A case of true hypersalivation
We herein report a case of true hypersalivation. A 24-year-old female had been aware of her hypersalivation since the age of 15. Due to the fact that the treatment she has so far received under a diagnosis of psychogenic hypersalivation had not been effective, she was referred to our hospital. The p...
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| Published in | OTOLOGIA FUKUOKA Vol. 52; no. 2; pp. 97 - 103 |
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| Main Authors | , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
JIBI TO RINSHO KAI
20.03.2006
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0447-7227 2185-1034 |
| DOI | 10.11334/jibi1954.52.2_97 |
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| Abstract | We herein report a case of true hypersalivation. A 24-year-old female had been aware of her hypersalivation since the age of 15. Due to the fact that the treatment she has so far received under a diagnosis of psychogenic hypersalivation had not been effective, she was referred to our hospital. The patient's volume of saliva at rest was very high (9-10ml/ 5 min.) and RI examination showed low accumulation at the bilateral submandibular glands. We considered that this phenomenon had occurred because the speed of salivation had overwhelmed the RI accumulation. Sialography revealed an enlargement of Wharton's duct. We thought that was due to the continuous flow of saliva. Submandibular nerve block remarkably decreased the volume of saliva. We therefore concluded that a functional disorder of the submandibular glands had caused the hypersalivation in this case. We prescribed antihistamines, minor tranquilizers, H1 receptor blocker and carbamazepine separately at different times, and carbamazepine proved to be quite effective. We finally resected the left submandibular gland and the postoperative course was consequently more favorable than we had expected. The volume of saliva at rest decreased to 1.5ml/5 min. On the 49th postoperative day and she is now making satisfactory progress. |
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| AbstractList | We herein report a case of true hypersalivation. A 24-year-old female had been aware of her hypersalivation since the age of 15. Due to the fact that the treatment she has so far received under a diagnosis of psychogenic hypersalivation had not been effective, she was referred to our hospital. The patient's volume of saliva at rest was very high (9-10ml/ 5 min.) and RI examination showed low accumulation at the bilateral submandibular glands. We considered that this phenomenon had occurred because the speed of salivation had overwhelmed the RI accumulation. Sialography revealed an enlargement of Wharton's duct. We thought that was due to the continuous flow of saliva. Submandibular nerve block remarkably decreased the volume of saliva. We therefore concluded that a functional disorder of the submandibular glands had caused the hypersalivation in this case. We prescribed antihistamines, minor tranquilizers, H1 receptor blocker and carbamazepine separately at different times, and carbamazepine proved to be quite effective. We finally resected the left submandibular gland and the postoperative course was consequently more favorable than we had expected. The volume of saliva at rest decreased to 1.5ml/5 min. On the 49th postoperative day and she is now making satisfactory progress.
