Contents
The salivary glands are located in the mouth and are responsible for the secretion of saliva. It is a clear, colorless liquid (body fluid) that lubricates the oral cavity, promotes taste sensations and the process of swallowing. In addition, saliva has a bactericidal effect and protects teeth from multiple damage by pathogens. Ultrasound is used to assess the functionality of the salivary glands or a comprehensive study of the oral cavity. For which diseases, ultrasound diagnostics is prescribed, how exactly the procedure takes place and how safe it is for the human body, we will try to answer further.
General characteristics of the study area
The salivary glands are located in the mouth and are responsible for the secretion of saliva. They are represented by multiple small glands (localized on the mucous membrane of the palate, cheeks, tongue, lips) and 3 pairs of large salivary glands – sublingual, submandibular, parotid. Small glands are also classified according to the nature of the secretion secreted – serous, mucous and mixed. Most of the serous secretory glands are located on the tongue, and their secretion is rich in protein. The palatine and part of the lingual glands are called mucous because their saliva is rich in mucus. The category of mixed includes molar, buccal, labial, part of the lingual glands, in the secret of which saliva is mixed in composition.
The parotid secretory glands produce thin saliva that is high in sodium/potassium salt and amylase (a digestive enzyme). The acidity of the liquid is 5,81 (pH), which is the highest among other glands. During the day, these cells produce from 200 to 700 milliliters of fluid – this is a third of the volume of the total production of saliva. The submandibular glands produce serous and mucous secretions. Its acidity is relatively low and equals 6,39. The sublingual salivary glands are responsible for the production of protein secretions. It is rich in mucin, has a pronounced alkaline reaction and high phosphatase activity.
The functioning of the glands ensures the secretion of hormone-like substances, protein / mucous components of saliva, filtration of its composition, and the release of end products of metabolism.
What diseases are affected by the salivary glands?
In most cases, the salivary glands are subject to inflammatory pathological processes, among which is sialadenitis. This is an inflammation of the secretory glands, which is fraught with swelling of the gland (most often the submandibular) and the formation of stones in the salivary ducts. The patient feels dry mouth, swelling of the oral cavity, pain, decreased secretion of saliva, pus may be discharged. Another common problem is parotitis. This is an inflammation of the parotid glands, which makes itself felt with sharp pain, severe swelling of the cheeks and the entire face, loss of appetite, lethargy, headache and fever.
The proliferation of salivary gland cells can lead to the development of neoplasms of a different nature. Among malignant tumors, doctors most often diagnose sarcoma / carcinoma / mucoepidermoid tumor. The most common form of a benign tumor is a polymorphic adenoma. The main problem is that the neoplasm develops without pronounced symptoms. Pathology is most often diagnosed in the later stages, when precious time is lost, and much more time, effort, material and emotional resources will be required for therapy.
If you notice even slight deviations (edema/swelling/pain/discomfort), contact your doctor immediately. The doctor will assess the nature and nature of the symptoms, prescribe a therapeutic or prophylactic course. Do not ignore body signals and always report suspicious changes to your doctor.
What you need to know about ultrasound diagnostics?
Ultrasonic vibrations with a frequency above 20 kHz are not perceived by the human ear, that is, they are outside the zone of human acoustic perception (range from 16 to 20 kHz), but with the help of ultrasound, for example, bats, dolphins and whales communicate freely.
One of the properties of high-frequency sound vibrations is free propagation in the soft tissues of living organisms. As soon as the wave penetrates the skin, it encounters a huge number of barriers. It can be various fluids, bones, soft tissues and other heterogeneous internal structures. All of them block the path of ultrasound and prevent it from spreading further. This process is called acoustic impedance. The intensity of acoustic impedance differs depending on the density/elasticity of the barrier. As soon as the sound wave reaches, for example, soft tissues, one part of it is absorbed by the medium, and the second part is reflected from it. This moment is the key to ultrasound.
What is the diagnostic principle? A special liquid gel is applied to the patient’s skin, which acts as a transition medium and allows ultrasound to penetrate into our body. Without a liquid gel, penetration is impossible because human skin reflects almost 100% of sound vibrations. A sensor is applied to the prepared area, which generates ultrasonic waves, captures their propagation and transmits information to a computer. The system evaluates the intensity of sound vibrations and forms a three-dimensional image of the internal cavity. All this happens so quickly that the doctor and the patient can observe what is happening in real time. The image is displayed on the screen immediately after the sensor contacts the skin.
To create the final image, 64 different shades of black and white scale are used. The intensity of white or black shades depends on the strength of the ultrasonic wave. The minimum signal is recorded in black (most often these are bones and compacted areas of the body), and the maximum signal is recorded in white (fluids, soft tissues, air).
Indications for ultrasound diagnostics
Indications for ultrasound diagnostics (both emergency and preventive) are always determined by the doctor. Reasons to see a doctor may include:
- change in the shape of the salivary glands;
- violation of the gland (for example, reduced / increased salivation);
- seals in the oral cavity, regardless of size and location;
- an increase in the size of the glands;
- pain/discomfort in the mouth and throat;
- the formation of ulcers or purulent formations on the mucous membranes;
- paralysis of the facial nerve (one of the symptoms of the development of a malignant neoplasm).
The patient can consult a general practitioner, otolaryngologist, dentist or oncologist. All these specialists are able to identify the problem, prescribe a diagnosis and make a course of treatment.
Ultrasound technique
Before an ultrasound examination, it is necessary to thoroughly clean the oral cavity and refuse to eat food a few hours before the manipulation. Standard hygiene routines like brushing your teeth and using mouthwash/floss will suffice. Ultrasound of the oral cavity is slightly different from examining other parts of the body, since the doctor gets access to the outside and inside of the scanned area.
The patient must provide the doctor of functional diagnostics with medical documentation, including a referral for ultrasound diagnostics, a preliminary diagnosis, the individual characteristics of the patient and specific recommendations for ultrasound.
During the procedure, the patient lies on his back on the couch. If the lying position causes discomfort, the person can say so and sit in a chair. The patient throws his head back (or a special support is placed under it) and follows the instructions of the specialist. Before the study, a liquid gel is applied to the outer surface of the oral cavity, then a sensor is applied and the salivary glands are examined. The outer surface provides access to the parotid glands, the inner surface provides access to the submandibular and sublingual glands. The specialist drives the sensor over the skin, examining each part of the oral cavity, until he collects the necessary information and confirms / refutes the diagnosis.
During an ultrasound examination, the patient does not feel pain. Possible nuances – minimal discomfort from cold liquid gel and manipulations.
Scanning and processing of information takes no more than 30 minutes. The doctor makes a preliminary diagnosis, transfers the results of the study to the patient and redirects to a specialized doctor. It is the attending physician who analyzes the results of ultrasound, compares them with the anamnesis and draws up an individual therapeutic course.
Ultrasound examination of the salivary glands is a diagnostic procedure that is used to monitor inflammatory / infectious / oncological processes in secretory cells. The main advantage of ultrasound is safety. Ultrasound passes without a trace through the tissues of the human body, without affecting their functions. In general, the method is accurate, informative and helps to detect and prevent diseases of the salivary glands in a timely manner. Carry out diagnostics only as prescribed by the attending physician and be healthy.