Where the ducts of the largest salivary gland open. Where is the parotid salivary gland? Inflammation of the parotid salivary gland: causes, symptoms, treatment

One of the sections of anatomy studies the digestive system, which consists of the gastrointestinal tract and auxiliary organs, which also include the salivary glands.

There are more than two hundred of them. They are part of the mouth and are divided into two types: large and small.

Parotid salivary gland - anatomy

The largest gland weighing 20-30 grams takes various forms: oval, triangular, trapezoidal, crescent and other variations.

It is located in the parotid-chewing region of the face, below and in front of the auricle. That is, it is placed over the back of the masseter muscle and is adjacent to the lower jaw.

The organ is enveloped by a leaf capsule - fascia.

Mandibular

The second largest iron, the mass of which in an adult reaches 10-15 g. Outwardly it resembles a flattened ellipse.

It belongs to the number of mixed ones, since it contains two types of cells - protein and mucous, which secrete a compound secret. The organ is limited by the anterior and posterior abdomen of the double-breasted muscle, from above by the lower jaw, and from below by the hyoid-lingual and maxillary-hyoid muscles.

The gland is enveloped by the second layer of the fascia.

Sublingual

The mass of the last large gland is 5 grams. The organ is oval. Consists mostly of mucous cells.

The structure of the glands

The gland is located on the surface of the jaw-hyoid muscle, under the membrane of the floor of the mouth. The organ is adjacent to the lower jaw in the fossa region, creating a sublingual fold. The other part is in contact with the sublingual, sublingual and sublingual muscles.

All large salivary organs are composed of disproportionate alveolar-tubular lobules.

The work of small salivary glands

The anatomy of the human salivary glands also contains small glands, they are scattered throughout the oral cavity and are divided according to their location: buccal, gingival, lingual, molar, palatine and labial. The last two are the most numerous.

Like large ones, they are also numerous in the composition of the secreted secret. The diameter of the small glands is 1-5 millimeters.

The excreted daily amount of saliva is approximately two liters. In this case, a third of the volume is produced by the small salivary glands, doing this constantly, and not like the large ones, only with irritation.

This function is very important because it prevents the oral mucosa from drying out.

Gland ducts

They fall into four main groups:

• Interlobular formed by one- or three-layer epithelium, and the outer part is covered by porous connective tissue.
• Interstitial ducts organs vary significantly. If in the parotid gland they are long and highly branched, then in the mandibular gland everything is the opposite. The cavities are covered with monolayer squamous or cubic epithelium and myoepithelial cells.
• Outlined are a continuation of the inserts and differ in diameter - they are larger. The canals are lined with a single layer of columnar epithelium and muscle cells. The ducts of the parotid and mandibular gland are well formed, highly branched and extended in length.

The area of \u200b\u200bthe intercalated and striated ducts in the hyoid gland is very small, they are underdeveloped and short:

• The common duct consists of cubic and stratified squamous non-keratinizing epithelium. The outer part is covered with a loose protective fabric. The parotid duct is located on the inner surface of the cheeks, at the level of the large molar. The ducts of the mandibular and sublingual glands are adjacent to the bottom of the oral cavity. The first opens on the lateral surface of the edge of the frenum of the tongue, the second - in front of the tongue, but behind the lower front teeth.

Thanks to the excretory ducts, saliva from the glands enters the oral cavity.

How saliva is produced

Saliva is a viscous transparent liquid that is formed in the mouth due to the work of the salivary glands. Production is triggered by a signal from the back of the brain, which contains the centers of salivation.

In specific conditions - when food irritates the nerve endings of the mouth, exposure to external pathogens (sight, smell of food) - the centers are triggered and send a command to large glands. The saliva of a healthy person is produced constantly, passing the way along the ducts.

When chewing and nervous excitement, profuse salivation occurs. But it decreases in stressful situations, a decrease in the amount of water in the body, and almost ceases to be produced during sleep and anesthesia. This explains the dryness and bad breath after waking up.

The composition and function of saliva

Components

Saliva production is uneven and varies with food intake, time of day or night, and age. Its main component is water, more than 98 percent of the total volume. The rest includes mineral and organic matter.

