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Graillon N, Marty P, Foletti JM, Chossegros C, Frandjian H. Idiopathic dilatation of the submandibular gland duct. Int J Oral Maxillofac Surg 2024; 53:389-392. [PMID: 37845088 DOI: 10.1016/j.ijom.2023.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/26/2023] [Accepted: 09/27/2023] [Indexed: 10/18/2023]
Abstract
Lithiasis and stenosis may cause salivary duct dilatation due to the increased pressure in the duct upstream of the obstruction. Idiopathic dilatations, also called megaducts, with no associated increase in pressure, have only been described in the parotid gland. The aim of this study was to describe the characteristics of submandibular duct dilatation unrelated to lithiasis, stenosis, or an imperforate duct, to report the existence of submandibular megaducts. This retrospective single-centre study included patients treated at La Conception University Hospital, Marseille, France, between 2007 and 2019. Patients with submandibular duct dilatation of ≥4 mm confirmed by magnetic resonance imaging sialography (sialo-MRI), who also underwent sialendoscopy to identify any associated stenosis, were included. Patients with lithiasis, stenosis, an imperforate ostium, or a history of trauma or surgery to the floor of the mouth were excluded. Five patients (three female, two male) aged 30-76 years with idiopathic duct dilatations in nine submandibular glands were included. The most commonly reported symptoms were submandibular swelling, pruritus, and discomfort, mostly outside mealtimes. Recurrence of symptoms after treatment was frequent. This study is novel in describing submandibular megaducts as opposed to dilatation caused by high pressure associated with stenosis, with confirmation by sialo-MRI and sialendoscopy.
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Affiliation(s)
- N Graillon
- Department of Oral and Maxillofacial Surgery, APHM, Conception University Hospital, Marseille, France; Laboratoire de Bioméchanique Appliquée (LBA), Gustave Eiffel University/Aix-Marseille University, Marseille, France.
| | - P Marty
- Department of Oral and Maxillofacial Surgery, Clinique Saint Pierre d'Ottignies, Ottignies-Louvain la Neuve, Belgium
| | - J-M Foletti
- Department of Oral and Maxillofacial Surgery, APHM, Conception University Hospital, Marseille, France; Laboratoire de Bioméchanique Appliquée (LBA), Gustave Eiffel University/Aix-Marseille University, Marseille, France
| | - C Chossegros
- Department of Oral and Maxillofacial Surgery, APHM, Conception University Hospital, Marseille, France
| | - H Frandjian
- Department of Oral and Maxillofacial Surgery, APHM, Conception University Hospital, Marseille, France
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Zhao D, Fan W, Jiang H, Meng L, Cai B, Zhang X, Yu W, Zhao L, Ma L. The impact of submandibular glands protection on xerostomia as monitored by diffusion-weighted imaging in nasopharyngeal carcinoma patients. Strahlenther Onkol 2024; 200:377-388. [PMID: 37955647 DOI: 10.1007/s00066-023-02167-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/01/2023] [Indexed: 11/14/2023]
Abstract
PURPOSE To determine the impact of sparing submandibular glands (SMGs) on alleviating xerostomia and the functional dynamics of the irradiated parotid glands (PGs) and sublingual glands (SLGs) by diffusion-weighted imaging. METHODS 97 participants underwent 9 rounds of DWI scans before IC (pre-IC), pre-radiation (pre-RT), the midpoint of radiation (mid-RT), the end of radiation (post-RT), 1, 3, 6, 9, 12 (12m-RT) months following radiation. Apparent diffusion coefficient of SMGs (ADCSMG), PGs (ADCPG), and SLGs (ADCSLG), xerostomia questionnaire scores (XQ), and saliva flow rate measures under unstimulated (uSFR) and stimulated condition (sSFR) were documented. RESULTS ADCPG, ADCSMG, ADCSLG, and XQ showed a rapid increase with a top at 3m-RT followed by regression, whereas uSFR and sSFR had the reverse trend. The change rate of ADC correlated with the dose to PGs, SMGs, and SLGs, as well as uSFR, sSFR, and XQ scores (p < 0.05 for all, except for uSFR with ADCPG (p = 0.063)). Maingroup for ADCPG, uSFR, and sSFR were significant (p values were 0.028, 0.000, 0.000 respectively); ADCPG in SMG sparing group was lower while uSFR, and sSFR were higher than those in the SMG-unsparing group. Simplegroup for ADCSMG, ADCSLG (all p < 0.05 from mid-RT to 12m-RT), and XQ (all p < 0.001 at mid-, 6m-, 9m-, and 12m-RT) were significant; ADCSMG, ADCSLG, and XQ were lower in the SMG-sparing group. CONCLUSIONS SMG protection has a great impact on the functional retention of PGs and SLGs, resulting in alleviating xerostomia and improving quality of life. TRIAL REGISTRATION The clinical trial was also registered with the Chinese Clinical Study Registry (registered number: ChiCTR1900024328, Date: July 6, 2019; URL: https://www.chictr.org.cn/showproj.aspx?proj=40726 ).
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Affiliation(s)
- Dawei Zhao
- Tianjin Medical University, Tianjin, China
- Department of Radiation Oncology, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, No.1 West Huan-Hu Rd, Tianjin, China
- Department of Radiation Oncology, First Medical Center of Chinese PLA General Hospital, No.28 Fuxing Road, Beijing, China
- Department of Radiology, Characteristic Medical Center of Chinese People's Armed Police Force, Tianjin, China
| | - Wenjun Fan
- Department of Radiation Oncology, First Medical Center of Chinese PLA General Hospital, No.28 Fuxing Road, Beijing, China
- Department of Radiation Oncology, Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, China
| | - Huayong Jiang
- Department of Radiation Oncology, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Lingling Meng
- Department of Radiation Oncology, First Medical Center of Chinese PLA General Hospital, No.28 Fuxing Road, Beijing, China
| | - Boning Cai
- Department of Radiation Oncology, First Medical Center of Chinese PLA General Hospital, No.28 Fuxing Road, Beijing, China
| | - Xinxin Zhang
- Department of Otolaryngology, First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Wei Yu
- Department of Radiation Oncology, First Medical Center of Chinese PLA General Hospital, No.28 Fuxing Road, Beijing, China.
- Department of Radiation Oncology, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China.
| | - Lujun Zhao
- Department of Radiation Oncology, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, No.1 West Huan-Hu Rd, Tianjin, China.
| | - Lin Ma
- Department of Radiation Oncology, First Medical Center of Chinese PLA General Hospital, No.28 Fuxing Road, Beijing, China.
- Department of Radiation Oncology, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China.
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Goebel F, Knopf K, Fiedler LS. Rare encounter: facial vein thrombosis and thrombophlebitis as a complication of acute submandibular sialadenitis. BMJ Case Rep 2024; 17:e259423. [PMID: 38350707 PMCID: PMC10868304 DOI: 10.1136/bcr-2023-259423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024] Open
Abstract
Thrombosis and thrombophlebitis of the facial vein represent exceptionally rare diagnoses, particularly when occurring as complications of acute sialadenitis of the submandibular gland. This case report details the experience of a middle-aged man initially presenting at a tertiary care ear, nose and throat department with right submandibular gland sialadenitis. Despite initiating outpatient treatment involving oral antibiotics and sialagogues, the patient returned after a week with persistent and worsening pain, accompanied by swelling of the right submandibular gland and cheek. Using ultrasound, the accurate diagnosis was promptly identified, revealing thrombosis in the facial vein.The patient underwent a comprehensive treatment regimen involving anticoagulation and intravenous antibiotics. With a subsequent reduction in pain and swelling, the patient was discharged, continuing oral anticoagulation and antibiotics. Outpatient follow-up revealed a complete recovery 3 weeks later. This case underscores the importance of timely and precise diagnostic measures in managing rare complications associated with sialadenitis.
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Affiliation(s)
- Frieder Goebel
- Otorhinolaryngology and head and neck surgery, SLK-Kliniken Heilbronn GmbH, Heilbronn, Germany
| | - Katrin Knopf
- Otorhinolaryngology and head and neck surgery, SLK-Kliniken Heilbronn GmbH, Heilbronn, Germany
| | - Lukas S Fiedler
- Otorhinolaryngology and head and neck surgery, SLK-Kliniken Heilbronn GmbH, Heilbronn, Germany
- Faculty of Medicine, Heidelberg University, Heidelberg, Germany
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Bhardwaj V, Gautam V, Verma H, Bhutada MD. Lost and found: foreign body in submandibular gland. BMJ Case Rep 2023; 16:e257564. [PMID: 37977847 PMCID: PMC10660160 DOI: 10.1136/bcr-2023-257564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2023] [Indexed: 11/19/2023] Open
Abstract
A young adult male patient presented with the history of a retained foreign body in the oral cavity. The object in question was a stapler pin that got accidentally lodged while the patient tried removing food particles from his mouth 28 days earlier. Aside from intermittent pain upon digital palpation on the right side of the floor of his mouth, he was asymptomatic. Clinical examination was unremarkable. Plain radiography and a computed tomogram revealed a linear foreign body in the right submandibular gland. The patient underwent a submandibular gland excision, during which a 2 cm long stapler pin was retrieved. This case highlights that not all foreign bodies cause inflammatory reactions as a telltale sign of their presence.
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Affiliation(s)
- Viny Bhardwaj
- Otorhinolaryngology, All India Institute of Medical Sciences, Delhi, Delhi, India
| | - Vimmi Gautam
- Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Hitesh Verma
- ENT and Hand and Neck Surgery, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Mayank Dilip Bhutada
- Otorhinolaryngology, All India Institute of Medical Sciences, Delhi, Delhi, India
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Rachida B, Kharrat O, Boughzala W, Hammouda SB, Abdeljelil NB, Kolsi N, Koubaa J. Pleomorphic Adenoma of the Submandibular Gland in a 10-Year-Old Child: A Case Report. Ear Nose Throat J 2023; 102:NP552-NP555. [PMID: 34233518 DOI: 10.1177/01455613211022113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We report the case of a 10-year-old girl with a painless slowly growing mass that had developed over the course of 2 years in the left submandibular area. Physical examination revealed a firm painless submandibular mass with no other associated signs. Ultrasound graphics were in favor of a sebaceous cyst. Fine-needle aspiration and magnetic resonance images (MRI) concluded to a pleomorphic adenoma of the submandibular gland. The patient underwent left submandibulectomy. Histopathological examination confirmed the diagnosis of pleomorphic adenoma arising from the submandibular gland. The postoperative course was uneventful. Pleomorphic adenoma of the submandibular gland represents a diagnostic and therapeutic dilemma in children. Preoperative evaluation, including MRI and fine-needle aspiration, is recommended. Total submandibulectomy is also recommended to minimize recurrences and to avoid malignant transformation.
