Dibue dia mu tshifu tshia mate (Sialolithiasis) ne Parotitis Suppurative: Disungula dia muinshi mua mukana¶

Divula dia tshimpitshimpi, dia kanyinganyinga muinshi mua tshiadi tshia kuinshi (submandibular gland) anyi buludiludi kumpala kua ditshi (parotide gland) didi dibuela mu bitupa bibidi bishilangane: dikanga dia njila wa mate ku diambuluisha dia dibue dia calcium phosphate (sialolithiasis), ne acute bactérie suppurative (uppurative bactérie) parotite anyi tshipupu tshia muinshi mua dikasa). Mu disama dia sialolithiasis didi kadiyi dikole (didi dienza 80 too ne ku 90 pa lukama dia bilumbu bia mu tshiadi tshia muinshi mua dikasa), dibue didi dibuikila tshitupa tshia Wharton panshi pa mukana anyi tshiamu tshia Stensen munda mua ditama; Dîba didi muntu umvua mupuya wa biakudia anyi udia, bimanyinu bia mijilu ya parasympathique bidi bilomba glande bua kupompa mate mu tshintu tshikanga, bienza bua divulangana dia lukasa dia mu tshikondo tshia kudia muinshi mua mpala didi dijika mêba 1 anyi 2 panyima pa didia, kakuyi kapia anyi pus. Mu dishilangana, tshipupu tshia bactérie tshikole anyi sialadenitis wa muinshi mua dikasa (tshitu tshikuata misangu ya bungi babedi badi kabayi ne mâyi mu mubidi, panyima pa dipanda, bakulumpe anyi badi bangata manga a anticholinergic, anyi tshidi tshikola panyima pa dibue didi dikuate) ntshilumbu tshia dipingana dia klzzwxh:0014 mu tshitupa tshia glande. Bidi bifikisha ku **divulangana dia mpala anyi dia mu nshingu didi ditungunuka, dikole bu dibue, dia kapia, dia mpukapuka dia mpala anyi dia mu nshingu, kapia kakole, tshintu tshikole tshia mubidi wa jne tshidi tshipatuka mu tshibuelelu tshia munda mua mukana, ne tshidi mua kupatuka mu tshitupa tshia muinshi mua tshiadishia mu tshifu too ne mu muaba wa parapharyngeal anyi panshi pa mukana (Ludwig's angina), udi mua kufikisha ku dikanga dia njila wa luya udi mua kushipa muntu. Shi muntu yense udi na disama dia mukana anyi dia ditama udi ne dikola dia panshi pa mukana muinshi mua ludimi, dipatuka dia mayi, dîyi dipueka, lockjaw (trismus), anyi lutatu lua kupuyakana, ubikile muaba unudi nomba ya tshimpitshimpi diakamue. Tangila kabidi mikanda yetu ya bana betu pa Ludwig's angina ne disama dia muinshi mua dikasa, epiglottitis, croup, ne stridor, ne sepsis ne septic shock.

Tshia kumpala tshiudi ne bua kuenza ntshia kutangila bimanyinu bia bactérie anyi bia mu njila wa luya (kapia, mashi adi apatuka munda mua mukana, dibandila dia panshi pa mukana, anyi trismus), enza mudimu ne **difila dia mâyi, dienza dia bintu bia mashika, dilengeja dia gland dia mabele dia kumpala, ne sialogogues mikole (matonyi a ludimwa anyi mafuta a Clozen) padi muntu kayi ne manyanu a vitamine *** udi ne disama dia mabue, ne keba diakamue lupitadi maluvu a lufu ne tshiamu tshia CT pikala wela meji ne: udi ne disama dia bactérie anyi dikola dia nshingu.

