Cyst salivary gland may form in oral cavity even in a baby. A mucus bubble occurs due to a plug in the glandular ducts and retention of secretions in them. The slimy fluid accumulates more and more, thereby provoking the growth of the capsule. It can take a long time to increase in size: a cyst of the parotid salivary gland, for example, grows for ten years. How dangerous is the disease and what is the prognosis for its treatment?
In the human oral cavity large number glands that secrete saliva. Small ones, the size of which does not exceed 5 mm, are located in the thickness of the mucous membrane of the tongue, palate, cheeks, and lips.
There are also large salivary glands, which are located in pairs:
The cysts formed here bear their own name. But classification cystic tumors is not limited to a local feature. According to the nature of their occurrence, they are:
Salivary gland retention cysts usually appear in newborns from one month to one year.
Cysts are also characterized by the type of content. It happens:
In some cases, the liquid may be a combination.
More than 50% of pathological neoplasms occur on small glands, and most often on inside lower lip. Their appearance is facilitated by:
All of them cause blockage of the duct of the minor salivary gland. When eating, the spherical formation may burst and release a yellowish liquid. But over time it accumulates again. A cyst of the minor salivary gland usually does not exceed 1-2 cm.
A cystic tumor must be differentiated from benign neoplasms in this place.
Usually, the symptoms of a minor salivary gland cyst hardly appear, and the pathology does not cause obvious concern. Pain occurs only with the development of inflammatory processes.
This type of disease is called ranula or “frog tumor”. It ranks second in prevalence - 35%. The sublingual salivary gland cyst is localized under the root of the tongue. It also differs from other varieties in its oval shape and bluish tint.
The causes of the tumor are as follows:
The development of the tumor causes deviation of the lingual frenulum. The capsule prevents the patient from speaking and eating normally. Sometimes it is damaged, opened, but again filled with salivary fluid.
A rounded, soft and elastic capsule occurs in the submandibular region in 4% of cystic formations. The tumor becomes visible gradually, spreading to the area under the tongue and causing asymmetry in the facial contour.
A submandibular salivary gland cyst is formed due to:
To exclude suspicion of other, more dangerous tumors, clinical diagnosis is performed.
Parotid cysts occur rarely and are localized under the ear, sometimes radiating to the neck. Cyst formation is promoted by:
It can even be recognized by external signs: occurring on the right or left, it provokes a disproportion of facial lines. There are no changes in the oral cavity. The neoplasm is almost not felt.
Infections cause possible complications. The skin begins to turn red, aching pain, jaw movement is limited.
If the source inflammatory process gets into the cystic capsule itself, an abscess may occur.
Sometimes a parotid gland cyst grows on both the right and left sides. As the size of the cyst increases, it may “bulge” into the oral cavity.
The patient will have to undergo the following procedures that will help confirm the diagnosis, location of the tumor, volume, stage of development and distinguish it from other pathologies. Diagnosis of a salivary gland cyst consists of:
The final diagnosis is made during examination.
Modern treatment of cysts salivary glands- This is most often an operation. Salivary gland cyst removal is performed different methods- depending on where it is located:
Used during surgery local anesthesia. The facial nerves are not damaged.
Sometimes delete is used pathological cavity laser. But it can only get rid of small cavities under the tongue and the mucous membranes of the cheeks and palate. The bulge is evaporated using a beam. The remains are “soldered” onto the oral mucosa.
At surgical method For the treatment of cysts, antibiotics are prescribed. They reduce inflammation and prevent the growth of pathology. The drugs are also prescribed after removal of the cystic tumor. Full recovery the patient passes in 3-5 days. During this time, swelling and pain disappear. But you can’t massage or heat your face for another month.
Traditional medicine does not welcome surgical treatment. It is believed that salivary duct cysts can be treated with the following gargles:
Decoctions are also prepared from other herbs that can reduce inflammation and heal wounds. This is raspberry, chamomile, viburnum, horsetail, aloe, sage, yarrow.
Under no circumstances should you burn, cut or puncture cysts yourself. So as not to call later ambulance, be sure to consult your doctor.