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Affiliation(s)
- Bouatay Rachida
- ENT Department, Fattouma Bourguiba Hospital of Monastir, Monastir, Tunisia
- University of Monastir, Monastir, Tunisia
| | - Ons Kharrat
- ENT Department, Fattouma Bourguiba Hospital of Monastir, Monastir, Tunisia
| | - Wiem Boughzala
- ENT Department, Fattouma Bourguiba Hospital of Monastir, Monastir, Tunisia
| | - Seifeddine Ben Hammouda
- University of Monastir, Monastir, Tunisia
- Department of Pathology, Fattouma Bourguiba Hospital of Monastir, Monastir, Tunisia
| | - Nouha Ben Abdeljelil
- University of Monastir, Monastir, Tunisia
- Department of Pathology, Fattouma Bourguiba Hospital of Monastir, Monastir, Tunisia
| | - Naourez Kolsi
- ENT Department, Fattouma Bourguiba Hospital of Monastir, Monastir, Tunisia
- University of Monastir, Monastir, Tunisia
| | - Jamel Koubaa
- ENT Department, Fattouma Bourguiba Hospital of Monastir, Monastir, Tunisia
- University of Monastir, Monastir, Tunisia
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Sánchez Barrueco A, Alcalá Rueda I, Ordoñez González C, Sobrino Guijarro B, Santillán Coello J, Tapia GD, Guerra Gutiérrez F, Campos González A, Brenna A, Cenjor Españo C, Villacampa Aubá JM. Transoral removal of submandibular hilar lithiasis: results on the salivary duct system, glandular parenchyma, and quality-of-life recovery. Eur Arch Otorhinolaryngol 2023; 280:5031-5037. [PMID: 37410145 PMCID: PMC10562331 DOI: 10.1007/s00405-023-08081-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 06/14/2023] [Indexed: 07/07/2023]
Abstract
OBJECTIVE(S) To confirm that hilar transoral submandibular sialolitectomy (TOSL) is the first treatment option for submandibular hilar lithiasis (SHL) in terms of glandular parenchyma recovery, salivary system restoration, and patient quality of life (QoL) improvement. METHODS Depending on whether the stone was easily palpable, TOSL was carried out with or without sialendoscopy. For the first time in the literature, Magnetic Resonance Sialography (MR-Si) was performed before and after TOSL, to evaluate stone characteristics, glandular parenchyma status, hilum dilation and main duct recanalization. Radiological data was examined independently by two radiologists. COSQ, a recently validated and specific questionnaire, was used to assess associated QoL. RESULTS Between 2017 and 2022, 29 TOSL patients were examined. With a high interobserver correlation, MR-Si was confirmed as a very useful radiological test in the pre- and post-surgical evaluation of SHL. The salivary main duct was completely recanalized in all cases. The presence of lithiasis was found in 4 patients (13.8%). After surgery, the majority of patients (79.31%) had hilum dilation. There was a statistically significant improvement in parenchyma status, but no significant progression to glandular atrophy. After surgery, COSQ mean values always improved (22.5 to 4.5). CONCLUSIONS TOSL is the ideal surgical technique for the management of SHL, resulting in improved parenchymal inflammatory changes, recanalization of Wharton's duct, and enhancement patients' QoL. As a result, before removing the submandibular gland, TOSL should be considered as the first treatment option for SHL.
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Affiliation(s)
- Alvaro Sánchez Barrueco
- Medicine Faculty, Alfonso X El Sabio University, Villanueva de La Cañada, Madrid, Spain
- ENT and Cervicofacial Surgery Department, Fundación Jiménez Díaz University Hospital and General Villalba University Hospital, Madrid, Spain
| | - Ignacio Alcalá Rueda
- Medicine Faculty, Alfonso X El Sabio University, Villanueva de La Cañada, Madrid, Spain
- ENT and Cervicofacial Surgery Department, Fundación Jiménez Díaz University Hospital and General Villalba University Hospital, Madrid, Spain
| | | | | | - Jessica Santillán Coello
- Medicine Faculty, Alfonso X El Sabio University, Villanueva de La Cañada, Madrid, Spain
- ENT and Cervicofacial Surgery Department, Fundación Jiménez Díaz University Hospital and General Villalba University Hospital, Madrid, Spain
| | - Gonzalo Díaz Tapia
- Medicine Faculty, Alfonso X El Sabio University, Villanueva de La Cañada, Madrid, Spain
- ENT and Cervicofacial Surgery Department, Fundación Jiménez Díaz University Hospital and General Villalba University Hospital, Madrid, Spain
| | | | - Alfonso Campos González
- Medicine Faculty, Alfonso X El Sabio University, Villanueva de La Cañada, Madrid, Spain
- ENT and Cervicofacial Surgery Department, Fundación Jiménez Díaz University Hospital and General Villalba University Hospital, Madrid, Spain
| | - Alessandra Brenna
- Medicine Faculty, Alfonso X El Sabio University, Villanueva de La Cañada, Madrid, Spain
| | - Carlos Cenjor Españo
- ENT and Cervicofacial Surgery Department, Fundación Jiménez Díaz University Hospital and General Villalba University Hospital, Madrid, Spain
| | - José Miguel Villacampa Aubá
- Medicine Faculty, Alfonso X El Sabio University, Villanueva de La Cañada, Madrid, Spain
- ENT and Cervicofacial Surgery Department, Fundación Jiménez Díaz University Hospital and General Villalba University Hospital, Madrid, Spain
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Abstract
Sjogren's syndrome (SS) is a chronic autoimmune condition commonly affecting the exocrine glands, causing oral or ocular dryness and extraglandular manifestations including arthralgia, cytopenia, and lymphoma. The presence of autoantibodies against SSA/Ro, labial salivary gland biopsy, ocular staining, Schirmer's test, or salivary flow assessment are included in the current classification criteria of SS. However, the availability and invasiveness of these procedures limit their widespread use in clinical settings. Salivary gland ultrasonography (SGUS) is a non-invasive imaging modality for the evaluation of the salivary gland parenchyma and is increasingly utilized to aid diagnosis and monitoring in SS. This article presents the protocol of SGUS for image acquisition at the parotid and submandibular glands. The objective is to present a standardized, reproducible, and practical approach to diagnostic SGUS for SS in daily clinical settings. Major salivary glands are scanned in a stepwise approach, beginning at the angle of the mandible for the superficial lobe of the parotid gland, followed by the deep lobe below the ramus of the mandible. Submandibular areas are then scanned for the submandibular glands. The steps in obtaining salivary gland images at each anatomical site are explained in the accompanying video. The echogenicity and echotexture at the thyroid gland are taken as a reference. The homogeneity, the presence and distribution of hypoechoic areas within the glands, and the border of the salivary glands are examined. The sizes and features of intra-/peri-glandular lymph nodes are recorded. The most distinctive sonographic feature in SS is glandular heterogeneity with the presence of hypoechoic/hyperechoic areas within the glands. In summary, while SGUS cannot diagnose SS on its own, it can supplement the current classification criteria of SS and guide the clinical decision for salivary gland biopsy to support the diagnosis of SS in patients with sicca syndrome or suspicious systemic features, combined with autoantibody testing.
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Affiliation(s)
- Iris Y K Tang
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong
| | - Carmen T K Ho
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong;
| | - Teresa W L Li
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong
| | - Philip H Li
- Division of Rheumatology and Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong
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Chen L, Nong L, Liu J, Chen L, Shao Y, Sun X. Value of High-Frequency Ultrasonography in the Qualitative and Semi-Quantitative Assessment of Immunoglobulin G4-Related Submandibular Sialadenitis. J Ultrasound Med 2023; 42:2235-2246. [PMID: 37162711 DOI: 10.1002/jum.16240] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 04/06/2023] [Accepted: 04/09/2023] [Indexed: 05/11/2023]
Abstract
OBJECTIVE To assess the value of high-frequency ultrasonography in the evaluation of immunoglobulin G4-related submandibular sialadenitis (IgG4-SS). METHODS Thirty-four submandibular glands in 17 patients with IgG4-SS were retrospectively enrolled, as well as 34 submandibular glands in 17 healthy control subjects. Qualitative ultrasonic features including submandibular gland size, border, echogenicity, and vascularity were reviewed. Two different scoring systems (0-16 and 0-48, respectively) were used for semi-quantitative analysis of imaging features. Comparison of both qualitative and semi-quantitative ultrasonic analysis were made between patients with IgG4-SS and healthy controls. Spearman correlation was used to explore relationships between variables. RESULTS The submandibular glands with IgG4-SS presented with enlarged size, rough border, increased vascularity, and abnormal echogenicity (All P < .05). The most common echogenicity pattern for IgG-SS was diffuse hypoechoic foci pattern (44.1%), followed by superficial hypoechoic pattern (20.6%), tumor-like pattern (14.7%), and diffuse hypoechogenicity pattern (11.8%). Most IgG4-SS glands presented linear hyperechogenicity in parenchyma (91.2%). Based on both scoring system, scores of IgG4-SS were significantly higher than those of the controls (All P < .05). Association analysis of both scoring systems showed positive correlation of scores with vascularity in the gland parenchyma (All P < .05). CONCLUSION The ultrasonic features of IgG4-SS comprise enlarged gland, rough border, increased vascularity, and abnormal echogenicity, which correlate with its pathological characteristics. The most common echogenicity pattern for IgG4-SS was diffuse hypoechoic foci pattern. Semi-quantitative analysis systems could be useful in the assessment of IgG4-SS. Ultrasound is a potential, valuable, and non-invasive tool for the diagnosis and evaluation of IgG4-SS.