Enza nunku mpindieu¶

1. Tangila diakamue bua kumanya ni udi ne disama dia mu njila wa luya anyi dia mu nshingu ne ubikile ku nomba wa lupitadi lua muaba unudi anyi ndaku ku tshibambalu tshia malu a lukasa tshia lupitadi pikalaku. Ela 911 mu États-Unis ne mu Canada, 999 mu Royaume-Uni, 112 mu Union européenne mujima, 000 mu Australie, anyi tangila mukanda wetu wa malu a pa buloba bujima nomba ya tshimpitshimpi Shi muntu udi na divula anyi dikolesha dia tshitupa tshia mubidi tshidi muinshi mua ludimi (dibandila dia panshi pa mukana), disama didi ditangalaka ku nseke yonso ibidi muinshi mua tshibeku, lutatu lua kumina mate anyi dipatuka dia mayi, dîyi dia tshisuku dia kapia didi diumvuika bimpe, stridor, trismus (dipanga dia kukangula mukana too ne mu butshiama bua minu ibidi), anyi mashika makole.
2. Tangila munda mua mukana ne muendu ku bipese bibidi bia mate bua kumona ni kudi dibue ditoke didi dimueneka anyi tshintu tshidi ne mâyi a jaune:
3. Submandibular Gland (Wharton's Duct): Lomba mubedi bua kubandisha nsongo ya ludimi luende too ne ku mutu kua mukana muende. Tangila sublingual caruncle, bitupa bibidi bikese bia munyinyi bidi ku luseke luonso lua frenulum lingual wa pankatshi anu kunyima kua menu a kuinshi. Dibue dikole ditoke anyi dia jaune didi dipatuka muinshi mua mucosa udi umueneka patoke didi dibue dia Wharton's duct distal; pus munene wa jaune udi upatuka mu tshibuelelu udi umvuija sialadenitis submandibulaire suppurative bactérienne acute.
4. Parotid Gland (Stensen's Duct): Koka ditama dia pambelu bitekete bitekete ku luseke ne tangila tshitupa tshia munda tshia ditama tshidi tshitangilangane ne dino dia ku mutu dia dikasa dibidi. Pus udi upatuka mu papille mukese au padibu bafina ditama dia pambelu bitekete bitekete udi ujadika parotite suppurative bactérienne acute.
5. Bikalaku kapia, dikoba dikunze dia kapia, disama dia nsukadi, anyi tshipupu (Acute Suppurative Sialadenitis): ndaku ku tshibambalu tshia malu a mpukapuka lelu bua kupeta manga a antibiotique adibu bafila mu mishipa, ne KUENA diakamue matonsi a ludimi lua ludimi lubi pikala tshina tshikanga tshijima ne tshikuate. Padi silogo udi wambuluisha bua kunzulula tshitupa tshia dikoba, udi wambuluisha bua kunzulula tshitupa tshia dikoba, udi mua kuambuluisha bua kunzulula tshitupa tshia dikoba. tshitupa tshikole tshia mubidi, tshitupa tshia mubidi tshidi tshikanga bua kupatula mate kumpala kua kunua mâyi ne manga adi anyanga tuzubu tua masama mmakepeshe ductal edema udi ukolesha kanyinganyinga ka mu tshitupa tshia mubidi.
6. Bikala disama dia dibue dia mu mate didi kadiyi dikole (Divula didi dijuka padi muntu udia, kakuyi kapia, kakuyi nsukadi, kakuyi dikoba dikunze): nua litre 2 anyi 3 ya mâyi dituku dionso ne wela tshiamu tshia Warm Moist Compress ku glande munkatshi mua minite 15 anyi 20 kunyima kua mêba 2 anyi 3. Kuikala ne mâyi a bungi mu tshitupa tshia mubidi tshidi tshienda tshikepela padiye wenda ukola udi upepeja disama dia misunya idi minyunguluke tshitupa tshia mate.
7. Wenza mudimu ne Sour Lemon Drop (Sialogogue) + Forward-Milking Massage Technique bua kupatula mabue makese (muinshi mua 4 mm) a mu mate: Panyima pa wewe mumane kuosha tshitupa tshia mubidi ne tshiamu tshia mashika ne mumane kunua makopo abidi manene a mâyi, nua tshitupa tshia ludimu tshikole, bonbon mukole anyi tshiamu tshia vitamine C tshidibu mua kutafuna. Padi mate a ku tshilelelu enda avula panyima pa dibue, enza mudimu ne minu ibidi bua kulenga (mabele) tshitupa tshia mubidi tshidi tshiya kumpala mu njila wa mubidi wa tshitupa tshia mubidi (kumbukila ku nseke ya mpala kumpala muinshi mua tshibeku too ne ku meno a kuinshi a kumpala bua tshitupa tshia muinshi mua dikasa, anyi kumbukila ku ditshi kumpala kupitshila ku ditama too ne ku tshitupa tshia kuulu tshia dikasa bua tshitupa tshia parot).
8. KUENA KUELA ntunga ya kusonga nayi, bipese bia bukubi, mishiku ya minu, anyi tshiamu tshia kusonga natshi panshi pa mukana bua kupatula dibue dia mate kumbelu to. Nerf wa ludimi (udi ufila diumvua ne dipembu ku ludimi) udi unyunguluka buludiludi muinshi mua tshina tshia Wharton mu panshi pa mukana ** ku luseke lua mushipa munene wa mukana ne mushipa wa munda**; dikuma dia ku nzubu didi dinyangakaja muonji wa ludimi anyi didi dijula ​​hematoma wa panshi pa mukana udi mua kukanga njila wa luya.

