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Takagi Y, Katayama I, Eida S, Sasaki M, Shimizu T, Sato S, Hashimoto K, Mori H, Otsuru M, Umeda M, Kumai Y, Toya R, Kawakami A, Sumi M. Three Signs to Help Detect Sjögren's Syndrome: Incidental Findings on Magnetic Resonance Imaging and Computed Tomography. J Clin Med 2023; 12:6487. [PMID: 37892630 PMCID: PMC10607120 DOI: 10.3390/jcm12206487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 10/04/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
This study aimed to retrospectively investigate the prevalence of Sjögren's syndrome (SS) among patients with ranulas, parotid cysts, or parotid calcifications; identify the characteristic magnetic resonance imaging (MRI) or computed tomography (CT) findings of the lesions associated with SS; and compare the SS disease stages among SS patients with the three lesion types. A total of 228 patients with the lesions were classified into SS, possible SS, and non-SS groups. The prevalence of SS among patients with ranulas, parotid cysts, or parotid calcifications was 16%, 24%, and 40%, and the rates of either SS or possible SS were 25%, 41%, and 64%, respectively. SS was associated with (i) ranulas: ≤17 mm; (ii) parotid cysts: bilateral and multiple; and (iii) parotid calcifications: in females, bilateral, multiple, parenchymal, and no coexisting calcifications in other tissues. SS patients with ranulas were significantly younger and had lower submandibular gland stage scores on MRI/CT than those with other lesions. Additionally, in 58% and 15% of SS patients with ranulas and parotid calcifications, respectively, detection of the lesions led to the diagnosis of primary SS. Therefore, recognizing the prevalence of SS among patients with these lesions and the findings associated with SS can help detect undiagnosed SS.
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Affiliation(s)
- Yukinori Takagi
- Department of Radiology and Biomedical Informatics, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8588, Japan; (Y.T.); (I.K.); (S.E.); (M.S.); (H.M.)
| | - Ikuo Katayama
- Department of Radiology and Biomedical Informatics, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8588, Japan; (Y.T.); (I.K.); (S.E.); (M.S.); (H.M.)
| | - Sato Eida
- Department of Radiology and Biomedical Informatics, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8588, Japan; (Y.T.); (I.K.); (S.E.); (M.S.); (H.M.)
| | - Miho Sasaki
- Department of Radiology and Biomedical Informatics, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8588, Japan; (Y.T.); (I.K.); (S.E.); (M.S.); (H.M.)
| | - Toshimasa Shimizu
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan; (T.S.); (A.K.)
| | - Shuntaro Sato
- Clinical Research Center, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan;
| | - Kunio Hashimoto
- Department of Pediatrics, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan;
| | - Hiroki Mori
- Department of Radiology and Biomedical Informatics, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8588, Japan; (Y.T.); (I.K.); (S.E.); (M.S.); (H.M.)
| | - Mitsunobu Otsuru
- Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8588, Japan; (M.O.); (M.U.)
| | - Masahiro Umeda
- Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8588, Japan; (M.O.); (M.U.)
| | - Yoshihiko Kumai
- Department of Otolaryngology-Head and Neck Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan;
| | - Ryo Toya
- Department of Radiological Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan;
| | - Atsushi Kawakami
- Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan; (T.S.); (A.K.)
| | - Misa Sumi
- Department of Radiology and Biomedical Informatics, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8588, Japan; (Y.T.); (I.K.); (S.E.); (M.S.); (H.M.)
