Lub luag haujlwm rau kev tso cov qaub ncaug, muaj ob hom ntawm cov qog ua kua qaub: cov qog ua kua qaub loj thiab cov qog ua kua qaub. Lawv tuaj yeem yog qhov chaw ntawm kab mob los yog kab mob, lithiasis, benign qog los yog, tsis tshua muaj, malignant hlav. Cov qog nqaij hlav qog noj ntshav yog cov qog nqaij hlav tsawg heev.

Muaj ob hom kab mob qog noj ntshav:

• accessory qog, nyob rau hauv ob sab phlu ntawm lub qhov ncauj kab noj hniav thiab tus nplaig. Lawv yog cov me me thiab yooj yim hauv cov qauv;
• lub ntsiab salivary qog, nyob sab nraum phab ntsa ntawm lub qhov ncauj kab noj hniav. Loj dua, lawv yog cov tib neeg lub cev nrog cov qauv ntau dua. Lawv yog tsim los ntawm secretory units thiab lwm yam, excretory.

Ntawm cov qog salivary tseem ceeb peb tuaj yeem paub qhov txawv:

• parotid qog nyob rau hauv pem hauv ntej ntawm pob ntseg, nyob rau hauv lub puab tsaig. Yog li ntawd muaj ob. Lawv cov kwj dej qhib rau ntawm lub ntsej muag sab hauv ntawm lub puab tsaig, ntawm theem ntawm cov molars;
• cov qog submandibular nyob hauv qab lub puab tsaig. Lawv cov kwj dej qhib tawm ze ntawm frenulum ntawm tus nplaig;
• cov qog sublingual yog nyob hauv qab tus nplaig. Lawv cov kwj dej kuj qhib ze ntawm frenulum ntawm tus nplaig.

Cov qog ua kua qaub ua rau qaub ncaug. Raws li kev ceeb toom, qaub ncaug yog sib xyaw ntawm dej, electrolytes, desquamated cells thiab serous secretions, nrog rau cov enzymes. Cov qaub ncaug ua tiav cov haujlwm sib txawv: nws tswj cov dej ntawm lub qhov ncauj, koom nrog thawj theem ntawm kev zom zaub mov ua tsaug rau cov enzymes, ua kom lub luag haujlwm tiv thaiv kab mob ua tsaug rau cov tshuaj tiv thaiv.

Cov qog qaub ncaug tseem ceeb zais cov qaub ncaug hauv cov lus teb rau stimuli thaum cov khoom siv ntawm cov qog ua kua qaub secrete tsis tu ncua.

Salivary caj pas lithiasis (sialolithiasis)

Pob zeb tuaj yeem tsim nyob rau hauv cov kua qaub ntawm ib qho ntawm cov qog submandibular feem ntau. Lawv thaiv qhov ntws ntawm cov qaub ncaug, ua rau tsis mob o ntawm cov qog qaub ncaug. Nws yog ib tug benign pathology.

Cov kab mob tua tau kab mob

Thaum cov qaub ncaug stagnates nyob rau hauv lub caj pas vim muaj kev cuam tshuam rau nws txoj kev khiav tawm (lithiasis, nqaim ntawm lub duct), nws tuaj yeem kis tau. Qhov no hu ua sialitis lossis glandular kab mob, parotitis thaum lub caj pas parotid raug cuam tshuam thiab submandibulitis thaum nws los txog rau lub caj pas submandibular. Lub caj pas ces o, nruj, mob. Pus tuaj yeem tshwm sim, nrog rau kub taub hau.

Juvenile recurrent parotitis

Ib daim ntawv tshwj xeeb ntawm parotitis cuam tshuam rau cov menyuam yaus thiab cov tub ntxhais hluas, lawv yog cov kab mob rov ua dua ntawm ib lossis ob lub qog parotid. Qhov kev pheej hmoo yog, nyob rau hauv lub sij hawm ntev, kev puas tsuaj ntawm glandular parenchyma (hlwb tsim cov ntaub so ntswg secretory).