Mutshi wa dipangadika: disama dia muinshi mua dikasa anyi dia mu tshiadi (dibue dia mate vs disama dia nsukadi vs disama dia tshiadi)¶

flowchart TD
    A["Disama dia kanyinganyinga kakole muinshi mua mpala (submandibular) anyi kumpala kua ditshi (parotid)"] --> B{"Kudi mabeji makunze a mu njila wa luya anyi a mitu anyi? (Kubandila panshi pa mukana, dipatuka dia mayi, stridor, trismus, anyi dikuluka dia mijilu ya ku mpala)"}
    B -->|Yes: Deep Neck Space Emergency or Parotid Abscess| C["Tungunuka ne kusomba mululame; Bikila EMS (911/999/112) diakamue: CT scan, dikuba dia njila wa luya, manga a antibiotique, dipanda dia mashi"]
    B -->|No airway or facial nerve red flags| D{"Dîba kayi ne mushindu kayi wa disama dia disama dia nsukadi?"}
    D -->|Swelling spikes within minutes of smelling or eating food, then shrinks 1 to 2 hours later; NO fever, NO pus| E["Sialolithiasis udi kayi ne lutatu (dibue dia mu tshina tshia mate)"]
    D -->|Continuous, rock-hard, hot, red swelling + spiking fever + yellow pus oozing from Wharton's or Stensen's duct| F["Disama dia Sialadenitis Suppurative Bactériale (dibue dikuate anyi Parotite wa dijimija dia mâyi mu mubidi)"]
    D -->|Bilateral (or sequential) ear-front swelling pushing earlobe upward/outward + viral prodrome in child/young adult| G["Disama dia tshiadi (Mumps, Influenza A, EBV, Coxsackie)"]
    D -->|Painless, slow-growing firm lump in parotid or submandibular gland lasting > 2 to 3 weeks| H["Disama dia mu tshiadi tshia mate / Disama dia Sialadenite dia kashidi: ultrasons ya lukasa ya ENT ne biopsie ya FNA"]
    E --> I["Difila dia mayi a bungi ku mishiku + dilengeja dia kapia + Dikopo dia ludimi lukole (sialogogue) + dilengeja dia mabele ditekete + NSAID"]
    I --> J{"Dibue didiku dipita mu meba 24 to ne ku 48 anyi, anyi dibue didi dimueneka anu ku tshibuelelu tshia tshina?"}
    J -->|Stone visible/palpable at sublingual caruncle or symptoms persist| K["ENT / Oral Surgery visit: non-contrast CT anyi ultrason + papillotomie wa mu biro anyi dipatula dia tshibombi tshia sialendoscopie"]
    J -->|Stone pops out into mouth and swelling resolves| L["Tungunuka ne kunua mâyi a bungi bua kuepuka dipingana dia"]
    F --> M["Dibuela mu lupitadi mu dituku dimue: IV Hydration + IV Ampicillin-Sulbactam (anyi Vancomycin pikala njiwu ya MRSA) + CT scan bua kumbusha tshipupu"]
    G --> N["Dilama dia diambuluisha, didimuija dia kuditapulula, dikuma dia mashika anyi dia kapia, acetaminophen/ibuprofen, kutangila orchite anyi meningitis"]

Difuanyikija dia mubidi ne dia mubidi: Bua tshinyi 85% ya mabue a mu mate adi afumina mu tshitupa tshia muinshi mua dikasa, eku disama dia Suppurative dibunda tshitupa tshia mu tshitupa tshia panshi¶

Kujingulula mushindu udi mubidi ne tshimuenekelu tshia mate a bitupa bibidi binene bia mate kudi kumvuija bua tshinyi mabue a tshiamu adi atamba kunyanga glande submandibulaire, kadi masama a bactérie adi afumina ku dipanga dia mâyi mu mubidi adi atamba kunyanga glande parotide:

Dishilangana dia disama dia ku luseke ne ku luseke: Dibue didi kadiyi dikole ne Sialadenitis wa Suppurative Sialadenitis wa tshipupu tshia Viral Mumps ne Abscess Dental¶

Mabue a mu tshiadi tshia mate (Sialolithiasis): Pathophysiology ne Protocol wa disukula dia ku nzubu¶

Mushindu udi mabue a mu mate afuka ne bua tshinyi dîba dia kudia didi dijula disama dia mate¶

Mashinyi a mu mayi (sialoliths) i bintu bia mu mayi bidi bienza nangananga ne calcium phosphate (hydroxyapatite ne whitlockite) ne calcium carbonate biteka pabuipi ne nidus organic microscopic wa condensed mucin gel anyi shed ductal cells. Bia kukema, mabue a mukana kaena apetangana ne hypercalcémie anyi mabue a mu mifuba; dienza dia mabue didi difumina ku dipanga dia mayi, dipanga dia mayi mu mubidi, dinua dia makanya, ne dienza dia mishipa.

1. Dikanga dia tshiamu tshia nzembu ne dikola dia dîba dia kudia: Munkatshi mua biakudia, dipatuka dia mate a muinshi mua buloba didi dienda bitekete (0.3 mL/minute) ne didi dipita dibue dia 2 too ne ku 5 millimetre. Diakamue paudi umvua mupuya anyi utafuna biakudia, mijilu ya mu mutu (CN VII chorda tympani bua tshitupa tshia muinshi mua dikasa; CN IX glossopharyngeal bua tshitupa tshia parotide) idi ifila divulangana dia mate misangu 10 (too ne ku 3 anyi 4 mL/minute).
2. Acute Ductal Hypertension (Salivary Colic): Divulangana dia mate didi dibuela mu dibue didi dikanga tshibuelelu tshikese, dilengeja tshitupa tshia gland. Mu 60 too ne ku 180 sekonde, tshitupa tshia muinshi mua dikasa anyi tshitupa tshia ditama tshia parotide tshidi tshienda tshikola tshilua tshitupa tshikole tshidi tshisama, pashishe tshidi tshijika mêba 1 anyi 2 kunyima kua didia padi mate apita bitekete bitekete pa dibue.

