Parotid gland

Parotid gland is a complex alveolar extensive protein and iron. It secretory departments presents system acini, highlighting the serosal (protein) secret that does not contain mucin. End secretory departments consist of secretory serous epithelial cells and myoepithelial cells. In apical parts of the secretory cells are secretory granules. The nucleus of the cell is located in the wider basal cell parts. The dimensions of the secretory cells undergo significant changes: they increase considerably in the phase of accumulation of secret and decrease when it is highlighted.
The great value in end secretory departments has a second layer of cells (myoepithelial cells). The origin of this epithelial cells, but in their cytoplasm contains fibers, containing muscle proteins, so these cells have the ability to shrink. Myoepithelial elements are contained also in insertion and lined ducts of the parotid salivary glands. These cells have a star shape and its appendages surround end secretory departments like baskets (pocket cells). Myoepithelial cells are essential to remove the secret: Contracting, they promote the release of the secret of the end of the departments of the salivary gland and enter it into the ducts.

the topography of the parotid gland
Fig. 1. The topography of the parotid gland. Fig. 2. Right parotid gland (view from the posteromedial side). Fig. 3. Right parotid gland (view from anteromedial side). 1 - n. auriculotemporalis; 2 - a. et v. temporalis superficial; 3 - arcus zygomaticus; 4 - ramus temporalis; 5 - ramus zygoinaticus; 6 - ductus parotideus; 7-rami buccales; 8 - a. et v. facialis; 9 - m. masseter; 10 - ramus marginalis inandibulae; 11 - glandula submandibularis; 12 - ramus colli; 13-a. carotis ext.; 14 - platysma; 15-v. jugularis int.; 16 - m. sternocleidomastoideus; 17-v. jugularis ext.; 18-v. retromandibularis; 19 - glandula parotis; 20-a. maxillaris; 21 - plexus parotideus; 22 - n. facialis; 23 - auricula; 24 - incremental part of the parotid gland; 25 - a. auricularis post.; 26 - a. transversa faciei.

Parotid gland (glandula parotis) is the largest of the salivary gland. Its main mass of the parotid gland (printing. Fig. 1-3) is pozavcherashny hole (fossa retromandibularis), the front part of it, estancias comes to a branch of the lower jaw, covering the rear third of the muscle (so masseter). At the bottom of the parotid gland is separated from the submandibular salivary gland fascial sheet, which links the angle of the mandible with vagina sternoclavicular-liners muscles. O. W. surrounded on all sides by the fascia (fascia parotidea), which forms a bed of cancer. Fascia has thin sections - "weak points". One - pharyngeal process, the second - to the diligence of O. J. to the external auditory passage. In these places inflammation O. W. pus easily breaks in parapharyngeal space or in the ear canal. From the front edge of O. J. departs excretory duct (ductus parotideus). In the tissue of the parotid gland are: facial nerve (n. facialis, USNO-temporal nerve (n. auriculotemporalis), external carotid artery (a. carotis ext.) pozavcherashny Vienna (v. retromandibularis).

Pathology. Very rare congenital absence or dystopia of the parotid gland and dystopia mouth ductless. May damage of O. J. cold or firearms; in recent cases of injuries shown layered stitching tissues. Salivary fistulas can be formed as a result of damage of O. J. when trauma or after operations on the occasion of inflammatory processes, tumours and salivary stones. There are fistula parenchyma (Fig) and duct, complete and incomplete. When complete fistula all the saliva through fistula, with incomplete - part through the duct part through a fistula. Fistulas can be opened on the mucous membrane of the cheeks or on the skin of the parotid region. In the latter case, constantly released saliva irritating to the skin, causes eczema. Particularly concerned with the saliva in food, in cold weather and heavy physical labour. For further diagnosis (complete, incomplete fistula) apply contrast radiography of the parotid glands (see Sialography).
When fresh, are not fully kapitalisierung, and sometimes small kapitalisierung salivary fistula can be applied searing 50% solution of silver nitrate or trichloroacetic acid. For this purpose on a thin probe is wound cotton wool and gives its solution, burn the walls of the fistula. Moxibustion is possible to make an introduction to the fistula few drops of tincture of iodine or alcohol. At the same time appoint liquid, mild food inside for 30 minutes before eating 0.1% solution of atropine on 5-8 drops, apply a pressure bandage. Resistant to conservative treatment salivary fistulas are subject to surgical treatment, the basic principle of which is to excision kapitalisierung progress and layered stitching tissues. When complete fistula it is necessary to form a new duct for the outflow of saliva in the mouth. In the postoperative period shows the same events that after burning.
Tuberculosis of the parotid gland, usually secondary, develops in the presence of a lesion in his lungs. Rarely, proceeds as chronic nonspecific mumps. The diagnosis is established study punctate. The specific treatment.
Cysts of the parotid gland are fairly rare. More often due to earlier trauma. Clinically manifested in the form of limited fluktuiruyushchimi education rounded. The treatment is surgical removal of the cyst.
The disease of Mikulich is a disease of unknown origin, expressed in a painless symmetrical increase in salivary and lacrimal glands with a decrease in their functions. The disease develops over the years and is manifested in the form of lymphomatosis glands or Wegener. Treatment: radiotherapy, inside drugs arsenic, potassium iodide.
Inflammation O. W.- see the Mumps. Tumor O. W.- see the Salivary gland tumors. Clonakenny disease - see Sialolithiasis.
The delete operation of the parotid gland - parotidectomy is shown in benign and malignant tumors, chronic recurrent parotitis, resistant to conservative treatment. In malignant tumors of O. J. remove entirely in the capsule with passing in her facial nerve.