Treatment folk remedies also includes compresses that are applied to the external skin(if possible). Using decoctions medicinal herbs, moisten a piece of gauze and stick it to the sore spot using a plaster.
The disease can be prevented and all unpleasant procedures can be avoided. Prevention includes:
If the cyst has already appeared and it does not cause concern, there is no need to postpone a visit to the doctor. Over time, tumors of the salivary glands cause serious complications in almost 100% of cases.
Dentists, like no one else, know best such a rather tricky disease as a cyst of the parotid salivary gland.
The reason for its appearance is primarily associated with a violation of the flow or retreat of the secretion of this gland. Blood clots appearing in it, recently experienced injuries, or traffic jams that appear due to very thick secretions settling on the vessels may be to blame for everything.
Less commonly, the appearance of a cyst is associated with benign or malignant formations, so-called tumors, which put too much pressure on the gland. Over a long period of time, a cyst can quietly develop in the salivary gland, without giving any sign of its existence, until it grows to a certain size and begins to “get in the way.”
Difficulties associated with chewing food, swallowing, and even pain when talking are signs that suggest that a parotid salivary gland cyst has formed. How dangerous is the disease? An enlarged growth can turn into a serious skin defect.
As is known from school course anatomy, the salivary glands have a very important function, which is to break down and process carbohydrates, as well as secrete secretions.
Food becomes softer and the digestion process is much easier.
In addition, saliva secreted by the salivary glands has a disinfecting effect and destroys microbes that enter the oral cavity, as it contains substances such as amylase, maltase, lysozyme and others.
The cyst can choose one of three locations where it most often develops:
All forms of cysts can appear completely unexpectedly and signal their existence only after they have sufficiently increased in size.
The development of a growth can be triggered by blood clots or blockages in the ducts of the gland, due to which the movement of secretions to and from the gland becomes problematic or may stop completely.
The appearance of a cyst may be due to the following reasons:
The most common reason is mechanical damage. They can occur during digestive processes in the mouth. Cases are much less common congenital cyst, which for a long time does not make itself felt, and then, under the influence of certain factors, increases in size.
Research conducted in this area helped to identify a number of other reasons for the appearance of parotid salivary gland cysts:
Often, the appearance and development of a parotid salivary gland cyst is painful and accompanied by tissue inflammation or the appearance of other diseases. The appearance of a growth is directly related to the appearance of microbes, viruses, injuries or other mechanical damage at the site of the disease.
It should be noted that in the first couple of days it is almost impossible to identify a cyst. For specific signs of its presence to appear, a little time should pass; at a minimum, it should increase in size.
If a person who suspects that he has incomprehensible pain when speaking or swallowing identifies a number of other reasons described below, it is necessary to urgently go to the hospital to see a dentist or see an ENT doctor:
Only a professional doctor can make a final diagnosis. Diagnosis of patients is carried out using special equipment using instruments and during examination by the doctor himself. During the examination, the doctor must first exclude a number of possible pathologies that have cyst-like symptoms, such as adenomas. Naturally, one visit to the doctor is not enough.
Parotid salivary gland cyst on x-ray photo
In order for the doctor to be confident in the correctness of the diagnosis, he must prescribe a number of examinations, including tests, ultrasound diagnostics, perhaps even an MRI or tomography, as well as sialography or cystography.
It is worth saying that sialography is one of the types of instrumental research, which aims to study the salivary gland and salivary ducts, determine their condition, the condition of the walls of the ducts, and check for the presence of blood clots and blockages.
Thanks to this, the doctor will be able to determine the presence of a cyst, calculate its approximate size, and location. Next, the doctor must prescribe a test called a biopsy.
The point of a biopsy is to take a small amount of fluid from the growth for analysis - to check for the presence cancer cells. Based on the results obtained, further treatment will be prescribed.
Unfortunately, no drug treatment for parotid cysts has yet been invented. Its removal can only be done surgically.
For a cyst of the parotid salivary gland, the operation is performed using the “extraoral approach method.” The operation is performed under local anesthesia.
As a rule, the cyst itself, the soft tissue affected around it, and possibly the ducts located next to it are removed. In some cases, the gland itself is removed along with the cyst, which eliminates the possibility of the cyst appearing again in the future.