Mukenji wa ku nzubu bua kumbusha mabue makese adi kaayi makole (muinshi mua 3 too ne ku 4 mm)¶

Mabue a bungi a mu mate adi makese kupita milimetre 3 anyi 4 mu tshitupa tshia kule adi apita nkayawu mu mêba 24 too ne ku 72 ku diambuluisha dia tshilele tshia dilama dia bintu, padiku kakuyi bimanyinu bia disama dia bactérie (kakuyi kapia, kakuyi dikunze dia dikoba, kakuyi pus):

1. Dikolesha dia mayi: Nua 2.5 too ne ku 3 litre ya mayi dituku dionso bua kuvudija bungi bua mayi adi panyima pa dibue, ne tangila manga onso adi kaayi ne mushinga a anticholinergic ne munganga webe.
2. Kapia ka mashika (15 too ne ku 20 minite kumpala kua Sialogogues): Kuata tshilamba tshia mashika, tshia mashika (40 too ne ku 42 degrés Celsius / 104 to ne 108 degrés Fahrenheit) pa tshitupa tshia mubidi tshidi tshiuwule munkatshi mua minite 15 bua kualabaja tshitupa tshia mashi.
3. Sialogogue Stimulation (Sour Lemon Drops / Vitamin C): Nua sour lemon wedge, bottled lemon juice drops, tart sour hard candy, or chewable Vitamin C tablet kunyima kua mêba 2 anyi 3 paudi mubike bua kujula mutoyi wa hydraulique wa bukole bua bungi wa mate mapiamapia adi panyima pa dibue.
4. Directional Forward-Milking Gland Massage: Diakamue panyima pa wewe mumane kunua dikopo dia ludimi lua ludimi lukole, enza mudimu ne minu ibidi bua kuela bipese bia bupole, bikole mu njila wa mukana mutangile ku tshibuelelu tshia mukana:
5. Submandibular (Wharton's Duct) Stone: Komba kumbukila kuinshi kua tshitupa tshia mpala kumpala too ne ku nsongo ya tshibeku (anyi ne munu mukezuke munda mua mukana mutangile ku nsongo ya mukana kumbukila kunyima too ne kumpala too ne ku meno a kuinshi kua mukana; kuela dibue panyima nansha kakese, didi dibueja dibue dia mu tshiadi muinshi menemene).
6. Parotid (Stensen's Duct) Stone: Komba kumbukila ku meso a tshitupa tshia ditshi kuya kumpala mu tshitupa tshia ditama too ne ku nseke ya mukana.
7. Anti-Inflammatory Analgesia (NSAIDs): Nua ibuprofen (400 to 600 mg kunyima kua mêba 6 to ne 8 ne biakudia) bua kukepesha disama dia mu mishipa.

Parotite ne Sialadenite: Bua tshinyi mbualu bua lukasa lua luondapu¶

Nnganyi udi upeta disama dia parotite ne mushindu kayi udi tuishi tua bactérie tubuela¶

Bishilangane na mabue a muinshi mua dikasa (adi akuata bansonga badi ne makanda a mubidi mimpe ne bakulumpe ba bidimu bia pankatshi), disama dia parotite suppurative bactérienne acute ditu dikuata babedi badi ne mate abu mapuekele too ne padiwu ajika (stasis wa mate): - Bisumbu bia njiwu mikole: Bantu bakulumpe badi ne dipanga dia mâyi mu mubidi (bua luya lukole, disama dia mu tshifu dia virus, diuretique, anyi didia dia mâyi mabi), babedi badibu bapasule panyima pa dipanda (nangananga kunyima kua dipanda dia mu difu anyi dia mifuba ne nsombelu wa NPO ne anesthesie wa générale wa atropine anyi gdrolycopy ), badi benza mudimu mu ICU babedi, babedi badi banua manga a anticholinergic (maluvu a tricyclic antidepressives, oxybutynin, benztropine, antihistamines, antipsychotics), ne babedi badi ne Sjogren's syndrome, diabete mellitus, anyi xerostomie wa radiation head-and-neck. - Retrograde Bacterial Ascent: Pa tshibidilu, dienda dia mate dia lukasa didi disukula tshitupa tshia Stensen kunyima kua minite mikese. Padi dipanga dia mayi mu mubidi anyi manga adi apangisha mashi bua kuondopa disama dia mukana, bactérie mikole idi isomba mukana, misangu ya bungi *klwxh:0037 idi kayiyi ipet penicillin (kuangisha ne MR mu babedi badi mu lupitadi anyi badib balama munzbu wa bakulakje**, **tshisumu shia viridans *Strpcoccus, accilophilus**e grippe bintu bidi kabiyi ne luya (Prevotella, Porphyromonas, Fusobacterium, Peptostreptococcus), bidi bienda pingana mu tshina tshia Stensen mu parotid acini, bienza bua se fulminant purulent inflammation munda mua 12 to 24 hours.

