technical Research (BJSTR) https://biomedres.us/fulltexts/BJSTR.MS.ID.000525.php

For more articles on BJSTR please click here: https://biomedres.us/index.php

For biomedical  open access journals

[lupinepublishers]

lupine publishers|CT Manifestation of Abscess Occupying the Infratemporal Fossa and Temporoparietal Region in a 73-Year-Old Male- Case Report

Abstract

Commonly available dental care and a widespread use of antibiotics in an outpatient setting have not eliminated odontogenic infections which may require inpatient admission as potentially life-threatening conditions. The spread of infection to the deep fascia of the head and neck may lead to severe and life-threatening complications, such as airway obstruction, mediastinitis, sepsis and septic shock, endocarditis or intracranial abscess formation. Clinical presentation of deep fasciitis of the head and neck may not correspond to the systemic deterioration in the same patient. Therefore, contrast-enhanced computed tomography should be a standard diagnostic imaging in such cases, as it enables accurate location of inflammation, whereas contrast enhancement enables differentiation between soft tissue inflammation and fluid collections based on their density relative to the one of air. It substantially aides the diagnosis, where the history and clinical presentation are inconclusive. The aim of the paper is to discuss the diagnostic management, presentation and spread of odontogenic infections of the head and neck by presenting the rare case of abscess occupying the left infratemporal fossa and temporoparietal region in a 73-year-old male.

Keywords: Craniofacial Ct; Odontogenic abscess; Odontogenic infection; Temporal fossa abscess; Phlegmon of the face; Surgical treatment

Introduction

General characteristics of head and neck infections

The head and neck infections have their distinct characteristics which differ them from the infections affecting other anatomical locations. It is primarily associated with a complex craniofacial and cervical anatomy, the presence of teeth in the oral cavity, the proximity of paranasal sinuses, abundant blood supply and the presence of vital sensory organs (visual, auditory and olfactory senses) [1,2]. Inflammation develops as a bodily defense mechanism against a noxious agent, which can be either a physical or a biological (e.g. pathogens). The bacterial infection develops as the host immune barrier becomes compromised. This is the key mechanism responsible for head and neck inflammation and infection. Pulp necrosis, periapical periodontitis with abscess formation, infected dental cysts as well as infectious complications of partially or completely impacted teeth are the main source of pathogens in head and neck infections [3,4]. Necrotised pulp of mandibular and maxillary molars, premolars and, less often, single root teeth is the most common site of origin [5-7]. Periodontitis is the aetiologic factor in 20-30% of odontogenic infections [8-10]. The second group of aetiologic factors in head and neck infections are non-odontogenic conditions, including sialadenitis, sinusitis, lymph node abnormalities, and skin infections, such as furunculus (boil). The inflammation can manifest clinically as inflammatory infiltration, abscess and the most severe form of infection, that is, phlegmon of the head and neck. Odontogenic infections are mostly cause by mixed bacterial flora. The most commonly cultured isolates include Streptococcus viridans and Klebsiella pneumoniae [10,11]. As the infection progresses, anaerobic bacteria emerge, which is associated with decreased oxyreductive potential and pH reduction in affected tissues [12-14]. Synthetic penicillin remains the drugs of choice in odontogenic infections of the head and neck, mainly due to its high efficacy, minimum side effects, easy availability and low cost. Second generation cephalosporins, belonging to the class of -lactam antibiotics, are used qually often. The main representative of this drug category is cefuroxime, which has a very broad spectrum, good penetration to the bone tissue, which is vital in treatment of odontogenic infections. It is administered parenterally in its leading pharmaceutical form in an inpatient setting. If anaerobic strain involvement is suspected, metronidazole is a treatment of choice [15-17]. The indications for antibiotic therapy include severe systemic symptoms, extensive local inflammation, immunosuppression, systemic comorbidities (diabetes, RA, liver damage) and upper face or mid-face involvement. Empirical, often combined, treatment should be started immediately and adjusted once the susceptibility testing report is available (usually 72 hours). Cultures and antimicrobial susceptibility testing aim at identifying the causal pathogens, their susceptibility to different antibiotic classes and determining the minimum inhibitory concentration (MIC) needed to inhibit the pathogen growth. The MIC is helpful for determining the effective dosage [18].