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The roles of heteromorphic crystals and organic compounds in the formation of the submandibular stones. Heliyon 2022; 8:e12329. [PMID: 36582680 PMCID: PMC9792800 DOI: 10.1016/j.heliyon.2022.e12329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 10/17/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022] Open
Abstract
Objective The study aimed to analyze the formation process of submandibular stones based on the theory of biological mineralization and inorganic crystal structure variation. Study design From January 2021 to December 2021, patients with submandibular stones treated in the Affiliated Hospital of Stomatology, Sun Yat-sen University (Guangzhou, China) were selected. According to the criterion of maximum transverse diameter ≥3 mm, a total of five submandibular stones meeting the requirement were included. After the surface of sample stones were washed, they were cut along the maximum transverse diameter. Next, the study employed Scanning Electron Microscope (SEM), Energy Dispersive X-ray Spectroscopy (EDS), and polycrystalline X-ray Diffraction (XRD) to analyze the composition and structure of submandibular stones. Results Five submandibular stones were included. The organic and inorganic compounds showed a rhythmic or irregular distribution. Submandibular stones were highly occupied with carbon (C), oxygen (O), calcium (Ca), and phosphorus (P). Hydroxyapatite (HAP) was the primary inorganic component. In addition, the precursor of HAP, namely Amorphous Calcium Phosphate (ACP), was also found. Tetrahedral Substitution Index (TSI) and Ca/P ratio reflected the degree of structural variation in HAP crystal, which fluctuated from 5.62-90.71 and 1.10-1.35, respectively. Conclusions The development of submandibular stones was influenced by inorganic crystals' chemical and structural variation as well as the organics' regulation towards the inorganic. The isomorphic substitution was accompanied by the occurrence of inorganic crystals, resulting in the crystal structure change. Organics might influence the appearance, aggregation, and mineralization of HAP during its formation.
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Obstructive Sialadenitis: Stones and Stenoses. CURRENT OTORHINOLARYNGOLOGY REPORTS 2021. [DOI: 10.1007/s40136-021-00339-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Krajewska Wojciechowska J, Krajewski W, Zatoński T. Otorhinolaryngological dysfunctions induced by chronic kidney disease in pre- and post-transplant stages. Eur Arch Otorhinolaryngol 2020; 277:1575-1591. [PMID: 32222803 PMCID: PMC7198632 DOI: 10.1007/s00405-020-05925-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 03/16/2020] [Indexed: 12/16/2022]
Abstract
Purpose Otorhinolaryngological abnormalities are common complications of chronic kidney disease (CKD) and its treatment. The main aim of this study was to provide a brief and precise review of the current knowledge regarding CKD and its treatment-related influence on head and neck organs. Methods The Medline and Web of Science databases were searched using the terms “chronic kidney disease”, “kidney transplantation”, “immunosuppression”, “dialysis” in conjunction with “otorhinolaryngological manifestation”. Articles that did not address the topics, low-quality studies, case reports, and studies based on nonsignificant cohorts were excluded, and the full text of remaining high-quality, novel articles were examined and elaborated on. Results Patients with CKD are prone to develop sensorineural hearing loss, tinnitus, recurrent epistaxis, opportunistic infections including oropharyngeal candidiasis or rhino-cerebral mucormycosis, taste and smell changes, phonatory and vestibular dysfunctions, deep neck infections, mucosal abnormalities, gingival hyperplasia, halitosis or xerostomia. Immunosuppressive therapy after kidney transplantation increases the risk of carcinogenesis, both related and not-related to latent viral infection. The most commonly viral-related neoplasms observed in these patients are oral and oropharyngeal cancers, whereas the majority of not-related to viral infection tumors constitute lip and thyroid cancers. CKD-related otorhinolaryngological dysfunctions are often permanent, difficult to control, have a significant negative influence on patient’s quality of life, and can be life threatening. Conclusion Patients with CKD suffer from a number of otorhinolaryngological CKD-induced complications. The relationship between several otorhinolaryngological complications and CKD was widely explained, whereas the correlation between the rest of them and CKD remains unclear. Further studies on this subject are necessary.