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Affiliation(s)
- Lei Chen
- Department of Ultrasound, Peking University First Hospital, Beijing, China
| | - Lin Nong
- Department of Pathology, Peking University First Hospital, Beijing, China
| | - Jumei Liu
- Department of Pathology, Peking University First Hospital, Beijing, China
| | - Luzeng Chen
- Department of Ultrasound, Peking University First Hospital, Beijing, China
| | - Yuhong Shao
- Department of Ultrasound, Peking University First Hospital, Beijing, China
| | - Xiuming Sun
- Department of Ultrasound, Peking University First Hospital, Beijing, China
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Ebina J, Mizumura S, Ishii N, Kobayashi Y, Shibukawa M, Morioka H, Nagasawa J, Yanagihashi M, Hirayama T, Kawabe K, Orimo S, Kano O. Reduced 123I-MIBG uptake in the parotid and submandibular glands in patients with Parkinson's disease identified using a quantitative semi-automatic method. J Neurol 2023; 270:4385-4392. [PMID: 37222842 DOI: 10.1007/s00415-023-11770-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 05/02/2023] [Accepted: 05/08/2023] [Indexed: 05/25/2023]
Abstract
OBJECTIVES To analyze 123I-metaiodobenzylguanidine (MIBG) uptake in the parotid and submandibular glands in patients with Parkinson's disease (PD) in comparison with controls, and to compare MIBG uptake between those glands and the myocardium. Furthermore, we aimed to identify the relationships between clinical features and MIBG uptake. METHODS We recruited 77 patients with PD and 21 age-matched controls. We assessed MIBG scintigraphy in the major salivary glands and myocardium. We calculated the MIBG uptake ratio in the parotid glands/mediastinum (P/M), submandibular glands/mediastinum (S/M), and heart/mediastinum (H/M) using a quantitative semi-automatic method. We investigated the correlations between MIBG uptake and clinical features. RESULTS The P/M and H/M ratios in the early and delayed phases were significantly reduced in PD patients compared to controls, while the delayed phase S/M ratio was reduced in PD patients compared to controls. The P/M ratio correlated with the S/M ratio, while neither the P/M nor S/M ratio correlated with the H/M ratio. Between PD patients and controls, sensitivity and specificity were 54.8% and 59.1% for the delayed phase P/M ratio, while sensitivity and specificity were 59.5% and 61.0% for the delayed phase S/M ratio, respectively. Furthermore, sensitivity and specificity for the delayed phase H/M ratio were 85.7% and 79.2, respectively. CONCLUSION MIBG uptake in the parotid and submandibular glands was reduced in patients with PD. Furthermore, sympathetic denervation in the major salivary glands and myocardium might progress independently. Our findings suggest a new aspect of the pathological distribution of PD.
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Affiliation(s)
- Junya Ebina
- Department of Neurology, Toho University Faculty of Medicine, 6-11-1 Omorinishi, Ota-ku, Tokyo, Japan
| | - Sunao Mizumura
- Department of Radiology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Nobutomo Ishii
- Central Radiology Division, Department of Radiology, Toho University Omori Medical Center, Tokyo, Japan
| | - Yukio Kobayashi
- Department of Radiological Technology, Kanto Central Hospital, Tokyo, Japan
| | - Mari Shibukawa
- Department of Neurology, Toho University Faculty of Medicine, 6-11-1 Omorinishi, Ota-ku, Tokyo, Japan
| | - Harumi Morioka
- Department of Neurology, Toho University Faculty of Medicine, 6-11-1 Omorinishi, Ota-ku, Tokyo, Japan
| | - Junpei Nagasawa
- Department of Neurology, Toho University Faculty of Medicine, 6-11-1 Omorinishi, Ota-ku, Tokyo, Japan
| | - Masaru Yanagihashi
- Department of Neurology, Toho University Faculty of Medicine, 6-11-1 Omorinishi, Ota-ku, Tokyo, Japan
| | - Takehisa Hirayama
- Department of Neurology, Toho University Faculty of Medicine, 6-11-1 Omorinishi, Ota-ku, Tokyo, Japan
| | - Kiyokazu Kawabe
- Department of Neurology, Toho University Faculty of Medicine, 6-11-1 Omorinishi, Ota-ku, Tokyo, Japan
| | | | - Osamu Kano
- Department of Neurology, Toho University Faculty of Medicine, 6-11-1 Omorinishi, Ota-ku, Tokyo, Japan.
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Krishnapura SG, Tomblinson CM, Topf MC. Rate of Submandibular Gland Atrophy Secondary to Chronic Sialolithiasis. Ear Nose Throat J 2023; 102:563-565. [PMID: 34056944 DOI: 10.1177/01455613211021178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The rate of salivary gland atrophy secondary to chronic obstructive sialolithiasis has not been well-documented. The combination of 5 imaging studies over 12 years in a patient with repeat imaging for an unrelated pathology provides a unique opportunity to assess glandular atrophy over time. We hope that this case will support previous literature with an in vivo representation of the rate of glandular atrophy.
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Affiliation(s)
| | - Courtney M Tomblinson
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Michael C Topf
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
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11
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Shih H, Huang JS, Huang TT, Wong TY, Chen MY, Chen KC. Gland-sparing neck dissection: oncological and functional outcomes in oral cancer patients. Int J Oral Maxillofac Surg 2023; 52:825-830. [PMID: 36517308 DOI: 10.1016/j.ijom.2022.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 11/21/2022] [Accepted: 11/25/2022] [Indexed: 12/14/2022]
Abstract
This study was performed to evaluate the subjective and objective functional outcomes of patients who had undergone submandibular gland-sparing neck dissection. All data were obtained from patients treated in a single hospital. Seventy-seven patients who had undergone complete submandibular gland sparing (CSGS) were included in the study. Cancer prognosis items were recorded. The subjective outcomes included patient self-evaluation of mouth dryness and the evaluation of the presence of saliva secretion following the application of digital pressure. Saliva scintigraphy served as the objective test. Self-reported xerostomia was compared between the CSGS patients and a control group of patients who had undergone unilateral submandibular gland removal (USGR; n = 74). In the CSGS group, local recurrence occurred in 3.8% of the 80 cancer sites, and neck recurrence occurred in 5.9% of neck dissection sites. Regarding the subjective measurements, 7.0% of the CSGS patients reported xerostomia and 91.9% demonstrated saliva secretion by digital pressure. Scintigraphy revealed actively secreting glands, with 42.9% of them showing normal gland function; none of the patients had severe xerostomia. The relative risk of dry mouth was significantly higher in the USGR patients than in the CSGS patients (P < 0.001). Submandibular gland sparing during neck dissection was found to result in satisfactory saliva secretion, with a relatively small risk of local or neck recurrence.
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Affiliation(s)
- H Shih
- Department of Dentistry, Division of Oral and Maxillofacial Surgery, China Medical University Hospital, Taichung, Taiwan
| | - J-S Huang
- Division of Oral and Maxillofacial Surgery, Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Dentistry, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - T-T Huang
- Division of Oral and Maxillofacial Surgery, Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Dentistry, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - T-Y Wong
- Division of Oral and Maxillofacial Surgery, Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Dentistry, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - M-Y Chen
- Division of Oral and Maxillofacial Surgery, Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Dentistry, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - K-C Chen
- Division of Oral and Maxillofacial Surgery, Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Dentistry, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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12
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McCleary SP, Roostaeian J. Commentary on: Deep Neck Contouring With a Focus on Submandibular Gland Vascularity: A Cadaver Study. Aesthet Surg J 2023; 43:817-819. [PMID: 37335934 DOI: 10.1093/asj/sjad189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/06/2023] [Accepted: 06/06/2023] [Indexed: 06/21/2023] Open
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13
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Açıkgöz G, Akgül HM, Kızıltunç Özmen H, Sezen O. Assessment of Dimensional Changes in Submandibular Glands in Head-Neck Radiotherapy Patients by Ultrasonography. J Ultrasound Med 2023; 42:1065-1073. [PMID: 36342110 DOI: 10.1002/jum.16119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/27/2022] [Accepted: 10/16/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES The present study investigated the dimensional changes in the submandibular glands following radiotherapy using ultrasonography. METHODS Twenty-three patients planned to receive head-neck radiotherapy were included in this study. The anteroposterior, superoinferior, mediolateral length, and volumes of 46 submandibular glands were measured by ultrasonography at 3 different time periods (before radiotherapy and in the second and sixth months after the radiotherapy onset) and evaluated in terms of dimensional changes and the effect of the radiation dose on these changes. The data were statistically analyzed using repeated measures analysis of variance (ANOVA) and 2-factor repeated measures ANOVA. RESULTS Before radiotherapy and in the second and sixth months after the radiotherapy onset, mean anteroposterior length of the submandibular glands was 32.39 ± 4.55, 30.38 ± 4.80, and 31.50 ± 3.68 mm, respectively; mean superoinferior length was 9.96 ± 1.54, 8.76 ± 1.26, and 9.08 ± 1.01 mm, respectively; mean mediolateral length was 24.66 ± 3.77, 22.03 ± 3.73, and 21.76 ± 4.01 mm, respectively; and mean volume was 4.21 ± 1.01, 3.08 ± 0.77, and 3.32 ± 0.63 cm3 , respectively. Moreover, there were significant differences in the anteroposterior (P < .01), superoinferior (P < .001), and mediolateral lengths (P < .001), as well as the volumes (P < .001) of the submandibular glands measured at the 3 different time periods. CONCLUSION In the second and sixth months after the radiotherapy onset, the sizes of the submandibular glands were markedly reduced, but it partially recovered to normal as more time elapsed after radiotherapy.
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Affiliation(s)
- Gözde Açıkgöz
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Pamukkale University, Denizli, Turkey
| | - Hayati Murat Akgül
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Pamukkale University, Denizli, Turkey
| | - Hilal Kızıltunç Özmen
- Department of Radiation Oncology, Faculty of Medicine, Atatürk University, Erzurum, Turkey
- Anesthesiology Clinical Research Office, Atatürk University, Erzurum, Turkey
| | - Orhan Sezen
- Department of Radiation Oncology, Faculty of Medicine, Atatürk University, Erzurum, Turkey
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14
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Zander DA, Gursahaney DL, Oliver C, Callen AL, Potigailo VL. CT and MR Imaging Appearance of the Pedicled Submandibular Gland Flap: A Potential Imaging Pitfall in the Posttreatment Head and Neck. AJNR Am J Neuroradiol 2023; 44:481-485. [PMID: 36927762 PMCID: PMC10084900 DOI: 10.3174/ajnr.a7825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 02/21/2023] [Indexed: 03/18/2023]
Abstract
Pedicled locoregional submandibular gland reconstruction flaps are increasingly used in oncologic head and neck surgery and have unique imaging characteristics that can mimic locally recurrent tumor. In this clinical report, 23 posttreatment imaging studies were evaluated in 19 patients who had undergone submandibular gland flap reconstructions after resection of a primary head and neck tumor. Submandibular gland flaps were most commonly mobilized into the parapharyngeal space or parotid bed, with others located inferior to the mandibular body and within marginal mandibulectomy defects. The original shape of the gland was typically not preserved. Identifying the submandibular gland hilum, vascular pedicle, glandular texture, and absence of submandibular gland in the orthotopic location was most useful in recognizing a flap. The interpreting radiologist must be familiar with the unique submandibular gland flap imaging characteristics to accurately differentiate normal postoperative appearance and recurrent tumor.
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Affiliation(s)
- D A Zander
- From the Departments of Radiology (D.A.Z., D.L.G., A.L.C., V.L.P.)
| | - D L Gursahaney
- From the Departments of Radiology (D.A.Z., D.L.G., A.L.C., V.L.P.)
| | - C Oliver
- Otolaryngology-Head and Neck Surgery (C.O.), University of Colorado School of Medicine, Aurora, Colorado
| | - A L Callen
- From the Departments of Radiology (D.A.Z., D.L.G., A.L.C., V.L.P.)
| | - V L Potigailo
- From the Departments of Radiology (D.A.Z., D.L.G., A.L.C., V.L.P.)