The first are:

• anions: chlorine, iron, iodine, phosphoric and carbonic acids, bicarbonates, thiocyanates and others;
• cations: magnesium, sodium, calcium, potassium, zinc, copper, aluminum.

Among the second:

• proteins, among them: mucin, lysozyme, peroxidase, histatin, immunoglobulins;
• lipids - fatty acids, cholesterol, glycerolipids;
• carbohydrates - mono- and disaccharides, glycosaminoglycans;
• enzymes - lysozyme, maltase, elastase, kallikrein, carbonic anhydrase.

In addition, biologically active substances are present in saliva - a number of vitamins of group B, C, nicotinic acid. And also hormones, including estrogens, cortisol, progesterone, cortisone, testosterone, prostaglandins.

Role

Saliva performs various functions in the human body:

• Digestive... It includes softening, wetting and enhancing the taste of food, bringing it to normal body temperature.
• Protective. Pellicle - a sticky layer protects tooth enamel from the harmful effects of alkalis and acids and the formation of tartar. And also, thanks to mucins, it protects against chemical and mechanical damage.
• Antibacterial... Reduces the penetration of viruses into the human body.
• Cleansing... Washes the oral cavity from food particles and some types of bacteria.
• Pain reliever... The protein opiorphin in saliva is an anesthetic.
• Excretory (excretory). When spitting from the body, human waste is removed: urea, toxins, hormones, salts of heavy metals, residues of medicinal substances.
• Speech... Moisturizing your mouth with saliva helps you make articulate sounds.
• Healing... The presence of hemostatic, bactericidal elements contributes to the rapid regeneration of injuries in the mouth.

Due to its varied composition and functions, saliva plays an important role in the human body.

X-rays of the salivary glands

Varieties

Sialography is an X-ray examination of the ducts of small and large glands to identify their pathologies.

There are six types of sialography:

1. Thermosialography uses a thermal imager to measure the temperature of the neck and face. If the latter is increased, then this indicates an inflammatory process or a malignant tumor.
2. Sialosonography - ultrasound diagnostics reveals sclerotic changes.
3. Pantomosialography checks several paired glands at once to obtain a more complete picture of the pathology.
4. Using digital sialography, the filling and withdrawal of substances from the ducts is analyzed.
5. Sialadenolymphography is designed to check the lymphatic apparatus to detect growths in it.
6. Computed sialotomography scans the space from the parotid glands to the hyoid bone. This method is suitable for the detection of tumors and salivary stones.

Execution technique

The diagnostic procedure takes place without preparation. It is only necessary to remove metal objects: chains, hairpins, earrings in order to prevent their shadow from falling on the investigated area.

A catheter or a slightly bent blunt needle is inserted into the gland duct, slightly expanding it. Then a contrast iodine-containing substance is injected with a temperature of 37-40 degrees.

The amount of substance varies depending on the sex and age of the patient. After that, the catheter is pushed a little deeper and fixed on the cheek. To make more saliva, patients are given citric acid. The filling level of the ducts is controlled by X-ray transmission, which is carried out in several planes. On the basis of the photographs taken within half an hour, it becomes clear whether there are abnormalities in the work of the salivary glands.

Healthy organs on X-ray images appear proportional, with a homogeneous structure and distinct outlines.

Contraindications

In some cases, sialography is undesirable, among them:

• Pregnancy. The exception is life-threatening;
• acute inflammatory processes in the oral mucosa;
• high sensitivity to iodine-containing drugs.

The salivary glands are versatile due to their composition.

Sometimes there are failures in their work. To identify pathologies and prescribe the correct treatment, X-ray is used.

Video on the topic

The human body is a "multi-component device" that is assembled from interconnected "parts". The salivary glands are one of the most important parts of the digestive function. But many do not understand the importance of this component in the body.

The salivary gland (glandulae saliariae) is a gland of external secretion that produces a liquid substance called saliva. And you can also say that these glands are an organ.

