Radioepitheliitis

Radioepitheliitis is the reaction of the mucous membranes on the action of ionizing radiation.
May occur in all organs, covered with mucous membrane. Radioepitheliitis often observed in the treatment of malignant tumors of the oral cavity, respiratory tract, gastrointestinal tract, bladder, female genital organs. Depending on the location of the lesion distinguish radiation laryngitis, cystitis, enterocolitis, and so on Radioepitheliitis can develop for remote radiation, intracavitary the introduction of radioactive preparations and implementation in the fabric of radioactive needles.
In the first two cases, radioepitheliitis occurs on the mucous membrane of all or almost all of the irradiated body; in the case of interstitial introduction - in a small area around drugs. The reaction proceeds in the form of dystrophic process and undulating course. Below is the example for radioepitheliitis the mouth. The first wave of mild swelling and redness of the mucous membranes, accompanied by a feeling of heat, a little pain; possibly increased salivation, changing its reduction with the emergence of a dense and viscous saliva, dry mouth. The duration of this phase of radioepitheliitis - about a week. The second wave R., coming after a short period of improvement, characterised by the same symptoms, however, become more pronounced.
In a week there is a third wave - emergence surface lesions covered diphterophorida films as separate Islands, which gradually merge together ("filmy" radioepitheliitis). There are significant swelling, severe redness, severe pain on swallowing saliva becomes thick and viscous, reduced taste sensations, later observed dryness of the mucosa as a result of atrophy of the mucous glands. The irradiation of the larynx possible difficulty breathing, violation of golosovaniya. Further there is a rejection of films, accompanied by discharge bloody-mucous fluid. In 1.5-2 weeks after cessation of exposure is observed restoration of mucous membranes. Radioepitheliitis can pass without a trace, however, there is atrophy of the mucous membranes with the formation of telangiectasia.
In connection with different radiosensitivity of the mucous membranes of the dose causing R. vary. R. in the oral cavity and larynx is developing at a dose of about 4000-5000 happy in the bladder and rectum, with the dose of 5000-7000 happy. The radiosensitivity of the mucous membrane of thin intestines higher than in other sections of the gastro-intestinal tract. Compared with the soft palate and side walls of the language of the hard palate and gums (table.) more radioresistant.
On the development of radioepitheliitis influence the General state of the organism, the presence of additional inflammatory process, the amount of one-time and total radiation dose.

The development of radioepitheliitis in the different departments of the oral cavity, depending on the absorbed dose
Localization Dose (rad), causing radioepitheliitis
I degree II degree
Cheeks
Gums
Hard palate
The soft palate
Language
500-525
1200-1600
1100-1250
370-420
1100-1300
2500-3500
-
-
1600-2700
4000-5000

Prevention and treatment. Before irradiation of the oral cavity and upper respiratory tract necessary readjustment of the oral cavity. To reduce the secondary scattering from metal prostheses and seals must be worn guards the teeth or remove prosthetic devices and to replace the metal fillings on the plastic. In the period of exposure in the home phenomena of radioepitheliitis - gargle or rinse 1% solution novokaina (relieving pain by blocking the nerve receptors), introduction to oral 50% emulsion balm of shestakovskoe fish oil. During exacerbation or occurrence of secondary infection in the upper respiratory tract and mouth - inhalation-aerosol of antibiotics with a 1% solution novokaina daily; during irradiation other areas - intramuscular administration of antibiotics.