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15
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Choi YJ, Jeon KJ, Lee A, Han SS, Lee C. Harmonization of robust radiomic features in the submandibular gland using multi-ultrasound systems: a preliminary study. Dentomaxillofac Radiol 2023; 52:20220284. [PMID: 36341993 PMCID: PMC9974233 DOI: 10.1259/dmfr.20220284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE This study aimed to identify robust radiomic features in multiultrasonography of the submandibular gland and normalize the interdevice discrepancies by applying a machine-learning-based harmonization method. METHODS Ultrasonographic images of normal submandibular gland of young healthy adults, aged between 20 and 40 years, were selected from two different devices. In a total of 30 images, the region of interest was determined along the border of gland parenchyma, and 103 radiomic features were extracted using A-VIEW. The coefficient of variation (CV) was obtained for individual features, and the features showing CV less than 10% were selected. For the selected features, the interdevice discrepancy was normalized using machine-learning method, called the ComBat harmonization. Median differences of the features between the two scanners, before and after harmonization, were compared using Mann-Whitney U-test; confidence interval of 95%. RESULTS Among total 103 radiomic features, 17 features were selected as robust, showing CV less than 10% in both scanners. All values of selected features, except two, showed a statistical difference between the two devices. After applying the ComBat harmonization method, the median and distribution of the 16 features were harmonized to show no significant difference between the two scanners (p > 0.05). One feature remained different (p ≤ 0.05). CONCLUSION On ultrasonographic examination, robust radiomic features for normal submandibular gland were obtained and interdevice normalization was efficiently conducted using ComBat harmonization. Our findings would be useful for multidevices or multicenter studies based on clinical ultrasonographic imaging data to improve the accuracy of the overall diagnostic model.
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Affiliation(s)
- Yoon Joo Choi
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, South Korea
| | - Kug Jin Jeon
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, South Korea
| | - Ari Lee
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, South Korea
| | - Sang-Sun Han
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, South Korea
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16
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Bravo FG. Commentary on: Age-Related Changes in the Submandibular Gland: An Imaging Study of Gland Ptosis Versus Volume. Aesthet Surg J 2022; 42:1236-1240. [PMID: 35724425 DOI: 10.1093/asj/sjac167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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17
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Jung JY, Yoon JK, Lee SJ, An YS. Sublingual Gland Observed on Salivary Gland Scan. Clin Nucl Med 2022; 47:876-877. [PMID: 35307724 DOI: 10.1097/rlu.0000000000004183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT The major salivary glands, namely, the parotid, submandibular, and sublingual glands, are important in maintaining oral cavity health. A salivary gland scan is used to evaluate the uptake and excretory function of the salivary glands. By intravenously injecting 99m TcO 4- , which is distributed like chloride ions in the body, the glands become visible on the salivary gland scan. The parotid and submandibular glands are typically appreciated on the salivary gland scan, but the sublingual gland is not. We present a rare image of a prominent sublingual gland on a salivary gland scan.
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Affiliation(s)
| | - Joon-Kee Yoon
- Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, South Korea
| | - Su Jin Lee
- Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, South Korea
| | - Young-Sil An
- Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, South Korea
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18
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Muntean D, Lenghel M, Ciurea A, Dudea S. Viscosity Plane-wave UltraSound (ViPLUS) in the assessment of parotid and submandibular glands in healthy subjects - preliminary results. Med Ultrason 2022; 24:300-304. [PMID: 35045136 DOI: 10.11152/mu-3397] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
AIMS Viscosity is an important mechanical property directly linked to the shear wave dispersion within tissues. The purpose of this study was to establish the normal viscosity value of the parotid gland (PG) and submandibular gland (SMG) in a group of healthy subjects, using the novel Viscosity Plane-wave UltraSound (ViPLUS) technique, and to assess its potential dependence on gender and age. MATERIAL AND METHODS The study group included a total of 49 healthy volunteers (median age 31, 65% females) prospectively examined between February 2021 and March 2021. The viscosity of both PG and SMG was measured using the new Aixplorer MACH 30 ultrasound system (SuperSonic Imagine, Aix-en-Provence, France) equipped with a curvilinear C6-1X transducer. The mean value of three valid measurements was considered (quantified in Pa.s). RESULTS The mean viscosity value for the PG was 2.13±0.23 Pa.s, significantly lower than the mean viscosity value of the SMG 2.44±0.35 Pa.s (p<0.0001). A negative low correlation between SMG viscosity and age was found (rho=-0.38, p=0.006). Viscosity values of the SMG were significantly lower in the age group between 35-77 years (2.12±0.35 Pa.s) than in the age groups 25-34 years (2.52±0.36 Pa.s), and 20-24 years (2.53±0.24 Pa.s), respectively (p<0.05). Viscosity values of both salivary glands did not differ significantly between gender groups. CONCLUSIONS Supersonic ViPLUS represents an innovative and useful non-invasive method to assess the viscosity of the parotid and submandibular glands. Age is a potential confounding factor in the evaluation of normal SMG viscosity.
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Affiliation(s)
- Delia Muntean
- Radiology Department, "Iuliu Hatieganu" University of Medicine and Pharmacy.
| | - Manuela Lenghel
- Radiology Department, "Iuliu Hatieganu" University of Medicine and Pharmacy.
| | - Anca Ciurea
- Radiology Department, "Iuliu Hatieganu" University of Medicine and Pharmacy.
| | - Sorin Dudea
- Radiology Department, "Iuliu Hatieganu" University of Medicine and Pharmacy.
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Abstract
INTRODUCTION Salivary glands lithiasis (Sialolithiasis) is defined as calcified concretions in the salivary glands. Most common localization is in submandibular gland. Usually, submandibular stones are mainly located in Wharton's duct, whereas parotid stones are more often located in the gland parenchyma. Sialoliths are usually 5-10 mm in size, and stones more than 10 mm are unusual sizes. Exact etiology of sialolith formation is still unknown. CASE REPORT We discuss a case of a 70-year-old patient, presenting painful swelling and a giant submandibular gland sialolith successfully treated with open surgery. CONCLUSIONS A careful anamnesis and physical examination of the patient are important in the diagnosis of sialolithiasis. In addition, several imaging techniques, such as panoramic X-rays and Ultrasound, can be applied. The management can be both medical and surgical.
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Affiliation(s)
- C Ungari
- Dipartimento di Scienze Odontostomatologiche e maxillo facciali, Roma, Italia
| | - A Cicconetti
- Dipartimento di Scienze Odontostomatologiche e maxillo facciali, Roma, Italia
| | - E Cerbelli
- Dipartimento di Scienze Odontostomatologiche e maxillo facciali, Roma, Italia
| | - A Sulpasso
- Dipartimento di Scienze Odontostomatologiche e maxillo facciali, Roma, Italia
| | - F Filiaci
- Dipartimento di Scienze Odontostomatologiche e maxillo facciali, Roma, Italia
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20
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Suto T, Kato H, Kawaguchi M, Matsuo M, Takiwaki M, Ogawa T. Reticular enhancement of the submandibular gland on contrast-enhanced magnetic resonance imaging in three cases with IgG4-related chronic sclerosing sialadenitis. Neuroradiol J 2022; 35:243-246. [PMID: 34293986 PMCID: PMC9130619 DOI: 10.1177/19714009211034475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The present case study reports contrast-enhanced magnetic resonance findings in three patients with histopathologically proven IgG4-related chronic sclerosing sialadenitis of the submandibular gland. All three patients presented with painless swelling of the submandibular region. The contrast-enhanced T1-weighted images showed reticular enhancement of the swollen submandibular gland. Radiological-pathological correlation revealed that the characteristic reticular enhancement corresponded to fibrosis and to inflammatory cell infiltration in the interlobular septa and in the periductal region of the submandibular gland.
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Affiliation(s)
- Taketo Suto
- Department of Radiology, Gifu University,
Japan
| | - Hiroki Kato
- Department of Radiology, Gifu University,
Japan
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21
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Wong TS, Gan RWC, Karsai L, Wong BYW. Nodular fasciitis of the submandibular gland. BMJ Case Rep 2022; 15:e245584. [PMID: 35365465 PMCID: PMC8977751 DOI: 10.1136/bcr-2021-245584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2022] [Indexed: 11/04/2022] Open
Abstract
A woman in her 20s presented with a non-tender swelling of the right submandibular gland. Ultrasound was suggestive of pleomorphic adenoma. The histology result of the excised tumour later confirmed a diagnosis of nodular fasciitis which is extremely rare in the submandibular gland. Postoperatively, she has made good recovery. Due to the similarity of the radiological image of pleomorphic adenoma and nodular fasciitis, it poses difficulty in diagnosing nodular fasciitis without cytology or histology of the salivary gland. Although being extremely rare, it would be worth to consider nodular fasciitis as one of the differential diagnosis in future cases of benign submandibular lesions.
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Affiliation(s)
- Ting Suen Wong
- Department of Otolaryngology Head & Neck Surgery, Hull University Teaching Hospitals NHS Trust, Hull, Kingston Upon Hull, UK
| | - Richard Wei Chern Gan
- Department of Otolaryngology Head & Neck Surgery, Hull University Teaching Hospitals NHS Trust, Hull, Kingston Upon Hull, UK
| | - Laszlo Karsai
- Department of Cellular Pathology, Hull University Teaching Hospitals NHS Trust, Hull, Kingston Upon Hull, UK
| | - Bun Yin Winson Wong
- Department of Otolaryngology Head & Neck Surgery, Hull University Teaching Hospitals NHS Trust, Hull, Kingston Upon Hull, UK
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22
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Luo WD, Jia YP, Gong J, Zhao Q. Unusual foreign body spontaneously discharged from the submandibular gland: A case report. J Clin Ultrasound 2022; 50:243-246. [PMID: 34287914 DOI: 10.1002/jcu.23045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/18/2021] [Accepted: 06/29/2021] [Indexed: 06/13/2023]
Abstract
Obstructive sialadenitis of the submandibular gland is most often caused by sialolithiasis and rarely by a foreign body. Here, we describe a patient with acute submandibular inflammation caused by a bamboo splinter. Transcutaneous and transoral ultrasound precisely located the splinter within Wharton's duct. Shortly thereafter, the bamboo splinter was spontaneously discharged while eating, which allowed complete remission of pain and swelling. Ultrasound confirmed the absence of the foreign body within Wharton's duct and relief of sialadenitis. Combined use of transcutaneous and transoral ultrasound can provide detailed information regarding the submandibular gland and foreign bodies, which enables proper treatment planning and adequate follow-up.