Classification of the salivary glands

TO are lassified in the following areas:

• By size: large and small
• By the type of saliva secreted: serous (protein), mucous and mixed.

Serous (protein) contains a large amount of protein, the mucous membrane contains the main amount of viscous mucus and minerals, and the mixed one has both proteins and minerals in equal proportions.

The small salivary glands include glands that are located throughout the oral cavity. They make up the bulk of the total number of glands. P subdivided on the:

Their function is to keep your mouth dry between meals. The small lingual glands, in turn, are divided into glands at the root of the tongue and glands at the tip of the tongue. In structure, they belong to the tubular alveolar glands. The glands of the tip of the tongue secrete a protein-mixed secretion, and a group of others, including the glands of the root of the tongue, secrete mucous-protein saliva.

Large salivary glands

amount large glands that produce saliva are 3 pairs:

• Parotid
• Submandibular
• Sublingual

Within 24 hours, these glands secrete a small mass of saliva, but when food enters the mouth, the amount increases greatly

Parotid glands

The parotid glands secrete proteinaceous saliva. These glands consist of a large number of lobules. In the constituent lobules, a number of departments:

• Secretory (alvioli, acini).
• Exhibition channels.
• Salivary streaked tubes.

The epithelium of the secretory department consists of 2 different types of serocyte cells and myoepithelial cells. The shape of serocytes is a cone. Myoepithelial cells serve as baskets for acini. There are filaments in their cytoplasm, which contributes to the reduction and secretion of saliva.

Submandibular glands by the composition saliva is mixed. Their departments for the production of secretions are of two types: protein-mucous and protein. The protein acini are composed in the same way as in the parotid glands. The inserts are short. The cells of the striated ducts perform a function similar to insulin.

Sublingual glands

The sublingual glands produce a mucous-protein secret in which mucoids predominate. Exhibition and striated ducts in these glands are poorly developed. In the sublingual glands, the salivary sections are of three types: proteinaceous, mucous and mixed. The main part is composed of mixed end sections.

Where are the salivary glands

All of these glands are found in the mouth. Small glands are located near the location of the mucous membrane of the tongue, palate, lips and cheeks. Large glands are located in the layers of the tongue floor, under the jaw and in the parotid layer. The parotid gland is located behind the jaw fossa, the submandibular gland is located in the submandibular triangle, and the submandibular salivary gland is located on the jaw-hyoid muscle.

Functions of the salivary glands

Act these glands are very important:

• Wetting and thinning food.
• Enhanced taste.
• Chewing food.
• Teeth protection.
• Cleansing the oral cavity.

All this is carried out by the salivary glands.

The numerous substances that make up the glands have a beneficial effect on digestion. The enzymes work within 30 minutes after ingestion of food. Although food is in the mouth for a fraction of a minute, it is there that the digestive process begins. Complete breakdown occurs in the stomach due to the production of gastric juice.

The main job of the salivary glands is to produce saliva.

It is a transparent, slightly viscous substance that consists of 99.5% water, the remaining 0.5% is:

Saliva contains a huge number of different microbesbut over time, people have become susceptible to many of them. And many bacteria are still not adapted to the body, saliva helps in their neutralization. Therefore, it is imperative to observe hygiene, as many microbes mutate and form serious infections.

Saliva functions

The functions of saliva are divided into 2 types:

• Digestive.
• Not digestive.

TO digestive features include:

• Enzymatic.
• Formation of a lump of food.
• Temperature regulation.

Enzymatic breaks down some substances such as complex carbohydrates. They help the stomach to digest food. The formation of the food bolus allows for smoother swallowing without damaging the pharyngeal tissue. The thermostat function cools or heats food up to 36 °.

TO not digestive features include:

• Moisturizer that prevents dry mouth from prevailing.
• The bactericidal helps the body to disinfect.
• Participation in the enrichment of teeth with minerals also protects the tooth enamel from damage.

The study of these glands was first carried out by Academician Pavlov. At the end of the 19th century, he conducted an experiment on a dog. Having cut the places where the glands are located, he brought them out. Clean saliva was collected in the container within 24 hours. This helped to obtain a complete chemical composition, as well as to recognize all functions and properties salivary glands.