During the operation, great difficulties for the surgeon can be caused by the location of the cyst - its inaccessibility. The surgeon must act very carefully, almost like a jeweler, so that, most importantly, he does not touch the facial nerve, which is located directly very close to the salivary gland and cyst itself.
In case unsuccessful operation to remove a cyst of the parotid salivary gland (reviews of this kind are few), the person’s facial expression will be skewed, the facial contour will be distorted, as well as paralysis of the muscles responsible for facial expressions.
After removing the growth or together with the gland, apply to the damaged area surgical sutures. If necessary, the surgeon can install a drainage, which is responsible for the outflow of fluid from the “source” and rapid healing.
As for the prevention of parotid salivary gland cysts, doctors always recommend that their patients, first of all, do not neglect the rules of personal oral hygiene and do not run the risk of injury with subsequent complications or infection.
In cases of unexpected edema, swelling in the neck or face, consult a doctor immediately.
Do not neglect annual (or, which is much better - every six months) examinations and medical examinations, contact a dentist or ENT doctor.
Doctors also advise undergoing a procedure such as. The procedure is full diagnostics oral cavity, removal of plaque, deposits, disinfection of the oral cavity, anti-inflammatory complex, teeth whitening and polishing, as well as a short consultation regarding further care for the oral cavity and teeth.
Ideally, it is recommended to visit the dentist not annually, but regularly every six months.
About the process of removing a parotid salivary gland cyst in the video:
– cavity formations that arise as a result of obliteration of the ducts of the salivary glands. A salivary gland cyst is manifested by the presence of a soft, painless formation, a slow increase in size, fluctuation, difficulty swallowing and speech. Diagnosis of a salivary gland cyst takes into account examination data, ultrasound of the salivary glands, sialography, puncture and fine needle aspiration biopsy cystic formation, cytological and biochemical research punctate. Treatment of salivary gland cysts is surgical (cystostomy, cystectomy, extirpation of the gland) using intraoral or extraoral access.
Salivary gland cyst - tumor-like formation maxillofacial area in the form of a cavity filled with liquid contents. Salivary gland cysts are relatively uncommon. In most cases, they come from the minor salivary glands (56%), less often - from the sublingual glands (35%), parotid (5%) and mandibular glands - (4%). Salivary gland cysts develop predominantly in individuals young(about 30 years old). Treatment of salivary gland cysts has its own specifics and is within the competence of maxillofacial surgery (dental surgery) and otolaryngology.
The formation of a cyst may be associated with difficulty or complete cessation of the outflow of salivary gland secretions. The causes of obstruction of the duct may be its blockage with a mucus plug; obliteration as a result of inflammation (sialadenitis, stomatitis), trauma to the gland with a prosthesis or a destroyed tooth; salivary gland stone obstruction; cicatricial narrowing, external compression by a tumor, etc. It is assumed that some salivary gland cysts may be of congenital origin and develop from an accessory rudimentary duct detached during embryogenesis.
In most cases, salivary gland cysts are single, single-chamber formations filled with colorless or yellowish mucous fluid. The cyst capsule is represented by a fibrous membrane; the inner surface is lined with multilayer flat and columnar epithelium or granulation tissue. An increase in the size of a salivary gland cyst can occur both due to the accumulation of salivary secretions in the obliterated cavity, and due to the transudation of fluid through the walls of the capillaries.
Based on the place of education they distinguish:
1. Cysts of the minor salivary glands (buccal, labial, palatal, lingual, molar).
2. Cysts of the major salivary glands:
In addition, cysts of the parenchyma and ducts of the salivary glands are distinguished by location. Depending on the structure, a salivary gland cyst can be retentional (true) or post-traumatic (false). Cysts of the salivary glands with mucoid mucous contents are called mucoceles.
Most often, such cysts are localized on the inner surface of the lower lip, less often in the cheeks or other parts of the oral cavity. A cyst of the minor salivary gland usually does not exceed 0.5-1 cm in diameter and slowly increases in size. A salivary gland cyst is defined as a mobile formation of round shape and elastic consistency, protruding above the surface of the mucous membrane.