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Affiliation(s)
- Wei-Dong Luo
- Department of Ultrasound, West China School of Public Health and West China. Fourth Hospital, Sichuan University, Chengdu, China
| | - Yi-Ping Jia
- Department of Ultrasound, West China School of Public Health and West China. Fourth Hospital, Sichuan University, Chengdu, China
| | - Jian Gong
- Department of Ultrasound, West China School of Public Health and West China. Fourth Hospital, Sichuan University, Chengdu, China
| | - Qin Zhao
- Department of Ultrasound, West China School of Public Health and West China. Fourth Hospital, Sichuan University, Chengdu, China
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23
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Mahmoud R, Ianculovici C, Kleinman S, Peleg O. IgG4-related sialadenitis - a rare bilateral submandibular gland enlargement: case report. Oral Maxillofac Surg 2022; 26:673-677. [PMID: 35028774 DOI: 10.1007/s10006-021-01020-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 11/09/2021] [Indexed: 11/26/2022]
Abstract
Immunoglobulin G4-related disease (IgG4-RD) is a fibroinflammatory condition of unknown etiology. Although the salivary glands are currently considered among the most commonly affected among them, oral and maxillofacial surgeons are generally not familiar with the condition. Enlargement of the major salivary glands may be the first identifiable sign of IgG4-RD. A salivary gland biopsy along with IgG4 serum level assessment may help differentiate IgG4-related sialadenitis (IgG4-RS) from malignancies, infectious diseases, and obstructive conditions. Greater knowledge and higher levels of awareness of IgG4-RS may contribute to the expansion of differential diagnostic and treatment approaches. This case report describes a patient with bilateral submandibular salivary gland swelling who was diagnosed as having IgG4-RS on the basis of the histopathologic findings of a submandibular salivary gland biopsy and subsequent IgG4 levels.
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Affiliation(s)
- Reema Mahmoud
- Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, 6 Weizman Street, 6423906, Tel-Aviv, Israel.
| | - Clariel Ianculovici
- Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, 6 Weizman Street, 6423906, Tel-Aviv, Israel
| | - Shlomi Kleinman
- Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, 6 Weizman Street, 6423906, Tel-Aviv, Israel
| | - Oren Peleg
- Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, 6 Weizman Street, 6423906, Tel-Aviv, Israel
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24
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Pereira FG, Nogueira R, Pataca I, Sampaio R. Chronic sclerosing sialadenitis (Küttner's tumour) of the submandibular gland: a neoplastic mimic. BMJ Case Rep 2022; 15:e245518. [PMID: 35022201 PMCID: PMC8756289 DOI: 10.1136/bcr-2021-245518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2021] [Indexed: 11/03/2022] Open
Abstract
A 74-year-old man was referred for a plastic surgery consultation for two previous acute episodes of right submandibular sialadenitis. Physical examination revealed a lump in the right submandibular region, painful on palpation. The initial impression on clinical examination was of sialolithiasis. The sonography demonstrated a structural heterogeneity of the submandibular gland with a hypoechogenic and vascularised nodular formation (1.5×1.2 cm), suggestive of a mixed tumour of the right maxillary gland, requiring histological evaluation. He underwent a right submandibulectomy and an IgG4-positive chronic sclerosing sialadenitis was diagnosed. The patient's condition evolved favourably, resulting in a full recovery. The clinical features and differential diagnosis of this entity are debated in light of relevant literature.
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Affiliation(s)
- Filipa Galante Pereira
- Pathology Department, Western Lisbon Hospital Center EPE Hospital de Egas Moniz, Lisbon, Portugal
| | - Ruben Nogueira
- Plastic Surgery Department, Western Lisbon Hospital Center EPE Hospital de Egas Moniz, Lisbon, Portugal
| | - Iris Pataca
- Radiology Department, Western Lisbon Hospital Center EPE Hospital de Egas Moniz, Lisbon, Portugal
| | - Rita Sampaio
- Pathology Department, Western Lisbon Hospital Center EPE Hospital de Egas Moniz, Lisbon, Portugal
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25
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Longo C, De Robertis R, Valdo M, Montemezzi S. A case of acute bilateral iodine-induced submandibular sialadenitis: Ultrasound findings. J Clin Ultrasound 2022; 50:70-73. [PMID: 34324207 DOI: 10.1002/jcu.23049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 07/14/2021] [Accepted: 07/18/2021] [Indexed: 06/13/2023]
Abstract
Acute sialadenitis is a rare adverse reaction to iodine-based contrast agents. Ultrasound (US) is usually the preferred imaging method to evaluate the salivary glands; along with clinical and anamnestic data, US allows the diagnosis of contrast-induced sialadenitis. We present a case of acute bilateral submandibular sialadenitis induced by intravenous administration of iodine-based contrast media for a contrast-enhanced computed tomography scan diagnosed by US.
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Affiliation(s)
- Chiara Longo
- Department of Radiologyss, Ospedale G.B. Rossi-University of Verona, Verona, Italy
| | - Riccardo De Robertis
- Department of Radiology, Ospedale Civile Maggiore-Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Moreno Valdo
- Department of Radiology, Ospedale Civile Maggiore-Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Stefania Montemezzi
- Department of Radiology, Ospedale Civile Maggiore-Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
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Hočevar A, Bruyn GA, Terslev L, De Agustin JJ, MacCarter D, Chrysidis S, Collado P, Dejaco C, Fana V, Filippou G, Finzel S, Gandjbakhch F, Hanova P, Hammenfors D, Hernandez-Diaz C, Iagnocco A, Mortada MA, Inanc N, Naredo E, Ohrndorf S, Perko N, Schmidt WA, Tamborrini G, Tomšič M, Chary-Valckenaere I, Zabotti A, Keen HI, Pineda C, D'Agostino MA, Jousse-Joulin S. Development of a new ultrasound scoring system to evaluate glandular inflammation in Sjögren's syndrome: an OMERACT reliability exercise. Rheumatology (Oxford) 2021; 61:3341-3350. [PMID: 34849616 DOI: 10.1093/rheumatology/keab876] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 11/16/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The aim of this exercise from the OMERACT ultrasound subgroup on Sjögren's syndrome (pSS) was to develop and assess the reliability of a consensus-based semiquantitative colour Doppler (CD) ultrasound scoring system for pathologic salivary gland vascularization in patients with pSS. METHODS Using the Delphi method a CD semiquantitative scoring system for vascularization of bilateral parotid and submandibular glands was developed and tested in static images and on patients (9 pSS patients and 9 sonographers). Intra-reader and inter-reader reliability of grading the salivary glands were computed by weighted Cohen and Light's kappa (κ) analysis, respectively. RESULTS The consensus-based semiquantitative score was: Grade 0, no visible vascular signals; Grade 1, focal, dispersed vascular signals; Grade 2, diffuse vascular signals detected in < 50% of the gland; Grade 3, diffuse vascular signals in > 50% of the gland. In static images, the intra- and inter-reader reliability showed excellent κ values (95% confidence interval) = 0.90 (0.87-0.93) and 0.80 (0.74-0.84), respectively) for all four salivary glands together. In patients, the intra- and inter-reader reliability for all four salivary glands together was κ = 0.84 (0.73-0.92) and 0.70 (0.64-0.76), respectively. CONCLUSION The consensus-based CD ultrasound scoring for the evaluation of salivary gland vascularization in pSS showed a good inter-reader reliability and excellent intra-reader reliability in static images and in patients. The clinical application of the developed scoring system should be tested in clinical settings.
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Affiliation(s)
- Alojzija Hočevar
- Department of Rheumatology, University Medical Centre, Ljubljana, Slovenia
| | - George A Bruyn
- Department of Rheumatology, MC Groep Hospitals, Lelystad, The Netherlands
| | - Lene Terslev
- Centre for Rheumatology and Spinal Diseases, Rigshospitalet, Copenhagen, Denmark
| | - Juan Jose De Agustin
- Department of Rheumatology, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Daryl MacCarter
- Rheumatology Department, North Valley Hospital, Whitefish, MT, USA
| | - Stavros Chrysidis
- Department of Rheumatology, Hospital of Southwest Jutland, Esbjerg, Denmark
| | | | - Christian Dejaco
- Department of Rheumatology, Medical University Graz, Graz, Austria
| | - Viktoria Fana
- Department of Rheumatology, Hospital of Bruneck (ASAA-SABES)
| | - Georgios Filippou
- Section of Rheumatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Stephanie Finzel
- Department of Rheumatology and Clinical Immunology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Frederique Gandjbakhch
- Sorbonne Université
- Rheumatology Department, Pitié Salpêtrière Hospital, APHP, Paris, France
| | - Petra Hanova
- Institute of Rheumatology, Prague, Czech Republic
| | - Daniel Hammenfors
- Department of Rheumatology, Haukeland University Hospital, Bergen, Norway
| | - Cristina Hernandez-Diaz
- Musculoskeletal Ultrasound Laboratory, Instituto Nacional de Rehabilitacion, Mexico City, Mexico
| | - Annamaria Iagnocco
- Academic Rheumatology Centre, Università degli Studi di Torino, Turin, Italy
| | | | - Nevsun Inanc
- Division of Rheumatology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Esperanza Naredo
- Rheumatology Department, Joint and Bone Research Unit, Hospital Universitario Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
| | - Sarah Ohrndorf
- Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, Berlin, Germany
| | - Nejc Perko
- Faculty of Electrical Engineering, University of Ljubljana, Ljubljana, Slovenia
| | - Wolfgang A Schmidt
- Medical Centre for Rheumatology Berlin-Buch, Immanuel Krankenhaus Berlin, Berlin, Germany
| | | | - Matija Tomšič
- Department of Rheumatology, University Medical Centre, Ljubljana, Slovenia
| | | | - Alen Zabotti
- Department of Medical and Biological Sciences, Rheumatology Institute, University Hospital Santa Maria della Misericordia, Udine, Italy
| | - Helen I Keen
- Rheumatology Department, Royal Perth Hospital, Perth, WA, Australia
| | - Carlos Pineda
- Division of Musculoskeletal and Rheumatic Diseases, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, Mexico
| | - Maria-Antonietta D'Agostino
- Department of Rheumatology, Università Cattolica del Sacro Cuore, Policlinico Universitario Agostino Gemelli, Rome, Italy
- Paris Saclay University of Versailles Saint Quentin en Yvelines, UMRII73
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Min HK, Kim SH, Park Y, Lee KA, Kwok SK, Lee SH, Kim HR. Ultrasonographic characteristics of major salivary glands in anti-centromere antibody-positive primary Sjögren's syndrome. PLoS One 2021; 16:e0259519. [PMID: 34731207 PMCID: PMC8565722 DOI: 10.1371/journal.pone.0259519] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 10/20/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To investigate salivary gland ultrasonography (SGUS) findings in primary Sjögren’s syndrome (pSS) patients positive for the anti-centromere antibody (ACA) and compare these with those in ACA-negative pSS patients. Methods We analyzed demographic, clinical, laboratory, and SGUS data of pSS patients who fulfilled the 2002 American-European Consensus Group classification criteria for pSS. SGUS findings of four major salivary glands (bilateral parotid and submandibular glands) were scored in five categories and compared between ACA-positive and ACA-negative pSS patients. Linear regression analysis was performed to elucidate the factors associated with SGUS score. Results In total, 121 pSS patients were enrolled (19, ACA-positive). The ACA-positive patients were older (67.0 vs 58.0 years, P = 0.028), whereas anti-Ro/SSA and anti-La/SSB positivity was more prevalent in the ACA-negative group (89.2% vs 21.1%, P < 0.001, and 47.1% vs 10.5%, P = 0.007, respectively). The total SGUS and hypoechoic area scores were lower in ACA-positive patients (16.0 vs 23.0, P = 0.027, and 4.0 vs 7.0, P = 0.004, respectively). In univariate regression analysis, being positive for unstimulated salivary flow rate (USFR < 1.5 ml/15 min), anti-Ro/SSA, and rheumatoid factor were positively associated whereas ACA positivity was negatively associated with the SGUS score. In multivariate regression analysis, being positive for USFR, anti-Ro/SSA, and rheumatoid factor showed significant association with the SGUS score. Conclusions ACA-positive pSS patients showed a lower SGUS score than ACA-negative patients, which was especially prominent in the hypoechoic area component.