Diseases of the salivary glands

Diseases of the salivary glands are very rare. It can come from blows to the face, from severe bruises to the ears and throat. There can also be one defect in these jelly - this is their absence in the oral cavity.

Sialoadenitis

Sialoadenitis can occur in the most common cases. Sialoadenitis can be:

• viral (popularly mumps) - arises from epidemics viral mumps.
• bacterial - affects the glands through infection through the lymph and blood. It occurs with poor hygiene, with complications after operations on the abdominal organs, with stone disease, if the canal is blocked.
• serous sialoadenitis, it is characterized by dryness in the oral cavity, the earlobe is raised, and when chewing, the pain increases.
• purulent sialoadenitis - instead of saliva, it can be secreted pus, the edema extends to the scales, cheeks, jaw. On palpation, the gland is painful and dense.
• gangrenous sialoadenitis - proceeds violently, necrosis of the tissues of the oral cavity occurs, the necrotic parts of the gland are released. The disease is fatal without proper treatment.
• chronic sialoadenitis is divided into 3 types:

1. interstitial lesions in 85% of parotid diseases;
2. parenchymal in 99% women are ill, the parotid glands are also affected;
3. sialodochitis affects only the ducts, occurs more often in the elderly.

Aggravation can start abruptly. As a rule, this is the beginning of autumn and the beginning of spring. Exacerbation begins with dry mouth, iron increases in size.

It is necessary to pay attention to the fact that each type of sialoadenitis is treated in different ways, therefore, if any signs appear, you need to urgently consult your doctor, and not self-medicate.

Diagnostics and prevention

Usually, the treatment includes food that increases salivation, the appointment falls on antibiotics, rinsing and massage of the glands. For prevention, you need to monitor hygiene. To treat teeth in time, for any infection, you need to gargle your throat, teeth and mouth.

- glands secreting a specific secret into the oral cavity - saliva.

In humans, in addition to numerous small salivary glands in the mucous membrane of the tongue, palate, cheeks and lips, there are 3 pairs of large salivary glands.

Types of salivary glands

There are the following paired large salivary glands:

• parotid;
• submandibular;
• sublingual.

Small salivary glands are divided into:

• buccal;
• molar;
• labial;
• lingual;
• glands of the hard and soft palate.

By the nature of the secreted secretion, the salivary glands are divided into:

• mucous membranes;
• serous (proteinaceous);
• mixed.

Serous glands are found mainly among the lingual, the saliva secreted by them is rich in protein. The mucous glands are the palatine and part of the lingual, the saliva they produce is rich in mucus. Mixed - buccal, molar, labial and part of the lingual secrete saliva mixed in composition.

Large the parotid salivary glands belong to the protein glands, and the large submandibular and sublingual glands belong to the mixed (mucosal) glands. The secretory function of the large salivary glands is of great importance for digestion.

The main mass of the parotid large salivary gland is located in the posterior jaw fossa, the anterior part of the gland lies on the masseter muscle. From the lateral surface, the parotid salivary gland is covered with a dense fascia, from which there are bridges that divide the gland into lobules.

In the thickness of the parotid salivary gland pass the facial nerve with its main branches, the external carotid artery, and large veins. The mouth of the excretory duct of the gland is located on the mucous membrane of the cheek at the level of the first - second molars of the upper jaw.

Small.Small salivary glands are located in the thickness of the oral mucosa or in the submucous layer of the lips, cheeks, palate, tongue (the most numerous among the small salivary glands are the labial and palatine). The sizes of small glands are varied, their diameter ranges from 1 to 5 mm.

BLOOD SUPPLY

The blood supply to the parotid salivary glands is carried out by the branches of the external carotid arteries; blood flows into the system of the external and internal jugular veins.

The submandibular salivary gland is located in the submandibular triangle. Its excretory duct opens in the anterior sublingual region on the sublingual papilla. The blood supply is carried out by the branches of the facial artery.