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Affiliation(s)
- Joanna Krajewska Wojciechowska
- Department and Clinic of Otolaryngology, Head and Neck Surgery, Medical University in Wroclaw, Borowska 213 Street, 50556, Wroclaw, Poland.
| | - Wojciech Krajewski
- Department and Clinic of Urology and Urological Oncology, Medical University in Wroclaw, Borowska 213, 50556, Wroclaw, Poland
| | - Tomasz Zatoński
- Department and Clinic of Otolaryngology, Head and Neck Surgery, Medical University in Wroclaw, Borowska 213 Street, 50556, Wroclaw, Poland
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Brooks JK, Jones JL, Price JB. Possible association of sialolithiasis with HIV infection and highly active antiretroviral therapy: A case report. SPECIAL CARE IN DENTISTRY 2020; 40:298-302. [DOI: 10.1111/scd.12455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 02/05/2020] [Accepted: 02/21/2020] [Indexed: 11/29/2022]
Affiliation(s)
- John K. Brooks
- Department of Oncology and Diagnostic SciencesUniversity of Maryland School of Dentistry Baltimore Maryland
| | - Joyce L. Jones
- Department of Internal MedicineThe Johns Hopkins University School of Medicine Baltimore Maryland
| | - Jeffery B. Price
- Department of Oncology and Diagnostic SciencesUniversity of Maryland School of Dentistry Baltimore Maryland
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Hoffman HT, Pagedar NA. Ultrasound-Guided Salivary Gland Techniques and Interpretations. Atlas Oral Maxillofac Surg Clin North Am 2019; 26:119-132. [PMID: 30077320 DOI: 10.1016/j.cxom.2018.04.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Henry T Hoffman
- Department of Otolaryngology, University of Iowa, University of Iowa Hospital, 200 Hawkins Drive, Iowa City, IA 52242, USA.
| | - Nitin A Pagedar
- Department of Otolaryngology, University of Iowa, University of Iowa Hospital, 200 Hawkins Drive, Iowa City, IA 52242, USA
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Imaging of Sjögren Syndrome and Immunoglobulin G4-Related Disease of the Salivary Glands. Neuroimaging Clin N Am 2018; 28:183-197. [DOI: 10.1016/j.nic.2018.01.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Abstract
OBJECTIVES Calcification of the torus tubarius has been rarely reported in the literature. Histopathologic studies have previously described cases of Eustachian tube calcification and cite an association with increasing patient age. The purpose of this study was to examine the prevalence of torus tubarius calcification and potential clinical significance on an unrestricted patient population using thin-section computed tomography (CT), which has not been previously reported. METHODS After the institutional review board approval, 1571 consecutive patients who underwent noncontrast head CT between January 2011 and July 2011 were retrospectively reviewed for torus tubarius calcification. Images were acquired at 1.25-mm slice thickness using a 64-detector row CT. Medical records were reviewed for chronic medical conditions including chronic kidney disease, alcoholism, autoimmune conditions, endocrine disorders, elevated alkaline phosphatase levels, history of otitis media, purified protein derivative positivity, history of head and neck surgery and radiation, and human immunodeficiency virus infection. Motion-limited studies and patients with limited clinical data were excluded. Statistical analyses were performed using the independent sample t test and Fisher exact test. RESULTS Ten (0.6%) of 1571 patients had torus tubarius calcification, of which 7 (70%) were unilateral, and 3 (30%) were bilateral calcification. There was no significant association between torus tubarius calcification and common medical disorders including endocrine disorders, human immunodeficiency virus, chronic kidney disease, alcoholism, purified protein derivative positivity, history of head and neck surgery or radiation, and autoimmune diseases. CONCLUSIONS Based on the largest series to date on an unrestricted population using thin-section CT imaging, calcification of the torus tubarius is a rare entity with an overall prevalence of 0.6%. Although the clinical significance remains uncertain, there is no significant association between torus tubarius calcification and common medical conditions.