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Affiliation(s)
- Hong Ki Min
- Division of Rheumatology, Department of Internal Medicine, Konkuk University Medical Center, Seoul, Republic of Korea
| | - Se-Hee Kim
- Division of Rheumatology, Department of Internal Medicine, Konkuk University Medical Center, Seoul, Republic of Korea
| | - Youngjae Park
- Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyung-Ann Lee
- Division of Rheumatology, Department of Internal Medicine, Soonchunhyang University Seoul hospital, Seoul, Republic of Korea
| | - Seung-Ki Kwok
- Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sang-Heon Lee
- Division of Rheumatology, Department of Internal Medicine, Research Institute of Medical Science, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Hae-Rim Kim
- Division of Rheumatology, Department of Internal Medicine, Research Institute of Medical Science, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
- * E-mail:
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Wortsman X, Moll-Manzur C, Ramírez-Cornejo C, Alfaro-Sepúlveda D, Mellado-Francisco G, Rezende J, Vera-Kellet C. Ultrasonographic Subclinical Signs of Inflammation of the Lacrimal, Parotid, and Submandibular Glands in Users of Cosmetic Fillers. J Ultrasound Med 2021; 40:2377-2389. [PMID: 33417303 DOI: 10.1002/jum.15621] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 12/08/2020] [Accepted: 12/13/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES To detect ultrasonographic inflammatory signs in the lacrimal, parotid, and submandibular glands in cosmetic fillers (CFs) users. METHODS A prospective and cross-sectional ultrasound study of the glands in cases with CFs was performed. The sample included users of hyaluronic acid, silicone oil, polymethylmethacrylate, polycaprolactone, calcium hydroxyapatite, and polyacrylamide. Abnormalities of the parenchyma and hypervascularity signs of the glands were compared with a control group (n = 10), evaluated by 2 observers, and correlated with the type, number, and location of the facial CFs. Cohen's kappa test and logistic regression models with odds ratios (OR) adjusted by age with 95% CI were performed. RESULTS Sixty-three patients with CFs met the criteria. Parotid and submandibular glands had the highest percentage of parenchymal involvement: 87.3 and 88.9%, respectively (p <.01). Abnormalities of the echostructure of the parenchyma and hypervascularity of the glands were detected with all kinds of fillers without significant differences per type. A significant substantial interrater kappa (0.61) with an agreement of 90% for all glands among observers was found. CONCLUSION Users of common types of CFs frequently present subclinical ultrasonographic signs of inflammation of the lacrimal, parotid, and submandibular glands. Further research on the topic seems necessary.
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Affiliation(s)
- Ximena Wortsman
- Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Santiago, Chile
- Department of Dermatology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Catherina Moll-Manzur
- Department of Dermatology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Cristian Ramírez-Cornejo
- Department of Dermatology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | | | - Juliana Rezende
- Department of Radiology, Fernandes Figueira Institute, Niteroi Hospital, Rio de Janeiro, Brazil
| | - Cristian Vera-Kellet
- Department of Dermatology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Connective Tissue Diseases Unit, Department of Dermatology, Pontificia Universidad Católica de Chile, Santiago, Chile
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Saniasiaya J. Unilaterally raised floor of mouth. Emerg Med J 2021; 38:764-783. [PMID: 34544684 DOI: 10.1136/emermed-2020-210434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2020] [Indexed: 11/04/2022]
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McGreal-Bellone A, Lapthorne S, Sadlier C, Moloney G. Suspected IgG4-related disease of the submandibular salivary gland and periorbital soft tissue in a man with latent tuberculosis. BMJ Case Rep 2021; 14:e242415. [PMID: 34429286 PMCID: PMC8386220 DOI: 10.1136/bcr-2021-242415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2021] [Indexed: 11/03/2022] Open
Abstract
A 77-year-old Lithuanian man presented to our institution with recurrent episodes of periorbital cellulitis, submandibular swelling and sialadenitis. Investigations revealed a positive QuantiFERON, raised inflammatory markers and normal autoimmune screen. Cross-sectional imaging showed no signs of occult malignancy, and work-up for mycobacterial infection including imaging and bronchoalveolar lavage did not show active tuberculosis. During hospitalisation, the patient developed fevers of unknown origin, which were investigated with a positron emission tomography (PET) scan and a bone marrow aspiration, without evidence of occult infection or malignancy. Serum IgG4 level was three times the upper limit of normal. The patient responded well to oral steroids but relapsed after completing a slow taper. Serum IgG4 level was three times the upper limit of normal. He had an American College of Rheumatology/European League Against Rheumatism score of 20, in conjunction with involvement of orbital and salivary tissue. Therefore, IgG4-related disease was considered the most likely diagnosis, despite prominent fevers, which are among the exclusion criteria for this diagnosis. After a multidisciplinary review including rheumatology and ophthalmology, the patient was commenced on maintenance methotrexate with remission of symptoms.
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Affiliation(s)
| | - Susan Lapthorne
- Department of Infectious Diseases, Cork University Hospital Group, Cork, Ireland
| | - Corinna Sadlier
- Department of Infectious Diseases, Cork University Hospital Group, Cork, Ireland
| | - Geraldine Moloney
- Department of Infectious Diseases, Cork University Hospital Group, Cork, Ireland
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Rajan S, Singh AK, Qayoom S, Niranjan P, Chakrabarti D. Polymorphous adenocarcinoma of the submandibular gland. BMJ Case Rep 2021; 14:e244218. [PMID: 34429294 PMCID: PMC8386208 DOI: 10.1136/bcr-2021-244218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2021] [Indexed: 11/04/2022] Open
Abstract
Polymorphous adenocarcinoma (PA) of the salivary glands is a rare malignancy that predominantly affects the minor salivary glands of the palate. Major salivary gland involvement is rare (<5%). The submandibular gland is a highly unusual location for this tumour. Recently, the WHO has updated the classification of salivary gland tumours in which the PA subtype has been modified. We report a very uncommon case of a classical variant of PA involving the submandibular gland in a 49-year-old woman managed at our institute and discuss the most recent pathological criteria for diagnosis, management strategy and prognosis of PA.
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Affiliation(s)
- Shiv Rajan
- Surgical Oncology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Ajay Kumar Singh
- Pathology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sumaira Qayoom
- Pathology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Palavalasa Niranjan
- Surgical Oncology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Deep Chakrabarti
- Radiation Oncology, King George's Medical University, Lucknow, Uttar Pradesh, India
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Sawan T, Tower JI, Gordon NA, Paskhover B. The Submandibular Gland and The Aging Neck: A Longitudinal Volumetric Study. Aesthetic Plast Surg 2021; 45:987-991. [PMID: 33079222 DOI: 10.1007/s00266-020-02009-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 10/04/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The true effect of aging and other patient factors on submandibular gland (SMG) volume is unclear. We sought to evaluate the effects of age, body mass index (BMI), sex and race on SMG volume using computed tomography (CT) imaging. METHODS We conducted a retrospective longitudinal study of adult subjects with multiple CT images of the neck at least 7 years apart. Subjects with history of salivary gland pathology, neck dissection, head and neck radiation, active infection or dental artifact were excluded. Three-dimensional volumes were measured. Age, BMI, sex and race data were analyzed to track their longitudinal effect on SMG volume. RESULTS The study comprised 64 patients (Females n=36; Males n=28) with mean age of 47.1 and 58.5 at each respective time point (mean difference 11.4). Mean SMG volume increased from 10.1 ml to 10.5 ml (P < 0.05). Males had significantly greater SMG volume compared to females. Majority of growth occurred in the < 40 year age bracket (0.1 ml/year), more significantly in the male cohort. When controlling for aging and sex, a change in BMI was the only patient factor that predicted a change in SMG volume. An increase of 1.0 kg/m2 predicted a 0.17 ml increase in gland volume. Race had no significant effect. CONCLUSION Our findings suggest that the majority of SMG volume change occurs in early adulthood ( < 40 years), especially in males. Among the factors we studied, a change in BMI was the only significant predictor of SMG volume change. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266 . Genital Surgery.