Bua tshinyi disama dia parotite didi ne njiwu (ditangalaka dia mu nshingu ne disama dia septicemie)¶

Tshitupa tshia parotide tshidi tshibuikila mu tshitupa tshikole tshidi katshiyi tshishintuluka (tshitupa tshia pa mutu tshia fascia wa mu tshifu), ne bitupa bia bungi bia munda bidi bitapulula tshitupa etshi mu bitupa bikese:

1. Dipanga dia dishintuluka dia kumpala dia dishima: Bu mudi tshitupa tshia parotide tshikole tshikole bu dibue ne katshiyi tshishintuluka, tshitupa tshia parotide katshiena tshiumvua tshitekete anyi tshienda tshikola (tshidi tshishintuluka) padi munganga ufina pa ditama kumpala kua dîba; pamutu pa nanku, ditama didi diumvuika dikole bu mutshi ne dikole, disokoka mifuba ya pus munda mua glande too ne padibu benza CT anyi ultrason.
2. Ditapuluka dia munkatshi mu tshitupa tshia parapharyngeal (Tshiibi tshia panyima tshidi katshiyi tshibuikila): Padi tshitupa tshia pambelu tshia tshitupa tshia parotide tshikale ne fascia munene, tshimanu tshia munkatshi tshia tshitupa tshia parotide tshidi tshilamakaja tshitupa tshia parapharyngeal tshidi ne fascia mutekete udi kauyi mujima. Nunku, tshipupu tshia mu tshiadi tshidi katshiyi tshiondapibua tshidi tshipatuka munda ne munkatshi mu tshitupa tshia parapharyngeal tshia ku luseke, tshifina njila wa luya lua mu tshiadi, tshibuela mu tshitupa tshia mu tshiadi (tshienza bua thrombophlebitis septique wa mushipa wa munda wa jugular anyi **mushipa wa mushipa wa mu tshiadi **), anyi tshipueka mu tshitupa tshia panyima tshia mashi muaba mu mediastinum.
3. Lufu lua bungi mu babedi batekete ne bakulumpe: Padiku kakuyi manga a antibiotique adibu bafila lukasa mu mijilu, dipingaja dia mâyi, ne dipatuila dia mashi padiku tshipupu, disama dia parotite acute suppurative mu bantu bakulumpe badi ne makanda makese anyi badi bafua panyima pa dipanda didi ne 10% too ne ku 20% ya lufu ku tshipupu tshia septic ne ku dipangisha dia njila wa luya.

Mikenji ya dilombola dia lupitadi ne ya ENT¶

1. Bimfuanyi bia tshikebelu: Ultrason ne CT Scan udi kayi ne dishilangana¶

• High-Resolution Ultrasound anyi Non-Contrast Thin-Slice CT Scan: Bimfuanyi bia X bia pa tshibidilu bidi bipua 15% too ne ku 20% ya mabue a muinshi mua dikasa ne 50% ya mabue a mu tshiadi. CT wa nshingu ne mpala udi kayi ne dishilangana (anyi ultrason wa ku luseke lua bulalu) udi uleja mabue a mu mate adi afika ku 98% too ne ku milimetre 1, eku IV Contrast-Enhanced CT wa mu nshingu udi ne bua kuenzeka dîba dionso didiku kapia, trismus, dibandila dia panshi pa mukana, anyi padibu bela meji ne: parotide anyi disama dia tshiadi anyi dikola dia submanbulaire udiku.
• Bua tshinyi Sialography ki mmuakanyine mu disama dia tshimpitshimpi: Kuela tshiamu tshia dilengeja natshi mu tshitupa tshia Wharton anyi tshia Stensen kudi kubengangana bikole mu tshikondo tshia sialadenitis suppurative acute, bualu bukole bua diela budi bunyangakaja njila ya acinar idi ne disama ne kuenzeja bactérie idi ne muoyo bua kubuela mu mashi.

2. Njila ya manga a antibiotique adibu bafila mu mishipa bua disama dia sialadenite didi dikola¶

Babedi badi na kapia, disama dia kikoba, dipatuka dia mu mishipa, anyi disama dia mubidi badi dijinga ne kubuela mu lupitadi diakamue, dipingaja dia mâyi mu IV isotonic crystalloid, dikola dia pus mu tshibuelelu tshia mushipa, ne antibiotique ya mu mishipa idi ne Staphylococcus ne betama-producing anaerobes:

• Community-Acquired Suppurative Sialadenitis (Low MRSA Risk): IV Ampicillin-Sulbactam (Unasyn) 3 g IV every 6 hours (anyi IV Amoxicillin-Clavulanate 1.2 g IV every 8 hours), OR IV Cefazolin / PLUS Metronaxone IV** (500 mg IV kunyima kua mêba 8) anyi IV Clindamycin.
• Bipeta bia mu lupitadi, panyima pa dipanda, bia mu nzubu wa bakulakaje, anyi bia sepsis mikole (njiwu mikole ya MRSA): Weja IV Vancomycin (15 to 20 mg/kg IV kunyima kua mêba 8 to ne 12) anyi IV Linezolid to IV Ampicillin-Sulbaclin** anyi Piperactam-Tacillin (Zosyn)** (bua kubuikila MRSA, anaerobes, ne Gram-negative bacilli ya mu lupitadi bu mudi Pseudomonas ne Klebsiella).

