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Capaccio P, Lazzeroni M, Lo Russo F, Torretta S, Di Pasquale D, Conte G, Firetto MC, Nicolino G, Gaffuri M, Carrafiello G. MR sialographic assessment of the masseter muscle and the ductal kinking in patients with recurrent parotitis. LA RADIOLOGIA MEDICA 2024; 129:785-793. [PMID: 38512620 PMCID: PMC11088540 DOI: 10.1007/s11547-024-01802-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 02/15/2024] [Indexed: 03/23/2024]
Abstract
Dysfunction of the masseter muscle may cause pathological kinking of the parotid duct leading to parotitis; MR sialography is a non-invasive radiological examination that allows to evaluate dynamically the ductal system of the parotid glands. In the present study we aimed to assess the relationships between Stensen's duct and masseter muscle and their implications in the aetiopathogenesis of recurrent parotitis secondary to masseter muscle dysfunction. Forty-one patients with recurrent unilateral parotitis and nine with bilateral recurrent parotitis, all with a clinical suspicious of masseter muscle hypertrophy due to bruxism were enrolled. They underwent ultrasonography as a first line examination and then MR sialography and sialendoscopy. Different anatomical features were studied. Involved parotid glands had a wider duct compared to contralateral unaffected parotid glands of patients with recurrent parotitis (p = 0.00134); male subjects with parotitis had a longer duct compared to the salivary glands of healthy patients (p = 0.00943 for affected glands and p = 0.00629 for the contralateral). A concordance between the evidence of an acute duct angle during sialendoscopy and a wider duct in patients with parotitis was observed although not statistically significant. These initial findings suggest that the masticatory muscle dysfunction related to bruxism seems to condition alteration of parotid duct course and anatomy thus favouring the occurrence of recurrent parotitis. A specific diagnostic iter based on clinical evaluation, dynamic ultrasonography and MR sialography, is therefore, mandatory to confirm the relationship between masseter muscle anatomy and parotid duct anomalies; this is the premise for an adequate therapeutic approach to underlying masticatory muscle disorder.
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Affiliation(s)
- Pasquale Capaccio
- Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Matteo Lazzeroni
- Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy.
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
| | - Francesco Lo Russo
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Sara Torretta
- Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Daniele Di Pasquale
- Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy
| | - Giorgio Conte
- Neuroradiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Cristina Firetto
- Operative Unit of Radiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Di Milano, 20122, Milan, Italy
| | - Gabriele Nicolino
- Breast Unit, Fondazione IRCCS San Gerardo Dei Tintori, Via G. B. Pergolesi 33, Monza, Italy
| | - Michele Gaffuri
- Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Gianpaolo Carrafiello
- Operative Unit of Radiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Di Milano, 20122, Milan, Italy
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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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Yang Q, Guo J, Zheng W. Acute and suppurative parotitis caused by foreign body in parotid duct. Minerva Med 2023; 114:577-579. [PMID: 35332755 DOI: 10.23736/s0026-4806.21.07827-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Qi Yang
- Department of Ophthalmology and Otorhinolaryngology, The 970th Hospital, Yantai, China
| | - Junfeng Guo
- Department of Ophthalmology and Otorhinolaryngology, The 970th Hospital, Yantai, China
| | - Weiwei Zheng
- Department of Ophthalmology and Otorhinolaryngology, The 970th Hospital, Yantai, China -
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Xu MJ, Chang JL. Practical Salivary Ultrasound Imaging Tips and Pearls. Otolaryngol Clin North Am 2021; 54:471-487. [PMID: 34024476 DOI: 10.1016/j.otc.2021.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Ultrasound imaging is a valuable and effective clinical tool for salivary gland disorder evaluation and management. Pathologies including salivary duct stenosis, sialolithiasis, neoplasms, and autoimmune disorders have characteristic sonographic features. Maneuvers such as bimanual palpation and oral administration of sialagogues during the ultrasound examination can enhance examination findings. Ultrasound guidance is useful for targeting needle biopsies of neoplasms, ensuring appropriate intraparenchymal gland injections, and augmenting salivary duct instrumentation and intraoperative management.
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Affiliation(s)
- Mary Jue Xu
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, 2380 Sutter Street Box 0342, San Francisco, CA 94115, USA
| | - Jolie L Chang
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, 2380 Sutter Street Box 0342, San Francisco, CA 94115, USA.
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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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