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Affiliation(s)
- Tareq Sawan
- Department of Surgery, Division of Otolaryngology, Yale School of Medicine, ENT Office, 47 College St, New Haven, CT, USA.
| | - Jacob I Tower
- Department of Surgery, Division of Otolaryngology, Yale School of Medicine, ENT Office, 47 College St, New Haven, CT, USA
| | - Neil A Gordon
- Department of Surgery, Division of Otolaryngology, Yale School of Medicine, ENT Office, 47 College St, New Haven, CT, USA
| | - Boris Paskhover
- Department of Otolaryngology - Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
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王 怡, 蔡 志, 彭 歆, 张 杰, 孙 志, 李 巍, 张 雷, 俞 光. [Measurement of the weight and volume of submandibular gland in vitro]. Beijing Da Xue Xue Bao Yi Xue Ban 2020; 53:126-132. [PMID: 33550346 PMCID: PMC7867988 DOI: 10.19723/j.issn.1671-167x.2021.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To measure the weight and volume of normal submandibular gland by in vitro detection of glandular body, to compare with the measurement values of CT volume rendering to evaluate the consistency of the two methods, and to explore the related factors affecting the weight and volume of the submandibular gland. METHODS The patients who underwent neck dissection due to oral cancer and were confirmed with normal submandibular gland by postoperative histopathology in Peking University School and Hospital of Stomatology from May 2019 to January 2020 were collected in this study and divi-ded into 4 groups according to the age standards raised by the Society of Geriatrics Chinese Medical Association and WHO (2000) age standards. The submandibular gland was carefully dissected along with the capsule immediately after neck dissection. The weight and volume of submandibular gland were accurately measured by an integrated aseptic measuring device. The volume of submandibular gland was measured by CT volume rendering before operation and the consistency of the two methods was evaluated. The 95% confidence interval of the weight and volume of submandibular gland in the different groups of Chinese people, which were divided by gender and age, were calculated, and the correlation with age, gender, height, weight, body mass index (BMI) and other factors was analyzed. RESULTS The weight and vo-lume of submandibular gland were measured in 220 subjects. The average weight and volume of submandibular gland were (11.69±2.45) g and (11.55±2.41) cm3 respectively. The volume of submandibular gland measured by CT volume rendering ranged from 70% to 82% of that measured by in vitro detection of glandular body, and the correlation coefficient between the two methods was 0.976 (P < 0.05). The gender difference of weight and volume of submandibular gland existed in the groups of youth, middle-aged, young elderly and elderly groups, the values of males were obviously higher than those of females (P < 0.05). There was no gender difference of weight and volume of submandibular gland in the adolescent group (P > 0.05). The weight and volume of submandibular gland had a strong positive correlation with body height (P < 0.05), a weak positive correlation with body weight (P < 0.05), and no correlation with BMI (P > 0.05). The female's weight and volume of submandibular gland in the young elderly and elderly groups were significantly lower than those in the other three groups (P < 0.05). CONCLUSION The normal reference range of the weight and volume of submandibular gland in vitro were established in different age and gender groups of Chinese people. The volume of submandibular gland mea-sured by CT volume rendering was 70%-82% of that measured by in vitro detection of glandular body. The results of the two methods had a high degree of consistency. The weight and volume of submandibular gland were related to age, gender, body height and body weight.
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Affiliation(s)
- 怡平 王
- 北京大学口腔医学院·口腔医院,颌面外科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 志刚 蔡
- 北京大学口腔医学院·口腔医院,颌面外科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 歆 彭
- 北京大学口腔医学院·口腔医院,颌面外科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 杰 张
- 北京大学口腔医学院·口腔医院,颌面外科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 志鹏 孙
- 北京大学口腔医学院·口腔医院,放射科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Oral Radiology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 巍 李
- 北京大学口腔医学院·口腔医院,颌面外科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 雷 张
- 北京大学口腔医学院·口腔医院,颌面外科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 光岩 俞
- 北京大学口腔医学院·口腔医院,颌面外科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
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王 怡, 蔡 志, 彭 歆, 张 杰, 孙 志, 李 巍, 张 雷, 俞 光. [Measurement of the weight and volume of submandibular gland in vitro]. Beijing Da Xue Xue Bao Yi Xue Ban 2020; 53:126-132. [PMID: 33550346 PMCID: PMC7867988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Indexed: 11/11/2023]
Abstract
OBJECTIVE To measure the weight and volume of normal submandibular gland by in vitro detection of glandular body, to compare with the measurement values of CT volume rendering to evaluate the consistency of the two methods, and to explore the related factors affecting the weight and volume of the submandibular gland. METHODS The patients who underwent neck dissection due to oral cancer and were confirmed with normal submandibular gland by postoperative histopathology in Peking University School and Hospital of Stomatology from May 2019 to January 2020 were collected in this study and divi-ded into 4 groups according to the age standards raised by the Society of Geriatrics Chinese Medical Association and WHO (2000) age standards. The submandibular gland was carefully dissected along with the capsule immediately after neck dissection. The weight and volume of submandibular gland were accurately measured by an integrated aseptic measuring device. The volume of submandibular gland was measured by CT volume rendering before operation and the consistency of the two methods was evaluated. The 95% confidence interval of the weight and volume of submandibular gland in the different groups of Chinese people, which were divided by gender and age, were calculated, and the correlation with age, gender, height, weight, body mass index (BMI) and other factors was analyzed. RESULTS The weight and vo-lume of submandibular gland were measured in 220 subjects. The average weight and volume of submandibular gland were (11.69±2.45) g and (11.55±2.41) cm3 respectively. The volume of submandibular gland measured by CT volume rendering ranged from 70% to 82% of that measured by in vitro detection of glandular body, and the correlation coefficient between the two methods was 0.976 (P < 0.05). The gender difference of weight and volume of submandibular gland existed in the groups of youth, middle-aged, young elderly and elderly groups, the values of males were obviously higher than those of females (P < 0.05). There was no gender difference of weight and volume of submandibular gland in the adolescent group (P > 0.05). The weight and volume of submandibular gland had a strong positive correlation with body height (P < 0.05), a weak positive correlation with body weight (P < 0.05), and no correlation with BMI (P > 0.05). The female's weight and volume of submandibular gland in the young elderly and elderly groups were significantly lower than those in the other three groups (P < 0.05). CONCLUSION The normal reference range of the weight and volume of submandibular gland in vitro were established in different age and gender groups of Chinese people. The volume of submandibular gland mea-sured by CT volume rendering was 70%-82% of that measured by in vitro detection of glandular body. The results of the two methods had a high degree of consistency. The weight and volume of submandibular gland were related to age, gender, body height and body weight.
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Affiliation(s)
- 怡平 王
- 北京大学口腔医学院·口腔医院,颌面外科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 志刚 蔡
- 北京大学口腔医学院·口腔医院,颌面外科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 歆 彭
- 北京大学口腔医学院·口腔医院,颌面外科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 杰 张
- 北京大学口腔医学院·口腔医院,颌面外科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 志鹏 孙
- 北京大学口腔医学院·口腔医院,放射科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Oral Radiology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 巍 李
- 北京大学口腔医学院·口腔医院,颌面外科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 雷 张
- 北京大学口腔医学院·口腔医院,颌面外科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - 光岩 俞
- 北京大学口腔医学院·口腔医院,颌面外科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
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Horvath E, Skoknic V, Majlis S, Tala H, Silva C, Castillo E, Whittle C, Niedmann JP, González P. Radioiodine-Induced Salivary Gland Damage Detected by Ultrasonography in Patients Treated for Papillary Thyroid Cancer: Radioactive Iodine Activity and Risk. Thyroid 2020; 30:1646-1655. [PMID: 32370663 DOI: 10.1089/thy.2019.0563] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: An important side effect of radioactive iodine (RAI) therapy in patients treated for papillary thyroid cancer (PTC) is chronic sialadenitis. Neck ultrasonography (US) easily recognizes radioiodine-induced salivary gland abnormalities. The objectives of this study were to determine the prevalence of US-detected sialadenitis caused by RAI and to identify the risk factors associated with this damage. Methods: This nonconcurrent cohort study includes all PTC-operated patients who were treated with RAI between 2007 and 2017 and were systematically evaluated with preoperative and follow-up neck US that included targeted exploration of the major salivary glands. Patients with pre-existing salivary gland diseases were excluded. The anatomical damage (diminished glandular volume, wavy contours, hypoechogenicity, and heterogeneity) was qualitatively assessed and compared with the preoperative study. RAI activity, sex, age, and preparation method were evaluated as risk factors using univariate and multivariate analyses with logistic regression. Results: Enrolled in this study were 570 patients who received a median RAI activity of 3700 MBq (100 mCi). On US, we found 143 patients (25.1%) with damage in at least one of their salivary glands: all had parotid damage (77 bilaterally) and 14 (9.8%) also had submandibular gland damage (7 of them bilaterally). The multivariate analysis indicated that the risk of sialadenitis was significantly (p < 0.01) correlated with both RAI activity and sex (14.1% of males vs. 28.5% of females). However, the main risk factor was RAI activity; no injury was detected in 156 patients who received 1110 MBq (30 mCi) and 1850 MBq (50 mCi) of RAI. In the groups of patients receiving 3700 MBq (100 mCi), 5550 MBq (150 mCi) and ≥7400 MBq (≥200 mCi), atrophy was found in 21%, 46.9%, and 77.7% of patients, respectively. Age and preparation method were not related to an increased risk of atrophy in this study. Conclusions: Chronic sialadenitis is common and affects approximately one fourth of patients who receive 3700 MBq (100 mCi) or higher RAI activity. The main risk factor for this injury is the total RAI activity administered. By using the lowest effective activity possible, irreversible anatomical damage in salivary glands can be minimized. US is an excellent tool to diagnose post-RAI atrophy.
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Affiliation(s)
- Eleonora Horvath
- Department of Radiology, Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile
| | - Velimir Skoknic
- Department of Radiology, Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile
| | - Sergio Majlis
- Department of Endocrinology, Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile
| | - Hernán Tala
- Department of Endocrinology, Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile
| | - Claudio Silva
- Department of Radiology, Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile
| | - Eliette Castillo
- Department of Radiology, Hospital Militar, Escuela Dr. Alejandro Dávila Bolaños, Managua, Nicaragua
| | - Carolina Whittle
- Department of Radiology, Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile
| | - Juan Pablo Niedmann
- Department of Radiology, Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile
| | - Paulina González
- Department of Radiology, Clínica Alemana de Santiago, Universidad del Desarrollo, Santiago, Chile
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Diekhoff T, Fischer T, Schefer Q, Posch MG, Dörner T, Laurent D, Li Y, Wagner FD, Oliver SJ. Ianalumab (VAY736) in primary Sjögren's syndrome: assessing disease activity using multi-modal ultrasound. Clin Exp Rheumatol 2020; 38 Suppl 126:228-236. [PMID: 33095139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 09/23/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES To apply serial ultrasound (US) assessments to show effects of ianalumab (anti-BAFF-R monoclonal antibody) on inflamed salivary glands of patients with primary Sjögren's syndrome (pSS). METHODS In a single-centre, 24-week double-blind study (NCT02149420), 27 pSS patients of moderate-to-severe activity were randomly assigned to receive a single i.v. dose of either 3 mg/kg or 10 mg/kg ianalumab, or placebo. Concurrent with clinical and laboratory outcomes, multi-modal US images were acquired of bilateral parotid glands (PG) and submandibular glands (SMG) at weeks 0, 6, 12, and 24. Applied US modalities included 1) B-mode echostructure scored by de Vita classification, 2) macrovascular blood flow by power Doppler, and in PG only 3) microvascularisation using contrast-enhanced US (area under the curve, time to peak or TTP) and 4) gland stiffness by sonoelastography. RESULTS Clinical study results were previously published. US data for PG differed from SMG but were comparable between respective left and right sides of these glands. Numerical improvements in salivary gland quality and declining tissue inflammation were observed in treated versus placebo groups, including more patients achieving ≥1-point reduction from baseline in De Vita score, together with trends towards decreased perfusion and stiffness. Correlations between clinical endpoints and US parameters were largely restricted to microvascular perfusion TTP and at the 12-week timepoint when ianalumab effects were predicted at maximal. CONCLUSIONS Early in vivo signs of salivary gland improvement in response to an effective intervention can be shown without need of biopsy by using a non-invasive, comprehensive, ultrasound-based approach over multiple time points.