A cyst of the minor salivary gland usually does not cause concern to the patient and painful sensations. Sometimes, when accidentally injured by food or biting, the salivary gland cyst opens with the release of a viscous translucent liquid with a yellowish tint; then the contents accumulate in it again. A minor salivary gland cyst must be distinguished from hemangioma, fibroma and other benign tumors of the oral cavity.
The sublingual salivary gland cyst (ranula, “frog tumor”) is localized in the area of the floor of the mouth, under the base of the tongue. Usually it shines through the mucosa in the form of a round or oval protrusion of a bluish color. Less commonly (when located above and below the mylohyoid muscle), the cyst has the appearance of an hourglass.
An enlarging cyst of the sublingual salivary gland can cause displacement of the frenulum of the tongue and interfere with eating and speaking. Periodic spontaneous emptying and filling of the sublingual salivary gland cyst with a clear secretion is possible.
Differential diagnosis of a sublingual salivary gland cyst is carried out with a submandibular gland cyst, dermoid cyst, lipoma. If the contents of the cyst become infected, exacerbation of chronic sialadenitis and salivary stone disease should be excluded.
Manifested by the presence of a round, soft-elastic, fluctuating formation in the submandibular region; when spreading to the sublingual area - bulging in the bottom of the mouth. Upon reaching large sizes a cyst of the submandibular salivary gland can cause deformation of the facial contour.
A cyst of the submandibular salivary gland requires differentiation from a lateral neck cyst, dermoid cyst, soft tissue tumors (hemangioma, lipoma, lymphangioma, etc.), lymphadenitis, submandibulitis.
A parotid salivary gland cyst is clinically manifested by a rounded swelling of soft tissue in the preauricular area, usually on one side, causing facial asymmetry. Upon palpation, the soft or dense elastic consistency of the cyst is determined. The skin over it is not changed, there is no pain or fluctuation.
When infected, a parotid cyst can become complicated by an abscess. In this case, skin hyperemia, pain in the parotid region, limited mouth opening, fluctuation, and low-grade fever appear. Differential diagnosis of parotid cysts is carried out with chronic lymphadenitis, tumors of the salivary gland.
Salivary gland cysts are recognized based on clinical picture, instrumental and laboratory research. Besides this, additional methods allow for differential diagnosis cystic formations with tumors of the salivary glands. To clarify the size, position of the cyst and its connection with the salivary gland, ultrasound of the salivary glands, cystography and sialography, CT and MRI in contrast mode are performed. Crucial importance in confirming the diagnosis belongs to puncture and fine-needle aspiration biopsy of the salivary gland cyst, followed by biochemical and cytological examination of the contents.
Treatment of salivary gland cysts at any location conservative methods not provided. Depending on the location of the cyst surgery performed through intraoral (for a cyst of the minor salivary gland) or extraoral (external, open) access.
Surgical treatment of retention cysts of the minor salivary glands involves their removal from the oral cavity under local infiltration anesthesia with the application of catgut sutures. Volume surgical intervention for a sublingual salivary gland cyst may include cystostomy, cystectomy, or cystosialadenectomy.
A cyst of the submandibular salivary gland usually needs to be removed along with the gland. For a parotid salivary gland cyst, the optimal method is to remove the cystic formation along with the adjacent parenchyma of the gland through external access (partial, subtotal or total parotidectomy) while preserving the branches facial nerve.
The main risk when removing a parotid salivary gland cyst is the possibility of damage to the branches of the facial nerve, which can lead to paralysis of the facial muscles. In addition, if not complete removal shell cysts of the salivary gland, a relapse of the disease may occur. Without treatment, there is always a risk of developing purulent complications(abscess, phlegmon).
Prevention of the formation of acquired salivary gland cysts consists mainly in the prevention of inflammatory diseases and injuries of the oral cavity,
Schematically, the salivary gland is a formation surrounded by a dense capsule and consisting of secretory tissue that produces saliva. The third essential part of the salivary gland (in addition to the capsule and secretory tissue) is the excretory duct.