3. Diumusha dia mabue mu mushindu mukesa (Sialendoscopy & Papillotomy) ne diumusha dia tshiamu tshia mitaku¶

1. Transoral Duct Slitting (Papillotomy / Ductoplasty) for Distal Submandibular Stones: Shi dibue didi dimueneka mu tshitupa tshia kumpala tshia mukana pabuipi ne caruncle wa sublingual, munganga wa ENT anyi wa oral-maxillofacial udi uteka suture wa traction kunyima kua dibue kumpala (bua dibue kadiyi mua kusesuka panyima pa dibue) lidocaine, udi wenza tshitupa tshikese tshia 3 too ne ku 5 mm pa mutu pa dibue kupitshila ku tshisasa tshia tshina tshia Wharton, udi ubandisha dibue, ne udi wenza bua miele ya tshina tshikale ne mushinga.
2. Interventional Sialendoscopy (Micro-Endoscopic Basket Extraction): Bua mabue a muinshi mua buloba (3 too ne ku 7 mm) mu tshina tshia Wharton anyi tshia Stensen padi disama dikole dimane kujika, bamanyi ba malu a ENT badi bela tshiamu tshia 0,8 to ne ku 1,6 millimetre semi-rigid fiber endoscope tshidi tshiunzuluka buludiludi mu tshibombi mukana (kakuyi dikoba dia pambelu) ne wenze mudimu ne tshiamu tshikese tshia tshibombi tshia dormima anyi holmium laser lithotripsy bua kutshibula ne kupatula dibue eku ulama tshitupa tshia mate.
3. Dipanda ne diumusha dia mashi bua bilonda: Shi CT anyi ultrasound ileja disangisha dia pus mu parotide anyi muinshi mua dikasa (bipu) anyi dipanga dia dilengejibua kunyima kua mêba 48 a manga a antibiotique IV, dipanda dia lukasa didi dienzeka mu nzubu wa dipanda (kuenza mudimu ne tshiamu tshia kupanda natshi tshidi tshishintulula mu matshi tshidi ne blair blair mufuanangane menemene ne matamba a muonji wa mpala [CN VII] bua kupatula pus kuyi ukosa muonji wa mpala).

Nomba ya tshimpitshimpi ya mu tshijengu ne mikenji ya bibambalu¶

• Etats-Unis ne Canada: Ela 911 diakamue bua disama dia muinshi mua dikasa anyi dia mu tshiadi didi dilondangana ne dibandila dia panshi pa mukana, dipatuka dia mâyi, dîyi dipueka, stridor anyi fièvre mukole. Bua disama dia tshiadi anyi mabue a mu mate, ndaku ku tshibambalu tshia malu a tshimpitshimpi tshia lupitadi tshidi ne Otolaryngology (ENT) ne Oral-Maxillofacial Surgery; londa mikenji ya American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) bua dienza dia CT, IV antistaphylococcal ne anaerobic antibiotics, ne gland-preserving sialendoscopy.
• Royaume-Uni: Ela 999 bua malu a tshimpitshimpi anyi disama dia sepsis. Bua disama dia tshiadi tshikunze, dia kapia ne kapia anyi pus mukana, ndaku ku Hospital Emergency Department (A&E) bua lukasa lukasa ENT / Maxillofacial admission ne IV antibiotics (co-amoxiclav + metronidazole anyi flucloxacillin + metronidazole). Bua disama dia tshitupa tshîpi dia kudia kadiyi ne disama, yukila ne NHS 111 anyi munganga webe anyi munganga wa meno bua kukutuma ku ultrason ne ku ENT sialendoscopy.
• Buobumue bua matunga a ku Mputu: Ela 112 mu matunga onso adi mu matunga a ku Mputu bua malu a tshimpitshimpi a mu njila wa luya anyi a mu mashi. Bibambalu bia sialendoscopie bia ku Mputu bidi bilonda mikenji ya European Salivary Gland Society (ESGS) idi itangila dipatula dia mabue a endoscopie adi kaayi ne gland padibu bajikija disama dikole.
• Australie ne Nouvelle-Zélande: Ela 000 mu Australie anyi 111 mu Nouvelle-Zélande bua malu a tshimpitshimpi a mu njila wa luya anyi a tshipupu. Londa mikenji ya luondapu (mu Australie) bua disama dia sialadenite dia bactérie: wangate tshitupa tshia pus tshidi tshipatuka mu tshitupa tshia Stensen anyi tshia Wharton kumpala kua kutuadija IV flucloxacillin anyi cefazolin (anyi vancomycin pikala njiwu ya MRSA) pamue ne metronidazole, ikala ne mâyi a mu IV, ne wangate ultrasound anyi CT.
• India, Japan, South Korea, and Asia-Pacific: Ela 112 / 108 mu Inde, 119 mu Japon ne mu Corée du Sud, 995 mu Singapour, anyi 999 mu Malaysie ne Hong Kong. Enda ku lupitadi lua pa mutu ne diambuluisha dia ENT dia mêba 24 ne diambuluisha dia lukasa dia njila wa luya.

