Peculiarities of the submandibular space inflammatory processes in the elderly people

Abstract

Summary. The course of inflammatory diseases of the submandibular space in the elderly people has its own characteristics, which are manifested by less manifestation of clinical signs of inflammation against the background of increasing laboratory signs of intoxication syndrome.

The aim of the study – to study the clinical and laboratory features of the inflammatory processes of the submandibular space in the elderly people.

Materials and Methods. To achieve this goal, a survey of 17 elderly people (60–75 years), who were treated for odontogenic phlegmons of the submandibular space, purulent submandibular sialoadenitis, as well as salivary stone disease in the acute stage. The control group consisted of 20 young (25–44 years) and middle (44–60 years) age. Assessment of the severity of the inflammatory process was performed on the following parameters: body temperature, pulse rate, severity of pain on the scale of the Verbal Descriptor Scale (Gaston-Johanson F., Albert M., Fagan E. et al., 1990). Generally required laboratory tests were also performed. Treatment was performed according to approved protocols.

Results and Discussion. The following results were obtained. In the elderly people, body temperature within subfebrile values ​​lasted until the 5th day of observation, while in the young and middle-aged it returned to normal on the 3rd day. The decrease in heart rate took place on the 5th day after the opening of the abscess, and in young and middle-aged people – on the 3rd. Pain in the area of ​​the surgical wound in the elderly people was less pronounced. Erythrocyte and hemoglobin levels in the elderly people were lower. The average number of leukocytes, as well as other indicators of the leukogram, except for lymphocytes, tended to increase. ESR was significantly increased (p<0.05).

Conclusions. Studies show that the course of purulent inflammatory processes of the submandibular space in the elderly people has its own characteristics. They begin with the appearance of moderate pain at the site of the disease, the slow formation of infiltrates in the thickness of the tissues, the temperature reaction is weak, slightly worsens the general condition. This indicates a secondary immune deficiency, which is also confirmed by blood parameters: the tendency to increase the leukogram and ESR on the background of a decrease in the number of lymphocytes. Manifestations of intoxication syndrome decrease in them more slowly, as evidenced by a longer period of stabilization of temperature and pulse.