Parotid, sublingual and submandibular salivary glands
Depending on the size and complexity of the structure, large and small salivary glands are distinguished. The large ones include the parotid, sublingual and submandibular glands. They have complex structure, are divided into lobes and salivation is carried out through a branched, tree-like system of ducts. Small salivary glands do not have a clear localization; their structure is much simpler. They are diffusely distributed in the structure of the cheeks, lips and palate, in some areas of the oral cavity there are more of them, in others - less. Excretory duct usually one.
The mechanism of occurrence of a retention cyst of the salivary gland is usually associated with a violation of the natural outflow of saliva. If the main duct is blocked for any reason, the main volume of the gland becomes overfilled with its own secretion. Such reasons may be:
In this case, the secreting tissue partially or completely atrophies, the gland capsule stretches in directions in which this is possible, taking into account the density of the surrounding tissues. In the absence of infection (suppuration), the contents of the cyst are viscous, transparent and colorless.
In addition to the formation of true cysts that develop in the capsule of the gland itself according to the described scheme, there are also false cysts. They occur after injury to the excretory duct and accumulation of saliva in soft tissues. Gradually, a connective tissue capsule forms around such an area of accumulated saliva and a cyst appears.
If the cyst small size, then its existence can be discovered by chance, it does not cause any complaints. But larger cysts, as a rule, exist painlessly. With submucosal localization, changes in facial contours are usually not observed. If the cyst develops subcutaneously (for example, in the parotid gland) and reaches a large size, then a visible and palpable swelling appears. With cysts in the area of the floor of the mouth, there may be a displacement of the root of the tongue, accompanied by difficulties in swallowing and articulation.
When examining a patient with a superficial salivary gland cyst, a painless round formation with a thin outer wall, elastic to the touch, with viscous liquid contents is objectively detected. In the case of deep localization, diagnosis can be difficult, so additional methods can be used - ultrasound, computed tomography etc.
The parotid salivary gland is located in the subcutaneous space in front and below the ear (parotid-masticatory region). It has a lobular structure, its duct opens in the oral cavity on the surface of the cheek in the area of the second molar (molar).
Cysts of the parotid salivary glands are relatively rare. They are divided into two groups - congenital and acquired, most often retention.
These cysts should be differentiated with inflammatory diseases parotid salivary glands, which usually causes general malaise, pain in the gland area, possible purulent discharge from proka and other signs of the inflammatory process. It is also important to distinguish a cyst cancer. Therefore, it is very important to conduct a histological examination of the contents of the cyst as early as possible.
Treatment of salivary gland cysts is surgical, which consists of complete removal of the cyst along with the membrane. The main danger of this operation lies in the close proximity of the branches of the facial nerve, injury to which can lead to innervation disorders facial muscles and facial asymmetry, as well as disorders of its sensitivity.
This type cysts are more common than submandibular gland cysts. It is located superficially at the base of the tongue. Previously, a cyst of the sublingual salivary gland was called a ranula. Diagnosis does not cause any difficulties - upon examination, an ovoid formation with a thin translucent outer wall is found, similar in appearance appearance with the laryngeal bladder of a frog (from this similarity comes another old name - “frog tumor”). On palpation the ranula is painless, with viscous liquid contents.
Ranula or "frog tumor"
Treatment is exclusively surgical. The previously common method, which involved cutting the vault of the cyst and emptying it, is now rarely practiced, as it often leads to relapse of the disease. Today, complete excision of the cyst along with its membrane is recommended.
Retention cyst of the minor salivary gland
The minor salivary glands are located in the soft tissues of the oral cavity - lips, cheeks and palate. Retention cysts of small glands most often occur after trauma to surrounding tissues, accompanied by scarring and damage to the outlet duct.
Clinically, such cysts appear as small rounded formations on the surface of the mucosa with liquid contents. They are painless and do not cause significant discomfort.
Treatment is surgical, carried out under local infiltration anesthesia. Two converging arcuate incisions are made bordering the cyst. After excision of the cyst, the surgical wound is sutured.
After removal of the cyst, the wound is sutured
Oncological diseases of the salivary glands are divided into benign and malignant neoplasms, as well as precancers - intermediate conditions preceding malignancy. Oncology of the salivary glands accounts for 2-3% of the total oncology of the body, while benign tumors account for more than 60% of all neoplasms of the salivary glands.