真性唾液過多症の1例を報告した。患者は24歳の女性で15歳頃より唾液過多を自覚していた。今日まで心因性のものとして加療されてきたが効果なく当科を紹介受診した。安静時唾液量は5分間で9-10mlと非常に多く、RI検査では両側の顎下腺で集積が低下していた。これは分泌に集積が追い付かない現象と理解した。唾液腺造影ではワルトン氏管の拡張が認められた。これは恒常的に多量な唾液が分泌されての現象ととらえた。顎下神経節をブロックして唾液量が著しく低下したことより顎下腺が責任腺と考えた。治療として抗ヒスタミン剤、マイナートランキライザー、H1受容体ブロッカー、カルバマゼピンを選択し投与した。結果、カルバマゼピンにてやや有効と判定された。最終的に左顎下腺摘出術を行ったが、結果は予想以上に良好で手術後49日目の安静時唾液量は1.5mlで、自覚的にも有効と判定された。 We herein report a case of true hypersalivation. A 24-year-old female had been aware of her hypersalivation since the age of 15. Due to the fact that the treatment she has so far received under a diagnosis of psychogenic hypersalivation had not been effective, she was referred to our hospital. The patient's volume of saliva at rest was very high (9-10ml/ 5 min.) and RI examination showed low accumulation at the bilateral submandibular glands. We considered that this phenomenon had occurred because the speed of salivation had overwhelmed the RI accumulation. Sialography revealed an enlargement of Wharton's duct. We thought that was due to the continuous flow of saliva. Submandibular nerve block remarkably decreased the volume of saliva. We therefore concluded that a functional disorder of the submandibular glands had caused the hypersalivation in this case. We prescribed antihistamines, minor tranquilizers, H1 receptor blocker and carbamazepine separately at different times, and carbamazepine proved to be quite effective. We finally resected the left submandibular gland and the postoperative course was consequently more favorable than we had expected. The volume of saliva at rest decreased to 1.5ml/5 min. On the 49th postoperative day and she is now making satisfactory progress. |
| Author | NAKAGAWA, Nobuko INO, Chiyonori KIN, Yoshinori TADA, Naoki KISHIMOTO, Asako MINAMI, Toyohiko |
| Author_FL | 南 豊彦 中川 のぶ子 多田 直樹 岸本 麻子 金 義慶 井野 千代徳 |
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| Author_xml | – sequence: 1 fullname: KISHIMOTO, Asako organization: Iwano Otorhinolaryngology Surgery Center – sequence: 1 fullname: MINAMI, Toyohiko organization: Department of Otorhinolaringology, Kohri Hospital of Kansai Medical University – sequence: 1 fullname: TADA, Naoki organization: Department of Otorhinolaringology, Kohri Hospital of Kansai Medical University – sequence: 1 fullname: KIN, Yoshinori organization: Department of Otorhinolaringology, Kohri Hospital of Kansai Medical University – sequence: 1 fullname: NAKAGAWA, Nobuko organization: Department of Otorhinolaringology, Kohri Hospital of Kansai Medical University – sequence: 1 fullname: INO, Chiyonori organization: Department of Otorhinolaringology, Kohri Hospital of Kansai Medical University |
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| References | 10) Wilkie TF: The surgical treatment of droolng. Plast Reconstr Surg 59: 791-797, 1979. 3) 神田敬他: 唾液腺分泌異常. JOHNS13: 401-403, 1997. 7) 森田昌世他: 異常に多量の流挺を主症状とした左内側側頭葉てんかんの1例. 臨神経41: 809-812, 2001. 6) 佐藤聡他: 唾液分泌量と嚥下障害. 難病と在宅ケア10: 55-57, 2005. 8) 谷本均他: 口蓋腺・軟口蓋咽頭側腺組織の機能亢進症例, 口咽科11: 399-404, 1999. 1) 丸笹直子他: 唾液過多を訴えた症例の検討. 口咽科11: 69, 1998. 5) 若江恵理子他: よだれが多い. 小児内科28: 1371-1373, 1996. 9) 井野千代徳他: 唾影像を用いての耳下腺腫脹度の検討. 耳鼻37: 191-196, 1991. 4) 宮下久夫: 唾液分泌異常とその対症療法. JOHNS 9: 1868-1870, 1993. 2) 日野敬他: 総唾液分泌検査. 日本口腔・咽頭科学会編, 7-15頁, 金原出版, 東京, 1997. |
| References_xml | – reference: 4) 宮下久夫: 唾液分泌異常とその対症療法. JOHNS 9: 1868-1870, 1993. – reference: 7) 森田昌世他: 異常に多量の流挺を主症状とした左内側側頭葉てんかんの1例. 臨神経41: 809-812, 2001. – reference: 6) 佐藤聡他: 唾液分泌量と嚥下障害. 難病と在宅ケア10: 55-57, 2005. – reference: 2) 日野敬他: 総唾液分泌検査. 日本口腔・咽頭科学会編, 7-15頁, 金原出版, 東京, 1997. – reference: 10) Wilkie TF: The surgical treatment of droolng. Plast Reconstr Surg 59: 791-797, 1979. – reference: 5) 若江恵理子他: よだれが多い. 小児内科28: 1371-1373, 1996. – reference: 3) 神田敬他: 唾液腺分泌異常. JOHNS13: 401-403, 1997. – reference: 9) 井野千代徳他: 唾影像を用いての耳下腺腫脹度の検討. 耳鼻37: 191-196, 1991. – reference: 1) 丸笹直子他: 唾液過多を訴えた症例の検討. 口咽科11: 69, 1998. – reference: 8) 谷本均他: 口蓋腺・軟口蓋咽頭側腺組織の機能亢進症例, 口咽科11: 399-404, 1999. |
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| Title | A case of true hypersalivation |
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