The sublingual salivary gland is located in the sublingual space on the maxillofacial muscle next to the excretory duct of the submandibular salivary gland. The main excretory duct opens on the sublingual papilla, the small excretory ducts - on the sublingual fold. The blood supply is carried out by the branches of the lingual artery.

EMBRYONIC SOURCES OF DEVELOPMENT AND THEIR DERIVATIVES

From the cutaneous ectoderm, the embryonic stratified epithelium of the oral cavity is formed, which gives rise to the parenchyma of the gland. The mesenchyme forms the stroma. Ganglionic plates appear from the neuroectoderm, forming the nervous apparatus of the glands.

GENERAL FUNCTIONS

• exocrine - secretion of protein and mucous components of saliva;
• endocrine - secretion of hormone-like substances;
• filtration - filtration of liquid components of blood plasma from capillaries into saliva;
• excretory - the allocation of end products of metabolism.

SALIVATION

Salivation - the processes of secretion and excretion of saliva into the oral cavity. It is produced by the salivary glands. The secretion of the large salivary glands is intermittent; the saliva secreted by them serves to wet the food in the oral cavity. The secretion of small salivary glands in humans is continuous; the saliva they produce moisturizes the oral mucosa.

Reflex salivation is carried out under the influence of parasympathetic and sympathetic nerves with the participation of the salivary center, embedded in the medulla oblongata. Salivation is also affected by humoral factors. For example, atropine suppresses the secretion of the salivary glands, and pilocarpine causes increased secretion even in conditions of their denervation.

Salivation can be impaired in various pathological conditions: excessive salivation (hypersalivation) is observed with nausea of \u200b\u200bvarious origins, trigeminal neuralgia, stomatitis; reduced (hyposalivation) - with some infectious diseases, pneumonia, diabetes mellitus, etc.

DISEASES OF THE SALIVARY GLANDS

Pathologies of the development of the salivary gland are very rare. Sometimes the congenital absence of these glands is possible.

Salivary gland injuries are rarely isolated. They can occur as a result of gunshot wounds, cutting or bruised lacerations. The parotid gland is most commonly affected.

In this case, the integrity of the excretory duct of the gland, the facial nerve and the external carotid artery is often violated. A wound to the parotid gland can be complicated by the formation of a salivary fistula. Irritation and maceration of the skin is sometimes noted around the mouth of the fistula. Treatment is prompt. Recurrences of salivary fistula are frequent.

After an inflammatory process or injury as a result of the closure of the common duct or the duct extending from the gland lobule, retention cysts are formed, more often in the small salivary glands (lower lip, cheeks), less often in the large salivary glands.

The most common salivary diseases:

• sialadenitis;
• sialolithiasis;
• mumps.

A person has small and large salivary glands. The group of small glands includes buccal, labial, molar, palatine and lingual. They are found in the thickness of the oral mucosa. Small glands are divided into 3 types according to the nature of the saliva secreted - mucous, serous or mixed. The large salivary glands are called the paired parotid, sublingual and submandibular.

Parotid topography

The parotid glands, the largest of all, secrete a protein secretion. The glands are located in the postmaxillary fossa, adjacent in depth to the muscles coming from the styloid process, the pterygoid and digastric muscles. The upper edge of the gland is located at the external auditory canal and the membranous part of the temporal bone, the lower edge is near the corner of the lower jaw. The superficial part of the glands lies under the skin, covers the chewing muscle and the branch of the lower jaw. Outside, the parotid glands have a dense fibrous capsule fused with the superficial layer of the neck's own fascia.

The organ tissue is represented by glandular lobules with an alveolar structure. The walls of the vesicles-alveoli are composed of secretory cells. In the layers of fibrous tissue between the lobules, there are intercalated ducts. One pole of the secretory cells are directed towards the ducts. The bases of the cells are adjacent to the basement membrane, in contact with the myoepithelial elements capable of contraction. The flow of saliva from the ducts is stimulated by the contraction of myoepithelial cells.