Infection spread within the head and neck

Spread of head and neck infections may occur in a contiguous fashion, along planes of least resistance from the supporting structures of the affected tooth to fascial spaces of the head and neck.Having crossed the strongest barrier of cortical bone and periosteum, the infection spreads along the adjacent soft tissues [18,19]. The crucial factors which determine the spread of infection include its site of origin (maxilla, mandible), anatomical relationship between the site of origin and muscle insertions/ ligaments, alongside the detailed anatomy of craniofacial and cervical fascial layers, spaces and fossae. The fascial space is referred to as the anatomical fascia-lined space, which contains loose connective tissue and additional structures. The fascia is a compact connective tissue membrane, which covers muscles, muscle groups and ensures structural integrity of the body. Its function is complex with protection and regeneration of tissue it surrounds as the key role. A thorough knowledge of the anatomy is essential to understand the passageway of infection and associated clinical signs and symptoms [20,21].

Case description

A 73-year old man presented as an emergency at the Department of Maxillofacial Surgery in Wrocław due to moderately increasing oedema of the left temporal region. He had a history of dental extraction of gangreneous roots of tooth 27 two weeks earlier under local anaesthesia, as well as chronic, treated, hypertension. He reported that 3 days following his extraction, the oedema developed “near his left ear”, which subsequently enlarged yet remained fairly asymptomatic. He did not present with any systemic symptoms such as fever, chills or malaise. The patient reported that he saw his GP about it twice, who recommended cold compresses and non-steroidal anti-inflammatory drugs (NSAIDs). Due to the problems with dental visit, GP issued a referral to hospital treatment to Maxillofacial Department. Clinically, intraoral examination revealed severe dental caries, roots of teeth 13, 23, 32, 42, 46 eligible for extraction and clinically healed dental alveolus of tooth 27 with no signs of inflammation within the left maxilla. An extraoral examination revealed significant head asymmetry. There was a massive oedema stretching from the left subtemporal space, through to the temporal and parietal region (Figures 1a-1c). The oedematous area was medium-soft, fluctuant and slightly tender upon palpation. There was no history of head or craniofacial injury. The patient was verbally responsive and oriented, in a good general condition, with no signs of fever or malaise. He was admitted to the Department of Maxillofacial Surgery as an inpatient for further diagnostic assessments and treatment.

His vital signs at admission were: temperature 36.4 C, blood pressure 140/80 and HR 100’. The patient reported using the following medications: trimetazidine MR 35mg (once a day each morning), atorvastatin 20mg (once a day each morning), ramipril 10mg (twice a day), aspirin 75mg (once a day at bedtime), and bisoprolol 5mg (once a day at bedtime). The WBC count was normal (7.34*10^3/uL, reference range 4-10*10^3/uL), but the C-reactive protein level was elevated (CRP 34.40mg/L, reference range 0-5mg/L). The contrast-enhanced CT of the head was performed immediately. The reported abnormalities included “an irregular area of oedema and inflammatory infiltration within the left masticator space and within the left subtemporal fossa with abscess formation, irregular in outline, sized 2.5 x 8.0cm and small gas collections (…). An extensive abscess and soft tissue phlegmon are present within the cranial integuments, in the left temporoparietal area. The abscess contains gas collections, is 2.7cm thick and 12cm wide (…).

The submandibular lymph nodes and lymph nodes against the carotid vessels on the left are fairly small.” The figures below present contrast-enhanced axial computed tomograms of the head and neck (Figures 2-4) and coronal (frontal) image reconstructions (Figures 5-7). In the light of the above findings, empirical intravenous antibiotic therapy was started, including biocefuroxim 1.5g every 8h, metronidazole 500mg every 8h, fluid replacement therapy (Ringer fluid 1000ml/24h) and pain management. The surgical intervention was performed right after CT scans evaluation and antibiotic deliviery. Under a general anaesthesia and orotracheal intubation, the two-step procedure was performed. The first step involved a comprehensive dental treatment-extraction of potencial inflammatory foci in oral cavity, and the second one - abscess incision and drainage. Having disinfected the skin in the left temporal area, fresh sterile drapes were put in place and the reported purulent fluid collections were incised and drained. Following a manual revision of abscess cavity recesses, a sample for microbial cultures was taken and drains were sutured in place (Figures 8,9). On subsequent days, the patient’s condition improved with decreasing amount of drained contents. On day 3. (72hrs), a negative culture for aerobic bacteria was obtained, followed by a positive culture for anaerobic bacteria on day 6. Gemella Morbillorum was isolated, resistant to metronidazole and susceptible to amoxicillin and clindamycin. Gemella morbillorum is Gram-positive, facultatively anaerobic and non-spore forming coccus. G. morbillorum liveas as a commensal organism of the mucous membranes of the human oropharynx, gastrointerstinal and female genital tracts [21].