Tumors of the parotid salivary gland develop differently depending on the type of tissue from which it is formed. A benign tumor is usually encapsulated and develops locally, while malignant tumors grow into surrounding tissues and often lead to metastasis.
Symptoms of a salivary gland tumor on early stages may be completely absent, they are often discovered by chance. As the tumor grows, a swelling appears, which will burn and lead to facial asymmetry.
Soreness is more common malignant neoplasms, however this sign cannot serve as a diagnostic differentiating feature.
The passage of the branches of the facial nerve in close proximity to the salivary gland should be taken into account not only when planning and carrying out treatment, but also when assessing clinical situation. So cancerous tumor, sprouting nerve tissue, leads to disruption of sensitivity and innervation of facial muscles, leading to paresis and paralysis.
Biopsy is the most reliable diagnostic method
The final diagnosis of suspected salivary gland cancer should be made exclusively by oncologists and must be confirmed by histological examination. The choice of treatment tactics and its volume largely depend on the morphological data.
A salivary gland cyst is a cavity formation that occurs in one or another salivary gland. The spherical capsule is soft to the touch and has clear contours. If the cyst ruptures, a viscous fluid is released.
Important! As a result of minor damage to the mucous membrane, the lumen of the salivary gland duct may become overgrown with epithelium, which will lead to blockage of secretion. But since the work of the gland does not stop, saliva accumulates, which leads to the development of a cyst.
To diagnose the disease, a specialist visually examines the pathology and prescribes sialography and ultrasound. For cytological and biochemical analyzes cysts of the salivary glands perform their puncture and biopsy. Choosing additional ways research, the doctor relies on clinical data.
The formation that forms as a result of blockage of the salivary gland duct can have different localization.
The cyst is located in the duct of the salivary gland or in its functional part (parenchyma). Volumetric formations consist of epithelial cells that transform into glandular masses. How exactly the deformation process occurs is not fully understood.
The location of cysts can be different:
By structure they are divided:
Many people do not know that a clear or bluish bubble that forms in the oral cavity is nothing more than a mucocele. This is what it is cystic formation, in which mucin accumulates (a mucous secretion produced by parenchyma cells) under the influence of many factors:
Mucocele of the salivary gland of the floor of the oral cavity differs from a true cyst in the absence of an epithelial membrane. If the pathology has formed in the sublingual area, it is called ranula, or “frog tumor”.
Important! If treatment is not started promptly, an infection may enter the affected area, which can lead to complications, such as an abscess.
Depending on the type of blocked gland, the patient experiences various manifestations diseases:
Ranula in children can be large, making swallowing or breathing difficult. The tongue, under the pressure of the tumor, rises and protrudes forward.
Important! In case sudden violation The baby's breathing is performed by puncturing the cyst. If the bulge is small and does not cause serious problems, surgery to remove the cyst is postponed for up to a year.
In adults, salivary gland ranula is often discovered incidentally. Difficulty breathing is observed only in the case of an inflammatory process.
Regardless of localization cavity formations, treatment is carried out through surgery. If a bacterial infection occurs, the patient is prescribed antibacterial therapy.
How to remove a salivary gland cyst? Most often, excision is performed when local anesthesia. An exception may be the parotid zone. This type of pathology involves the use of general anesthesia.
Excision methods depend on the location of the tumor:
Important! Although the procedure for excision of a tumor is quite simple, the patient may still experience suspicious symptoms (swelling, bleeding, increased body temperature). In this case, you should urgently seek help.
Some patients complain that after they have had a salivary gland cyst removed, they experience re-education. There is a possibility of relapse only in case of poor-quality excision of the membrane cells. Therefore, it is very important not to damage its walls when removing the capsule.
Important. If you do not remove the salivary gland cyst, over time it will increase in size, which will complicate treatment.
A person has many salivary glands located in the oral cavity. The gland duct is the most vulnerable place. Since its dimensions are microscopically small, even with minor trauma to the cavity (bite, blow, burn) it can be easily damaged.
For the purpose of prevention, it is recommended to minimize injuries to the mucous membrane, protect from infection if possible and maintain careful oral hygiene. If tumors appear and a salivary gland cyst is suspected, you should visit medical institution(dental clinic).
