Necrotizing Sialometaplasia (NSM / नेक्रोटाइजिंग सायलोमेटाप्लासिया) एक rare, benign, self-limiting inflammatory condition है जो oral minor salivary glands को प्रभावित करती है।
- अक्सर hard palate (सख्त तालू) में दिखाई देती है।
- Initially यह ulcerative lesion के रूप में होती है और कई बार इसे malignancy (सिर और मुख का कैंसर) से confuse किया जा सकता है।
- यह condition self-healing होती है और आमतौर पर 4–12 weeks में resolve हो जाती है।
Necrotizing Sialometaplasia क्या है (What is Necrotizing Sialometaplasia)
- Ischemic (blood supply compromised) injury of salivary gland tissue
- Necrosis (tissue death) followed by squamous metaplasia of ducts and acini
- Benign and self-limiting, but clinically resembles squamous cell carcinoma
- Commonly affects adults aged 30–60 years, slight male predominance
Necrotizing Sialometaplasia कारण (Causes of Necrotizing Sialometaplasia)
1. Ischemic Injury
- Trauma to palate (dental procedures, injections)
- Local pressure (ill-fitting dentures)
- Surgery or biopsy
2. Vascular Compromise
- Smoking
- Vasoconstrictor injections
- Local infection causing reduced blood flow
3. Idiopathic
- Many cases occur without obvious cause
Necrotizing Sialometaplasia लक्षण (Symptoms of Necrotizing Sialometaplasia)
- Painful or painless ulcer on hard palate
- Firm submucosal nodule before ulceration
- Central necrosis with raised erythematous border
- Sometimes mild swelling and tenderness
- Lesion does not heal quickly, usually 2–6 weeks initially
Misdiagnosis as malignancy is common due to ulcerative appearance।
Necrotizing Sialometaplasia कैसे पहचाने (Diagnosis of Necrotizing Sialometaplasia)
- Clinical Examination – firm submucosal swelling, central ulcer
- Histopathology / Biopsy – shows necrosis, squamous metaplasia, preserved lobular architecture
- Imaging (rarely) – CT/MRI to rule out malignancy or deeper lesions
- Patient History – trauma, dental procedures, smoking history
Biopsy essential to differentiate from squamous cell carcinoma।
Necrotizing Sialometaplasia इलाज (Treatment of Necrotizing Sialometaplasia)
1. Observation / Conservative Management
- Most cases self-healing within 4–12 weeks
- Analgesics for pain relief
2. Supportive Therapy
- Good oral hygiene
- Avoid trauma or irritation to affected site
- Topical antiseptics or mouthwash if secondary infection suspected
3. Surgery / Intervention
- Rarely required, only for persistent or suspicious lesions
- Excision if diagnosis uncertain and malignancy needs to be ruled out
4. Follow-up
- Monitor healing and lesion resolution
- Ensure no recurrence or signs of malignancy
Early biopsy prevents misdiagnosis and unnecessary aggressive treatment।
रोकथाम (Prevention)
- Avoid trauma to oral mucosa during dental procedures
- Properly fitting dentures
- Cautious use of local anesthetic with vasoconstrictors
- Maintain good oral hygiene
सावधानियाँ (Precautions)
- Biopsy recommended for non-healing ulcers
- Avoid smoking and irritants during healing
- Report persistent pain, rapid growth, or atypical appearance to dentist or oral surgeon
- Regular follow-up to ensure complete healing
FAQs (अक्सर पूछे जाने वाले प्रश्न)
Q1. क्या Necrotizing Sialometaplasia cancer है?
नहीं, यह benign और self-limiting condition है।
Q2. Lesion कितने समय में ठीक हो जाता है?
सामान्यतः 4–12 weeks में खुद ही heal हो जाता है।
Q3. क्या इसे surgery की आवश्यकता होती है?
ज्यादातर cases में नहीं। Surgery सिर्फ diagnostic या persistent lesion के लिए।
Q4. कौन high risk में है?
Dental trauma, vasoconstrictor injections, ill-fitting dentures, और smoking करने वाले adults।
निष्कर्ष (Conclusion)
Necrotizing Sialometaplasia (नेक्रोटाइजिंग सायलोमेटाप्लासिया) एक rare benign ulcerative condition है जो oral minor salivary glands, especially hard palate को affect करती है।
Early recognition, biopsy for diagnosis, conservative management और lesion monitoring से unnecessary aggressive treatment से बचा जा सकता है।
अगर किसी को persistent ulcer, submucosal swelling या painful lesion हो, तो तुरंत oral surgeon या dentist से consultation जरूरी है।