The antibiotic treatment was adjusted accordingly replacing metronidazole with clindamycin 600 mg every 12 hrs and leaving biocefuroxim dosage unchanged. The decision was guided by susceptibility test findings and the fact that clindamycin itself has fairly low efficacy against Gram-negative aerobic bacteria [17]. The laboratory tests were repeated 5 days later, with a CRP reduction to 13.37mg/L. One day later, the follow-up contrast-enhanced CT of the head and neck was performed (Figures 10,11). The report stated that “the previously reported extensive inflammatory infiltration and soft tissue abscess within the left craniofacial area was incised and drained, subsequently reducing in size (…). The inflammatory lesions within the temporal and subtemportal fossa as well as within the masticator space have also slightly decreased in size”. The patient was hospitalised for 18 days. One day prior to scheduled discharge, the drains were removed and laboratory tests repeated. The findings included CRP reduction to 4.91mg/L [reference range 0-5.0mg/L] and almost completely resolved oedema. The patient was discharged home with continued course of antibiotics (clincamycin 600 mg PO twice a day), wound cleaning and dressing change instructions and a follow-up appointment at the Maxillofacial Clinic booked in 7 days.

Discussion

Odontogenic infections still constitute a major group of head and neck infections [2-4]. An infection presenting as local infiltration or abscess may develop secondarily to pathogenic flora presence in necrotic pulp or after any intraoral/ dental procedures involving the alveolar process. The most common procedure is dental extraction, which is always associated with bacteriemia. With local and/or systemic vulnerability and risk factors, dental extraction may lead to a local or-very rarely-systemic infection. The treatment of choice in abscesses is a surgical intervention including incision and drainage, in some cases accompanied by medical treatment [6,8,11]. The decision of inpatient admission can be very challenging at times. It should be informed by a thorough history, clinical assessment and diagnostic imaging [12,20]. Any potential life-threatening conditions associated with dyspnoea warrant inpatient admission. Similarly, intraoral abscesses, including canine fossa abscesses, should be treated surgically under general anaesthesia. The infection spread in this case via the route typical of maxillary molars, along the subtemporal space, extending through the temporal space, up to the parietal area [10-13]. Effective treatment of odontogenic infections of the head and neck requires accurate diagnosis. It should be noted that the severity of the general condition may not correspond to the clinical presentation, especially with the involvement of parapharyngeal or pterygomandibular spaces [9,13,20]. Contrastenhanced computed tomography is a diagnostic imaging modality of choice in extensive infections of the head and neck, as it enables precise location of the inflammation, especially with the infection spread to the deep fascia of the head and neck. Contrast-enhanced computed tomography helps to differentiate between the nature of the condition (inflammatory infiltration, abscess, phlegmon) and precisely determines its location, identifying the surgical target [1,16,13]. The abscess occupying the infratemporal, temporal and parietal fossae may also be occurred by trauma or laryngological causes. However odontogenic infections constitiute over 49% in head and neck region [1,14,16].

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[jyothsnarajan]

The Submandibular Gland: Structure, Function, and Clinical Significance

  The Submandibular Gland: Structure, Function, and Clinical Significance

Introduction

The submandibular gland is one of the major salivary glands located in the human oral cavity. It plays a vital role in the process of digestion and maintaining oral health. This article provides an overview of the submandibular gland, discussing its structure, function, and clinical significance, including treatment options available in Warangal, Hanumakonda, Kukatpally, and Hyderabad.

Anatomy of the Submandibular Gland

The submandibular gland, also known as the submaxillary gland, is a paired exocrine gland located beneath the floor of the mouth, on either side of the mandible, hence its name. It is the second-largest salivary gland in the human body, following the parotid gland. The gland has a roughly almond-shaped structure and is composed of both serous and mucous acini (secretory units). It is connected to the oral cavity through a duct called Wharton's duct.

Function of the Submandibular Gland

Saliva Production: The primary function of the submandibular gland is to produce saliva. Saliva is essential for various processes in the oral cavity, including digestion, speech, and maintaining oral hygiene.

Enzyme Secretion: The serous acini of the submandibular gland secrete saliva rich in enzymes, such as amylase, which helps break down starches in food during the initial stages of digestion.

Lubrication: Saliva produced by the submandibular gland aids in the lubrication of food, making it easier to swallow.

Antibacterial Properties: Saliva contains enzymes and antimicrobial proteins that help protect the oral cavity from harmful bacteria.

Clinical Significance and Treatment Options

Salivary Stones: One common issue associated with the submandibular gland is the formation of salivary stones, also known as sialolithiasis. These stones can block the duct, causing pain and swelling in the gland. Treatment, including submandibular gland swelling treatment in Warangal and Hanumakonda, may involve removal of the stone or managing symptoms.

Infections: Infections of the submandibular gland can occur, resulting in conditions like sialadenitis. These infections may be bacterial or viral in origin and require appropriate antibiotic treatment. Seek submandibular gland swelling treatment in Warangal for prompt care.