The intralobular striated ducts are lined from the inside with a layer of prismatic epithelium. Connecting, the striated ducts form interlobular ducts with stratified squamous epithelium. The common excretory duct of the gland is formed by the fusion of the interlobular ducts. Its length is 2–4 cm. The duct lies on the surface of the cheek muscle 1–2 cm below the arch of the zygomatic bone. At the front edge of the muscle, it pierces the fatty body and the muscle itself, opening on the eve of the mouth opposite 1–2 upper molars ( large molar). The neurovascular bundle runs through the parotid gland. It contains the external carotid, superficial temporal, transverse and posterior ear arteries; facial nerve and posterior maxillary vein.

Submandibular topography

The submandibular gland secretes saliva of a mixed protein-mucous nature. It has a lobular structure. The gland is located in the submandibular fossa, bounded from above by the maxillary-hyoid muscle, behind - by the posterior abdomen of the digastric muscle, in front - by the anterior abdomen of this muscle, outside - by the subcutaneous muscle of the neck. The gland is covered with a capsule representing the layer of the neck's own fascia. The internal structure of the gland and its ducts is similar to the structure of the parotid gland. The excretory duct of the submandibular gland exits on its medial surface and lies between the maxillary-hyoid and hyoid-lingual muscles.

Topography of the hyoid gland

The sublingual salivary gland predominantly secretes a mucous secret (mucin), formed by lobules with an alveolar structure. The gland is located under the lateral part of the tongue on the sublingual muscle. The ducts of the sublingual and submandibular glands open on both sides of the frenum of the tongue.

Embryonic development

The salivary glands are formed from the epithelium of the oral cavity of the embryo, growing into the underlying mesenchyme. By the 6th week of the embryo's life, the submandibular and parotid glands are laid, at the 7th week - the sublingual glands. The secretory sections of the glands are formed from the epithelium, and the connective tissue septa between the lobules from the mesenchyme.

Functions

The saliva secreted by the glands has a slightly alkaline reaction. The secretion of the glands includes: inorganic salts, water, mucus, lysozyme, digestive enzymes - maltase and ptyalin. Saliva is involved in the breakdown of carbohydrates, moisturizes the mucous membrane, softens food and has a bactericidal effect on microorganisms.

Inflammatory diseases

The common name for inflammation of the salivary glands is sialoadenitis. Inflammatory diseases in the salivary glands occur when an infection enters with blood, lymph, or ascending from the oral cavity. The process of inflammation can be serous or purulent.

The viral infectious disease of the parotid gland is mumps or mumps. If the child has symmetrically swollen and sore parotid glands, these are symptoms of mumps. Male infertility is a complication of childhood mumps. The mumps virus damages not only the salivary glands, but also the germ cell tissue of the testicles. Prevention of mumps disease and its complications is the vaccination of preschool children against mumps.

Autoimmune inflammation with the accumulation of lymphoid cells in the tissues of the salivary glands develops in Sjogren's syndrome ( group of diffuse connective tissue diseases). Sjogren's syndrome is an autoimmune lesion of exocrine glands, joints and other connective tissue structures. The causes of the disease are considered viral infections, coupled with a genetic predisposition.
Sialoadenitis stone - the formation of a stone in the salivary duct and reactive inflammation of the organ. The duct calculus prevents saliva from flowing out and can cause a retention cyst to form.

Other causes of the formation of retention cysts of the salivary glands: trauma, inflammation of the ducts, followed by their blockage and impaired saliva outflow. A cyst with a mucous (mucoid) secretion is called a mucocele.

Damage

Facial trauma can be accompanied by damage to the tissue and excretory ducts of the parotid gland. These injuries are dangerous by the formation of salivary fistulas, narrowing or overgrowth of the excretory duct, which leads to stagnation of saliva. Acute organ damage is determined by the following symptoms: salivation from a wound, the formation of salivary flow - the accumulation of saliva under the skin. Treatment of the consequences of trauma to the parotid gland - wound closure, surgery to restore the orifice of the duct when it is overgrown, surgical plastics of salivary fistulas.

Tumor diseases

True tumors of the salivary glands can develop from the epithelium of the ducts and secretory cells. A benign neoplasm is called adenoma, malignant - cancer or sarcoma. Tumors of the salivary glands do not hurt in the initial stages. Therefore, unilateral painless enlargement of the salivary gland is an indication for consultation with an oncologist and additional research.