Nkonko itubu bela misangu ya bungi¶

Bua tshinyi tshiadi tshianyi anyi tshiadi tshianyi tshidi tshivula ne tshinsama anu pandi ntuadija kudia, pashishe meme kupingana panshi dîba dimue pashishe?¶

Tshilejilu etshi tshia kale tshidibu babikila ne: disama dia mu tshikondo tshia kudia (colic salivaire) ne ntshimanyinu tshidi katshiyi tshishintuluka tshia dibue dia mu glande salivaire (sialolithiasis) didi dikanga tshitupa tshia tshitupa tshia Wharton tshidi muinshi mua ludimi luebe anyi tshitupa tshia Stensen tshidi munda mua ditama diebe. Paudi ununka, umona anyi utafuna biakudia, buongo buebe budi bumanyisha tshitupa tshia mate bua kuvudija mate misangu dikumi mu tusekonde tukese. Bu mudi dibue dia tshiamu tshia calcium dibuikila tshiamu tshia kupatuka natshi, dibue dia tshimpitshimpi didi dipingana munda mua tshitupa tshia mubidi, diolola tshitupa tshiadi bu tshintu tshia mayi ne dienza bua tshipupu tshikole tshikole ne kanyinganyinga kakole. Mu meba 1 anyi 2 adi alonda kunyima kua wewe mumane kudia, mate adi makuate adi apita bitekete bitekete pa dibue ne disama didi dienda dipueka too ne padi udia udi ulonda.

Bua tshinyi 85 pa lukama ya mabue a mu tshiadi tshia mate adi enzeka mu tshiadi tshia muinshi mua tshiadi pamutu pa tshiadi tshia ditama?¶

Bualu busatu bua mubidi ne bua tshimuma budi buenza bua se: glande submandibulaire (muinshi mua mpala) ikale ne mabue a bungi kupita glande parotide (mu ditama): (1) Mulonda wende wa mâyi (mushindu wa Wharton) mmule, mukese, ne udi wenda ubanda ne bukole budi bukokela bintu panshi bua kufika panshi pa mukana, wenda unyunguluka tshitupa tshia mpala tshidi tshinyunguluka nsuki yanyi bitupa bidi bikuata bipepele; (2) Mate a muinshi mua dikasa adi ne proteyine ya mucin mikole ne mikole pamutu pa kuikala ne mâyi malelela; ne (3) mate a muinshi mua tshiadi adi ne bungi bua bungi bua calcium ne phosphate ions ne pH wa alkaline, udi wenza bua mabue a calcium phosphate alue mabue.

Mmunyi mundi mua kumanya ni tshitupa tshianyi tshia mate tshidi tshiuwule tshidi anu dibue dikanga anyi disama dia njiwu dia bactérie (suppurative sialadenitis)?¶

Tangila malu anayi adi mashilangane: (1) Dîba: Dibue dipepele didi dikanga didi divula dîba dia kudia ne didi dipueka pankatshi pa biakudia, kadi disama dia bactérie didi dishala divula, dikole bu dibue, ne dikuma mêba 24 ku dituku; (2) Lukoba ne luya: Dibue dipepele didi dishiya lukoba lua pambelu lumueneka bu lua pa tshibidilu kakuyi luya, kadi sialadenitis wa bactérie udi wenza bua lukoba lua pambelu lua ku ditama anyi lua mu nshingu luikale lukunze ne lua kapia ne luya lua bungi ne mashika; (3) Pus mukana: Mu disama dia bactérie, pus munene wa jaune anyi wa vert udi upatuka mu tshibuelelu tshia mukana tshidi muinshi mua ludimi luebe anyi munda mua ditama diebe; ne (4) Bimanyinu bia mu njila wa luya: Disama dia muinshi mua dikasa dia bactérie didi mua kubandisha panshi pa mukana muinshi mua ludimi ne kufikisha ku dipatuka dia mayi anyi ku lutatu lua kumina.