Tus kab mob kis

Ntau tus kab mob tuaj yeem ncav cuag cov qog ua kua qaub, tshwj xeeb tshaj yog cov qog parotid. Qhov zoo tshaj plaws paub yog kab mob qog noj ntshav, paramyxovirus hu ua tus kab mob "mumps" uas kis tau yooj yim los ntawm qaub ncaug. Mumps yog tshwm sim los ntawm qhov mob o ntawm ib lossis ob lub qog parotid, mob pob ntseg, mob caj pas, ua npaws, thiab qaug zog heev. Feem ntau mob me me hauv cov menyuam yaus, tus kab mob tuaj yeem ua rau muaj teeb meem hauv cov tub ntxhais hluas, cov neeg laus thiab cov poj niam cev xeeb tub: meningitis, hnov ​​​​lus tsis hnov ​​​​lus, pancreatitis, testicular puas tsuaj uas tuaj yeem ua rau muaj menyuam tsis taus. Cov tshuaj tiv thaiv MMR yog qhov zoo tshaj plaws los tiv thaiv kab mob qog noj ntshav.

Pseudo-allergic sialitis

Tsis tshua paub thiab feem ntau ua rau kev kho mob wandering, pseudo-allergic sialitis tshwm sim nws tus kheej los ntawm qee zaum mob o ntawm ib lossis ntau lub qog qaub ncaug thaum noj mov lossis gustatory lossis olfactory stimulation, nrog rau khaus tseem ceeb. Qhov ua rau tus kab mob no tseem tsis tau paub hnub no.

Cov qog zoo

Feem ntau cov qog salivary qog yog benign. Lawv feem ntau txhawj xeeb txog cov qog parotid. Lawv tshwm sim raws li ib qho kev sib cais, ruaj, mobile thiab tsis mob nodule uas hlob qeeb.

Cov qog ntau tshaj plaws yog pleomorphic adenoma. Nws tuaj yeem ua rau mob qog nqaij hlav, tab sis tsuas yog 15 txog 20 xyoo tom qab nws tshwm. Lwm cov qog nqaij hlav muaj nyob: monomorphic adenoma, oncocytoma thiab cystadenolymphoma (Warthin's qog).

Malignant qog - qog nqaij hlav qog nqaij hlav

Malignant salivary qog manifested raws li ib tug nyuaj, nodular loj, feem ntau adherent rau cov ntaub so ntswg nyob ib sab, nrog ib tug tsis zoo-txhais qhia. Cov no yog cov qog nqaij hlav tsawg (qhov tshwm sim tsawg dua 1 / 100), uas sawv cev tsawg dua 000% ntawm cov qog ntawm lub taub hau thiab caj dab. Metastatic evolution yog pom nyob rau hauv kwv yees li 5% ntawm cov neeg mob.

Muaj ntau hom qog nqaij hlav cancer ntawm cov qog qaub ncaug. Qhov kev faib tawm tshiab kawg ntawm Lub Koom Haum Saib Xyuas Kev Noj Qab Haus Huv Ntiaj Teb (2005) yog li lees paub 24 yam sib txawv ntawm cov qog nqaij hlav qog nqaij hlav thiab 12 hom benign epithelial qog. Nov yog cov tseem ceeb:

• mucoepidermoid carcinoma yog cov qog nqaij hlav ntau tshaj plaws ntawm cov qog qaub ncaug. Nws feem ntau cuam tshuam rau lub caj pas parotid, tsis tshua muaj lub caj pas submandibular lossis cov qog qaub ncaug me ntawm lub palate;
• Adenoid cystic carcinoma yog hom qog hlav thib ob. Nws feem ntau cuam tshuam rau cov qog ua kua qaub thiab tuaj yeem kis mus rau cov hlab ntsha ntawm lub ntsej muag. Nyob ntawm qhov xwm txheej ntawm cov qog nqaij hlav cancer, qhov sib txawv yog tsim los ntawm cribriform adenoid cystic carcinoma (feem ntau), cov khoom adenoid cystic carcinoma thiab tuberous adenoid cystic carcinoma;
• salivary duct carcinoma feem ntau cuam tshuam rau lub caj pas parotid. Kev loj hlob sai thiab txhoj puab heev, nws kis tau yooj yim rau cov qog nqaij hlav;
• acinar cell carcinoma feem ntau cuam tshuam rau lub caj pas parotid, qee zaum ob qho tib si;
• thawj lymphomas ntawm cov qog salivary yog tsawg.

Lwm hom qog nqaij hlav qog muaj nyob, tab sis lawv muaj tsawg dua.