Classification of neoplasms of the salivary glands by the nature of tumor growth:
benign forms;
local destructive forms;
malignant forms.

Of the benign tumors, the most common pleomorphic adenoma is a mixed tissue. It is characterized by slow growth over many years. The tumor can grow large, but it is painless and does not metastasize. Malignancy of pleomorphic adenoma develops in 3.6-30%.

Indications for operations on the salivary glands:
the formation of stones in the salivary ducts;
benign and malignant tumors.

Treatment of cysts and tumors of the salivary glands - removal of the affected organ. The remaining healthy glands provide saliva production.

Diagnostic methods

For effective treatment of cancer of the salivary glands, the condition of the lymph nodes and surrounding tissues is assessed for the presence of metastases. More research is needed to obtain information on the location, number and size of stones or tumors:
contrast radiography - sialography;
probing of ducts;
cytological examination of the secret;
Ultrasound - ultrasound examination;
magnetic resonance imaging or computed tomography;
biopsy, specifying the histological type of tumor.

About transplant

Scientists have developed an autotransplantation technique - transplanting one of the patient's own salivary glands under the skin of the temple. The operation can effectively treat dry eye syndrome, significantly improving the condition of patients. Clinical trials were carried out at the University of São Paulo in Brazil, where 19 people were operated. The results of the operations showed a good clinical effect. Surgeons from the University of Napoli and other medical centers in Germany have also received good results.

Experimental transplantation of embryonic tissue of the large salivary glands in laboratory animals ( guinea pigs) performed at the Belarusian State Medical University in 2003. The work of medical scientists in this direction continues.

What is the salivary gland? The salivary gland (glandulae salivariae) is an external secretion gland that produces a special substance called saliva. These glands are located throughout the oral cavity, as well as in the maxillofacial region. The ducts of the salivary glands open in different places in the mouth.

In the definition of the term "salivary gland" there is a mention that it is an organ of external secretion - this means that the products synthesized in it enter the cavity associated with the external environment (in this case, it is the oral)

Types and functions

There are several classifications.

The sizes of glandulae salivariae are:

• large;
• small.

By the nature of the secreted secret:

• serous - saliva is enriched with a large amount of protein;
• mucous - the secret contains mainly a mucous component;
• mixed - they can secrete serous and mucous secretions.

The main function of glandulae salivariae is to produce saliva.

Saliva is a transparent, slightly viscous, slightly alkaline substance. More than 99.5% of its composition is water. The remaining 0.5% are salts, enzymes (lipase, maltase, peptidase, etc.), mucin (mucus), lysozyme (antibacterial substance).

All functions of saliva are divided into 2 types - digestive and non-digestive. Digestives include:

• enzymatic (the breakdown of certain substances, for example, complex carbohydrates, begins in the mouth);
• the formation of a food lump;
• thermoregulatory (cooling or heating food to body temperature).

Non-digestive functions:

• moisturizing;
• bactericidal;
• participation in the mineralization of teeth, maintaining a certain composition of tooth enamel.

Note. The study of the function of glandulae salivariae was carried out by Academician Pavlov during experiments on dogs at the end of the 19th century.

Small salivary glands

They make up the bulk of all glandulae salivariae. They are located throughout the mouth.

Depending on the location, the small glands are called:

• buccal;
• palatine;
• lingual;
• gingival;
• molar (located at the base of the teeth);
• labial.

According to the secreted secretion, most of them are mixed, but there are serous and mucous membranes.

The main function is to maintain a normal level of saliva in the mouth. This does not allow the mucous membrane to dry out between meals.

Large salivary glands

The number of large salivary glands in humans is six. Of these, there are:

• 2 parotid;
• 2 submandibular;
• 2 sublingual.

Note. The glands are laid at 2 months of embryonic development from the epithelium of the oral mucosa and initially look like small strands. In the future, their size increases, future ducts appear. At the 3rd month, a channel appears inside these outflow tracts, connecting them to the oral cavity.