Tumors: Tumors, both benign and malignant, can develop in the submandibular gland. These can lead to swelling, pain, and changes in saliva production. Diagnosis and submandibular gland surgery in Hanumakonda or Kukatpally may be necessary, and further treatment options like salivary gland removal surgery in Kukatpally and Hyderabad may be considered based on the type and stage of the tumor.

Sjögren's Syndrome: This autoimmune disorder can affect the submandibular gland and other salivary glands, leading to reduced saliva production and dry mouth. Management may involve medications and submandibular gland removal in Hyderabad in severe cases.

Conclusion

The submandibular gland is a crucial component of the human oral cavity, responsible for saliva production, enzyme secretion, and maintaining oral health. Understanding its anatomy and functions is essential for diagnosing and managing various clinical conditions associated with this gland. If you are in Warangal, Hanumakonda, Kukatpally, or Hyderabad and require treatment for submandibular gland-related issues, it is important to consult with a qualified healthcare professional who can provide appropriate care and guidance tailored to your specific needs.

About

Dr. Gouda Ramesh is a seasoned ENT surgeon in Hyderabad with more than 18 years of experience. He is an expert in performing complex ENT surgeries and adept in coblator assisted adeo- tonsillectomy, endoscopic laser tympano-mastoidectomy, micro-debrider assisted sinus surgeries (FESS), radiofrequency, laser micro-laryngeal surgeries, and thyroid surgeries, bronchoscopy. He has successfully performed more than 10000 surgeries and treated more than 200000 patient. Gouda ENT is the best ENT hospital in Hyderabad.

[rohans18]

Sialadenitis Market

[drnishantsaurabhsaxena]

Best ENT Doctor in kanpur

Dr Nishant saurabh Saxena is one of the best ENT Doctor in Kanpur that provides all the problem regarding Eye , Ear , Nose.

We are having facility for micro to major surgery and tests for all ENT problems like :

Ear Surgery- -----------------

Dizziness, tinnitus Nose and Sinus Surgery Repair of ear drum perforation and Mastoid Diseases Cochlear Implant Surgery Myringotomy   Reconstruction of middle ear ossicles Ear lobule repair with laser.     Radio Frequency Surgery for Ear     Discharging ear or ear pus Hearing loss- Hearing Reconstructive Surgery       Facial Nerve paralysis     Repair of nasal fractures Pituitary tumors Advanced techniques     Control of epistaxis Micro Cosmetic Surgery of the Nose and Face Functional Endoscopic sinus surgery     Foreign Body Removal like rubbe Nose polyposis

Throat Surgery-- ---------------------

Vocal cord medialization. Tonsillectomy.   Sub mandible sialadenitis   Surgical treatment for snoring.   Removal of vocal cord lesions.   Oesophagoscope     Uvuloplatopharyngoplasty.

Neck Surgery-- --------------------

Parathyroidectomy   Parotidectomy     Thyroidectomy    

Dr. Nishant Saurabh Saxena  is well versed and proficient in treating all the ENT related problems especially snoring management, sleep endoscopy, endoscopic nasal and sinus surgery, micro ear surgery, thyroid surgery, hearing aid machine, and voice surgery. He has a rich experience of performing all detailed ENT surgeries known for his soft and polite nature, he is very sharp in his knowledge of medicine. Known for specialization in coblation surgery, it is a unique method of delivering radiofrequency energy to soft tissue for applications in ENT. The literal meaning of the word coblation means controlled ablation that is a controlled procedure used to destroy soft tissue.

Apart from clinical works, his keen interests fall under an Assistant Professor at the GSVM, Medical College in Kanpur. He is known for acknowledging the medical students for delivering his authentic knowledge in the form of lectures. Dr. Nishant Saurabh Saxena is also involved in actively participating in academic improvement through the publication of new research and also organizing many workshops.

Dr. Nishant Saurabh Saxena M.S.(E.N.T), AIIMS, New Delhi Specializes in Coblation Surgery. Dr. Nishant Saurabh Saxena, a medical expert, is an exclusive specialist in surgery and medical treatment of the ears nose, and throat, as well as the related head and neck areas, he regularly handles cases like nosebleeds, Adenoidectomies, infected mastoids, tonsillectomies, and sinusitis.

Dr. Nishant Saurabh Saxena is a proud student of AIIMS, New Delhi, the top college of medicine, he has been providing comprehensive medical and surgical care for patients with diseases and disorders that involve or affect the nose, ear, and throat for the past 15 years.

[skycanvas-and-swayingmoon]

My fever has subsided quite a bit, and the sialadenitis symptoms have virtually disappear after a few days.

But I'm coughing a lot more than usual haha :')