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Avignon S, Foletti JM, Collet C, Guyot L, Chossegros C. [Calcifications of the parotid space. A review]. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2017; 118:167-172. [PMID: 28391078 DOI: 10.1016/j.jormas.2017.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 11/22/2016] [Accepted: 03/15/2017] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Parotid lithiasis is the main cause of calcifications in the parotid space. However, there are many other less known causes. The aim of our study was to point out the non-lithiasic causes of calcifications in the parotid space. MATERIAL AND METHODS We conducted an exhaustive review of the literature by mean of PubMed, using the keywords "parotid" and "calcification" and limiting our analysis to the original articles in humans published in English and in French. Articles reporting about microscopic calcifications and who were not dealing with parotid calcifications were excluded. RESULTS Twenty articles met the inclusion criterions. Tumoral and non-tumoral local causes and systemic causes of parotid calcification were found. The way they revealed was variable. The main tumoral local causes were pleomorphic adenomas, salivary duct carcinomas and adenocarcinomas. The main non-tumoral local causes included vascular malformations and calcified parotid lymph nodes. The main systemic causes were chronic kidney diseases, HIV infection, chronic alcoholism, elevated levels of alkaline phosphatase and auto-immune diseases. DISCUSSION Eighteen different etiologies of parotid space calcifications could be identified. First line exploration of these lesions relies mainly on conventional radiography and ultrasound examination that are easily available. CT scan remains the reference examination.
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Affiliation(s)
- S Avignon
- Service de stomatologie et de chirurgie maxillo-faciale, CHU de la Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
| | - J-M Foletti
- Service de chirurgie maxillo-faciale, stomatologie et plastique, hôpital Nord, chemin des Bourrelys, 13015 Marseille, France
| | - C Collet
- Service de stomatologie et de chirurgie maxillo-faciale, CHU de la Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
| | - L Guyot
- Service de chirurgie maxillo-faciale, stomatologie et plastique, hôpital Nord, chemin des Bourrelys, 13015 Marseille, France
| | - C Chossegros
- Service de stomatologie et de chirurgie maxillo-faciale, CHU de la Timone, AP-HM, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France
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Jáuregui E, Kiringoda R, Ryan WR, Eisele DW, Chang JL. Chronic parotitis with multiple calcifications: Clinical and sialendoscopic findings. Laryngoscope 2016; 127:1565-1570. [PMID: 27861944 DOI: 10.1002/lary.26386] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 09/01/2016] [Accepted: 09/27/2016] [Indexed: 12/13/2022]
Abstract
OBJECTIVES/HYPOTHESIS To characterize clinical, imaging, and sialendoscopy findings in patients with chronic parotitis and multiple parotid calcifications. STUDY DESIGN Retrospective review. METHODS Clinical history, radiographic images and reports, lab tests, and operative reports were reviewed for adult patients with chronic parotitis and multiple parotid calcifications who underwent parotid sialendoscopy. RESULTS Thirteen of 133 (10%) patients undergoing parotid sialendoscopy for chronic sialadenitis had more than one calcification in the region of the parotid gland. Seven patients (54%) were diagnosed with immune-mediated disease from autoimmune parotitis (positive Sjögren's antibodies or antinuclear antibodies) or human immunodeficiency virus (HIV) disease. The six patients (46%) who did not have an immune-mediated disorder had most calcifications located anterior or along the masseter muscle. Eight of 13 patients (61%) had at least one calculus found in the parotid duct on sialendoscopy. Four patients (38%) had multiple punctate calcifications within the parotid gland, all of whom had either autoimmune parotitis or HIV. None of the proximal or punctate parotid calcifications posterior to the masseter were visualized on sialendoscopy. CONCLUSIONS Chronic parotitis in conjunction with multiple parotid calcifications is uncommon and was identified in 10% of our cohort. We contrast two classifications of parotid calcifications: 1) intraductal stones that cause recurrent duct obstruction and are often located within the main parotid duct along or anterior to the masseter and 2) punctate intraparenchymal parotid gland calcifications that are not visualized on sialendoscopy and may represent underlying inflammatory disease. LEVEL OF EVIDENCE 4 Laryngoscope, 127:1565-1570, 2017.
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Affiliation(s)
- Emmanuel Jáuregui
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco School of Medicine, San Francisco, California, U.S.A
| | - Ruwan Kiringoda
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A
| | - William R Ryan
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco School of Medicine, San Francisco, California, U.S.A
| | - David W Eisele
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, U.S.A
| | - Jolie L Chang
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco School of Medicine, San Francisco, California, U.S.A
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