During the day, large glandulae salivariae synthesize a small amount of saliva, but when food is ingested, its amount increases dramatically.

Parotid gland

It is the largest of all the salivary glands. By the type of secreted secretion, it is serous. Weight is about 20 grams. The volume of secretion secreted per day is about 300-500 ml.

This salivary gland is located behind the ear, mainly in the posterior mandibular fossa, in front of the limited angle of the lower jaw, behind - the bony part of the auditory canal. The front edge of the glandula parotidea (salivary gland) lies on the surface of the masseter muscle.

The body of the gland is covered with a capsule. The blood supply comes from the parotid artery, which is a branch of the temporal artery. Lymphatic drainage from this salivary gland goes into two groups of lymph nodes:

• superficial;
• deep.

The excretory duct (stenons) starts from the front edge of the glandula parotidea, then, passing through the thickness of the masseter muscle, it opens in the mouth. The number of outflow pathways can vary.

Important! Since the body of the glandula parotidea is located mostly in the bony fossa, it is well protected. However, it has two weak points: its deep part, adjacent to the internal fascia, and the posterior surface in the region of the membranous part of the ear canal. These places during suppuration are the area of \u200b\u200bformation of the fistulous tract.

Submandibular salivary gland

So is the great glandulae salivariae. It is somewhat smaller in size and weighs about 14-17 grams.

According to the type of secret produced by this gland, it is mixed.

Glandula submandibularis has an excretory duct called Warton's. It starts from its inner surface, going obliquely up into the oral cavity.

Sublingual salivary gland

It is the smallest of the large salivary glands. Its weight is only 4-6 grams. It is oval in shape, maybe slightly flattened. The type of secretion is mucous.

The excretory duct is called Bartholin's. There are options for opening it in the sublingual area:

• independent opening, often not far from the frenum of the tongue;
• after fusion with the ducts of the submandibular glands on the caruncula sublingualis;
• many small ducts, opening on the caruncula sublingualis (hyoid fold).

Diseases of the salivary glands

All diseases of glandulae salivariae are divided into several groups:

• inflammatory (sialoadenitis);
• salivary stone disease (sialolithiasis);
• oncological processes;
• malformations;
• cysts;
• mechanical damage to the gland;
• sialosis - the development of degenerative processes in the tissues of the gland;
• sialoadenopathy.

The main symptom of the presence of glandulae salivariae disease is their increase in size.

The second symptom that characterizes the presence of problems with glandulae salivariae is xerostomia, or a feeling of dry mouth.

The third symptom of anxiety is pain. Its occurrence is possible both in the area of \u200b\u200bthe gland itself, and irradiation into the surrounding tissues.

Important! If you have at least one of the above symptoms, you should see a doctor.

Examination of patients with suspicion of the presence of certain disorders in the salivary gland begins with examination and palpation. Additional methods are probing (detects the presence of narrowing of the outflow tract), sialometry (measuring the rate of saliva secretion) with microscopy of the secretion obtained.

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Treatment

Treatment of pathological processes in the salivary glands is carried out depending on the etiology of the disease.

The most common of all diseases is sialoadenitis. For the treatment of the inflammatory process, conservative etiotropic treatment is usually used. It consists in the appointment of antibiotics, antiviral, antifungal drugs. With the development of an extensive purulent process, the gland cavity is opened and drained.

Important! After surgical treatment, a scar remains on the skin in the access area (in the treatment of mumps and sialosubmandibulitis). After surgery, the salivary gland is completely restored after a while.

Also, a surgical method of treatment is resorted to when sialolithiasis occurs.

Oncological processes in the area of \u200b\u200bglandulae salivariae are treated with combined methods. More often, a surgical method (complete excision of the tumor and gland tissues) is combined with subsequent radiation or chemotherapy.

Conclusion

The salivary glands play an important role in human life. And it is very important not to allow the development of pathological processes in them. The simplest way of prevention is to maintain hygienic cleanliness of the oral cavity, exclusion of smoking and alcohol. This will help maintain the full function of the glands for a long time.