Cov kab mob tua tau kab mob

Kev kho tshuaj tua kab mob yog sau tseg. Kev kuaj ultrasound yog ua los xyuas kom meej tias cov qog ua kom zoo.

Tus kab mob kis

Lub pob ntseg feem ntau kho nws tus kheej li ntawm kaum hnub. Txij li tus kab mob kis tau tus kab mob, tsis muaj tshuaj tua kab mob tsim nyog. Tsuas yog kub taub hau thiab mob tuaj yeem kho nrog tshuaj tua kab mob lossis tshuaj tua kab mob.

Kev kis kab mob ntawm cov qog qaub ncaug tuaj yeem dhau los ua tus kab mob kis kab mob. Tom qab ntawd nws yuav tsum tau siv tshuaj tua kab mob.

Salivary lithiasis

Salivary pob zeb feem ntau ploj mus nrog kev pab los ntawm kev massages ntawm lub caj pas salivary. Yog tias lawv pheej ua, sialendoscopy (endoscopy ntawm cov ducts thiab cov qog ua kua qaub) yuav ua tau. Lwm cov txheej txheem, hu ua extracorporeal lithotripsy, muaj kev tawg ntawm cov pob zeb nrog extracorporeal shock waves.

Sialectomy (ib txoj kev phais uas muaj nyob rau hauv qhib lub salivary duct kom rho tawm lub xam) tau nqa tawm tsawg thiab tsawg txij li thaum txoj kev loj hlob ntawm ob txoj kev.

Pseudo-allergic sialitis

Kev tswj hwm pib nrog kev kho mob ntawm kev tawm tsam ntawm 2 lub lis piam ua ke nrog kev kho bi-tshuaj tua kab mob, kev kho corticosteroid, antispasmodics, antiallergics thiab benzodiazepine. Kev kho mob mus sij hawm ntev raws li tsis muaj zog corticosteroids thiab antiallergic yog tom qab ntawd.

Cov qog zoo

Kev kho mob ntawm benign qog yog phais excision. Nws yuav tsum ua kom tiav thiab nrog cov npoo kev nyab xeeb kom txwv qhov kev pheej hmoo ntawm kev rov tshwm sim.

Cov qog nqaij hlav cancer

Kev kho mob qog nqaij hlav qog nqaij hlav qog nqaij hlav yog kev phais nrog cov npoo loj ntawm kev nyab xeeb, qee zaum ua raws li kev kho mob hluav taws xob rau qee yam qog noj ntshav. Nyob ntawm kev sib kis, cov qog nqaij hlav hauv caj dab qee zaum raug tshem tawm. Chemotherapy tsis qhia, tshwj tsis yog muaj tsawg zaus.

Qhov kev kwv yees muaj qhov sib txawv nyob ntawm seb qhov mob qog noj ntshav, nws kis tau, nws theem ntawm kev loj hlob thiab kev ua tiav ntawm kev phais.

Feem ntau nws yog qhov muaj ib pawg uas ua rau tus neeg mob mus ntsib nws tus kws kho mob lossis nws tus kws kho mob ENT. Tau ntsib nrog ib pob hauv cov qog ua kua qaub, ntau yam kev ntsuam xyuas yuav raug sau tseg:

• kev soj ntsuam kuaj mob los ntsuas qhov ntsuas ntawm qhov txhab, qhov chaw nyob hauv cheeb tsam thiab cheeb tsam txuas ntxiv nrog kev tshawb fawb ntawm ncauj tsev menyuam lymphadenopathy (lymph nodes);
• x-ray qhia cov pob zeb;
• sialography cuam tshuam nrog kev txhaj tshuaj ib yam khoom sib txawv rau hauv lub caj pas qaub ncaug kom nws opaque. nws yog tsuas yog siv rau kev tshawb fawb ntawm kis kab mob ntawm cov qog salivary;
• ib qho kev kuaj anatomo-pathological ntawm cov qauv hauv qhov tshwm sim ntawm cov qog; kom paub meej qhov kev kuaj mob ntawm malignant neoplasia, qhia nws hom histological thiab yog tias ua tau nws qib;
• MRI, los yog ua tsis tau qhov ultrasound lossis CT scan;
• CT scan ntawm lub caj dab thiab thorax txhawm rau nrhiav kev cuam tshuam metastatic.