Mmunyi mudi kunua dikopo dia ludimi lukole mua kuambuluisha dibue dia mu tshiadi tshia mate, ne dîba kayi diudi kuyi ne bua kuenza nanku?¶

Aside wa citrique udi mu matonsi a ludimwa, mu bitupa bia ludimu lupialupia, anyi mu bipese bia vitamine C bidi mua kutafuna ke tshintu tshikole tshidi tshikolesha mate (a sialogogue). Paudi ne dibue dikese dia mu mate didi kadiyi ne lutatu (kadiyi ne kapia ne kakuyi tshintu tshidi tshifumina ku tuishi tua masama), kunua mâyi a bungi, kuosha tshitupa tshia mubidi ne tshilamba tshia kuowa natshi mâyi, kunua dikopo dia ludimi lua ludimi lukole, ne kuela tshitupa tshia mubidi kumpala bitekete bitekete mu tshitupa tshia dibue didi dienza bua dibue dikese dipatuke mu tshitupa tshia mubidi tshidi tshipatuka mu tshitupa tshia mukana muebe. Ino, shi udi na luya lukole, kikoba tshikunze, ne tshitupa tshia mubidi tshidi tshibuikila, udi ne tshia kuangata mayi a mu tshifu ne manga a lufu ku lupitadi kumpala kua kuenza mudimu ne manga a tshisuku.

Kuikala ne dibue dia calcium mu tshiadi tshianyi tshia mate kudi kumvuija ne ndi ne calcium wa bungi mu mashi anyi anyi nendue kupeta mabue a mu mifuba anyi?¶

Tòo. Nansha mudi mabue a mu mate menza ne calcium phosphate (hydroxyapatite), makebulula a mu malu a luondapu adi ajadika ne: mabue a mu mifuba kaena ne diumvuangana ne bungi bua calcium mu mashi (hypercalcémie), didia dia calcium dia bungi mu biakudia anyi didia dia mabele, ne kaena avudija njiwu ya kupeta mabue a mu mifuba to. Mabue a mu mate adi afuma anu bua malu adi munda mua tshitupa tshia mate, bu mudi dipanga dia mâyi mu mubidi, dienda dia mate bitekete bitekete, dinua dia makanya, ne tshimuenekelu tshia alkaline tshia mate a muinshi mua dikasa.

Bua tshinyi bidi ne njiwu pikala tshitupa tshia parotide tshidi tshiuwule kumpala kua ditshi tshienza bua luseke lumue lua mpala anyi lua kuseka lupueke?¶

Muonji wa mpala (Cranial Nerve VII), udi ulombola bukole buebe bua kubandisha tshianza tshiebe, kuela mêsu ne kukanga dîsu diebe bikole, ne kuseka mu mushindu udi kauyi umvuangana, udi upitshila buludiludi munkatshi mua tshitupa tshia mpala tshidi kumpala kua ditshi. Mabue a mu mate mapepele ne bipupu bia virus kabitu anu bipangisha mijilu ya ku mpala to. Shi muntu udi na tshitupa tshia mukana tshidi tshiuwule udi ne butekete bua mpala, tshitupa tshia mukana tshidi tshipueka, anyi kayi mua kukanga tshilamba tshia dîsu ku luseke alu, bidi bileja ne: udi ne disama dia parotide dikole didi dinyangakaja bitupa bia mubidi anyi tumor mubi wa mu parotide udi unyanga tshitupa tshia mubidi, udi ulomba bua kuenza CT anyi MRI ne MRI ya lukasa lukasa mu lupitadi dikonkonona.

Miaba ne buludiki bua mbulamatadi¶

• Tshilongelu tshia mu Amerike tshia Otolaryngology-Head and Neck Surgery (AAO-HNS, États-Unis): Mibelu ya mudimu wa luondapu ne meyi a buobumue pa bidi bitangila disama dia Sialolithiasis, Sialendoscopy, ne dilama dia Sialadenitis wa tshimpitshimpi.
• European Salivary Gland Society (ESGS) ne British Association of Oral and Maxillofacial Surgeons (BAOMS): Classification and Treatment Algorithms for Obstructive Salivary Gland Diseases (Sialolithiasis) and Acute Bacterial Parotitis.
• Infectious Diseases Society of America (IDSA) and Therapeutic Guidelines (Australia): Antimicrobial Therapy for Acute Suppurative Parotitis and Submandibular Deep Neck Space Infections (coverage for Staphylococcus aureus/MRSA, Streptococcus, and anaerobes or anaerobes).
• Tshibambalu tshia malu a bukola bua mubidi tshia ditunga (NHS, Royaume-Uni) ne Tshibambalu tshia malu a bukola bua mubidi ne dilama dia bantu (NICE): Mabue a mu tshiadi tshia mate (Sialolithiasis) ne Sialadenitis: Disungula dia dibendele dikunze ne dilama dia malu a luondapu.
• Bulongolodi bua malu a bukola bua mubidi pa buloba bujima (OMS) ne nzubu ya diluisha ne dikuba dia masama (CDC): Dishilangana dia disama dia parotite (mumps) ne disama dia parotite dia bactérie dikole.

Malu adi apetangana¶

• Ludwig's angina, abscess wa meno, ne disama dia muinshi mua tshiadi
• Bell's palsy vs stroke: dinyanguka dia mpala, dipanga dia mpala, ne dikuata dia mêsu
• Epiglottite, croup, stridor, ne acute upper upper way obstruction
• Muaba muume (osteitis alveolaire) ne disama dia panyima pa diumusha
• Nomba ya njiwu bilondeshile ditunga