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Affiliation(s)
- Torsten Diekhoff
- Institute for Radiology, Charité University Hospital, Berlin, Germany
| | - Thomas Fischer
- Institute for Radiology, Charité University Hospital, Berlin, Germany
| | | | | | - Thomas Dörner
- Department of Medicine/Rheumatology and Clinical Immunology, Charité University Hospital, Berlin, Germany
| | | | - Yue Li
- Novartis Pharma AG, Basel, Switzerland
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Kise Y, Shimizu M, Ikeda H, Fujii T, Kuwada C, Nishiyama M, Funakoshi T, Ariji Y, Fujita H, Katsumata A, Yoshiura K, Ariji E. Usefulness of a deep learning system for diagnosing Sjögren's syndrome using ultrasonography images. Dentomaxillofac Radiol 2020; 49:20190348. [PMID: 31804146 PMCID: PMC7068075 DOI: 10.1259/dmfr.20190348] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 11/28/2019] [Accepted: 11/29/2019] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES We evaluated the diagnostic performance of a deep learning system for the detection of Sjögren's syndrome (SjS) in ultrasonography (US) images, and compared it with the performance of inexperienced radiologists. METHODS 100 patients with a confirmed diagnosis of SjS according to both the Japanese criteria and American-European Consensus Group criteria and 100 non-SjS patients that had a dry mouth and suspected SjS but were definitively diagnosed as non-SjS were enrolled in this study. All the patients underwent US scans of both the parotid glands (PG) and submandibular glands (SMG). The training group consisted of 80 SjS patients and 80 non-SjS patients, whereas the test group consisted of 20 SjS patients and 20 non-SjS patients for deep learning analysis. The performance of the deep learning system for diagnosing SjS from the US images was compared with the diagnoses made by three inexperienced radiologists. RESULTS The accuracy, sensitivity and specificity of the deep learning system for the PG were 89.5, 90.0 and 89.0%, respectively, and those for the inexperienced radiologists were 76.7, 67.0 and 86.3%, respectively. The deep learning system results for the SMG were 84.0, 81.0 and 87.0%, respectively, and those for the inexperienced radiologists were 72.0, 78.0 and 66.0%, respectively. The AUC for the inexperienced radiologists was significantly different from that of the deep learning system. CONCLUSIONS The deep learning system had a high diagnostic ability for SjS. This suggests that deep learning could be used for diagnostic support when interpreting US images.
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Affiliation(s)
- Yoshitaka Kise
- Department of Oral and Maxillofacial Radiology, Aichi Gakuin University, Nagoya, Japan
| | - Mayumi Shimizu
- Department of Oral and Maxillofacial Radiology, Kyushu University Hospital, Fukuoka, Japan
| | - Haruka Ikeda
- Department of Oral and Maxillofacial Radiology, Aichi Gakuin University, Nagoya, Japan
| | - Takeshi Fujii
- Department of Oral and Maxillofacial Radiology, Aichi Gakuin University, Nagoya, Japan
| | - Chiaki Kuwada
- Department of Oral and Maxillofacial Radiology, Aichi Gakuin University, Nagoya, Japan
| | - Masako Nishiyama
- Department of Oral and Maxillofacial Radiology, Aichi Gakuin University, Nagoya, Japan
| | - Takuma Funakoshi
- Department of Oral and Maxillofacial Radiology, Aichi Gakuin University, Nagoya, Japan
| | - Yoshiko Ariji
- Department of Oral and Maxillofacial Radiology, Aichi Gakuin University, Nagoya, Japan
| | - Hiroshi Fujita
- Department of Electrical, Electronic and Computer Faculty of Engineering, Gifu University, Gifu, Japan
| | - Akitoshi Katsumata
- Department of Oral Radiology, Asahi University School of Dentistry, Mizuho, Japan
| | - Kazunori Yoshiura
- Department of Oral and Maxillofacial Radiology, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Eiichiro Ariji
- Department of Oral and Maxillofacial Radiology, Aichi Gakuin University, Nagoya, Japan
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Silva JL, Faria DS, Neves JS, Cerqueira M, Peixoto D, Teixeira F. Salivary gland ultrasound findings are associated with clinical and serologic features in primary Sjögren's syndrome patients. Acta Reumatol Port 2020; 45:76-77. [PMID: 32608383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Salivary gland ultrasound (SGUS) has been applied in the diagnosis of primary Sjögren's syndrome (pSS). To investigate the association of SGUS findings with clinical and analytical features of pSS patients. MATERIAL AND METHODS 54 pSS patients underwent SGUS evaluation. The parenchymal homogeneity of bilateral parotid and submandibular glands was graded using a score of 0 (normal) to 4 (gross inhomogeneity). Patients were classified into two groups according to the highest SGUS score obtained. The grades 1 and 2 were considered to be normal and grades 3 and 4 to represent pathological SGUS findings. Demographic, clinical and laboratorial data were collected and compared between the groups. RESULTS Nineteen of 54 patients had pathological SGUS findings. These were associated with higher ESSDAI and positivity for rheumatoid factor and anti-SSB antibody. Anti-SSB antibody was strongly and independently associated with pathological US findings in the salivary gland of pSS patients. CONCLUSION This study provides further evidence that salivary gland ultrasound is linked to clinical and autoimmunity profile in pSS and confirm what has been reported in the literature. SGUS represents a useful imaging tool for diagnostic and prognostic of pSS.
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Chu C, Feng Q, Zhang H, Zhao S, Chen W, He J, Sun L, Zhou Z. Evaluation of salivary gland fat fraction values in patients with primary Sjögren's syndrome by mDIXON quant imaging: Initial findings. Eur J Radiol 2019; 123:108776. [PMID: 31864144 DOI: 10.1016/j.ejrad.2019.108776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 11/06/2019] [Accepted: 12/01/2019] [Indexed: 11/19/2022]
Abstract
PURPOSE To explore the role of salivary fat fraction (FF) values in evaluating patients with primary Sjögren's syndrome (pSS). MATERIAL AND METHOD A total of 28 patients with pSS, ten patients with suspected pSS, and 28 volunteers were enrolled. The FF values of the parotid and submandibular glands were generated from mDIXON Quant. A one-way analysis of variance was used to compare the FF values among the groups. A receiver-operating characteristic analysis was applied to assess the diagnostic performance of the parotid and submandibular FF values in distinguishing patients with pSS from non-pSS subjects. In particular, we focused on distinguishing patients with grade 0 pSS from those with suspected pSS. RESULTS The parotid and submandibular mean FF value of patients with pSS was significantly higher than that of healthy volunteers. The submandibular mean FF value of patients with pSS was higher than those suspected ones. Submandibular FF value performed better than parotid FF value in differentiating patients with pSS from those non-pSS subjects (area under the curve [AUC] = 0.927 vs. 0.734), patients with pSS from patients with suspected pSS (AUC = 0.907 vs. 0.725). This value also performed better at distinguishing patients with grade 0 pSS from those patients with suspected pSS (AUC = 0.925 vs. 0.783). CONCLUSIONS The salivary gland FF value, especially the submandibular gland FF value, distinguished patients with pSS from those patients with suspected pSS and healthy volunteers.
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Affiliation(s)
- Chen Chu
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.
| | - Qianqian Feng
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.
| | - Huayong Zhang
- Department of Rheumatology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.
| | - Shengnan Zhao
- Department of Rheumatology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.
| | - Weibo Chen
- Philips Healthcare, Shanghai, 200233, China.
| | - Jian He
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.
| | - Lingyun Sun
- Department of Rheumatology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.
| | - Zhengyang Zhou
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.
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Jiang L, Hu C, Chen L, Chen L. Diagnosis of solitary fibrous tumor in the submandibular gland: Case report and literature review. J Clin Ultrasound 2019; 47:486-489. [PMID: 31364769 DOI: 10.1002/jcu.22760] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 07/03/2019] [Accepted: 07/09/2019] [Indexed: 06/10/2023]
Abstract
Solitary fibrous tumors (SFTs) rarely occur in the head and neck area. Imaging findings are nonspecific, and immunohistochemical (IHC) analysis is necessary for a definitive diagnosis. We report the case of a patient with a mass in the submandibular region that was initially diagnosed as basal cell adenoma. After excision and IHC examinations, a SFT was diagnosed.
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Affiliation(s)
- Liping Jiang
- Department of Ultrasonography, First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Cai Hu
- Department of Ultrasonography, First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Li Chen
- Department of Ultrasonography, First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Lu Chen
- Department of Ultrasonography, First Affiliated Hospital of Nanchang University, Nanchang, China
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Abstract
We report a 54-year-old man, who presented with an acute onset of diplopia and ptosis on the left side. On admission, neurological examination showed left oculomotor and abducens nerve palsy. Brain MRI showed thickening of the left parieto-temporal dura mater with gadolinium enhancement. Whole-body CT revealed a mass lesion in the right submandibular gland, diffuse goiter, and bilateral hilar lymph node enlargement. Initially, IgG4-related disease was considered because of an elevated serum IgG4 level (240 mg/dl); however, biopsy of the submandibular gland showed non-caseating epithelioid cell granulomas that suggested sarcoidosis, which could be associated with the intracranial lesions causing his neurological manifestation. In cases of hypertrophic pachymeningitis, especially with increased serum IgG4 including our case, a careful assessment with pathological examination is critical for identifying various underlying conditions.
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Affiliation(s)
- Yuzo Fujino
- Department of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Kozo Saito
- Department of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Keiko Maezono
- Department of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Takashi Kasai
- Department of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
| | - Toshiki Mizuno
- Department of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine
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Inanc N, Şahinkaya Y, Mumcu G, Türe Özdemir F, Paksoy A, Ertürk Z, Direskeneli H, Bruyn GA. Evaluation of salivary gland ultrasonography in primary Sjögren's syndrome: does it reflect clinical activity and outcome of the disease? Clin Exp Rheumatol 2019; 37 Suppl 118:140-145. [PMID: 31287407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 04/29/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVES To evaluate associations between salivary gland ultrasonography (SGUS) and clinical characteristics, disease activity and outcome in patients with primary Sjögren's syndrome (pSS). METHODS The parotid and submandibular salivary glands were examined by ultrasonography using two different scoring systems proposed by Hocevar et al. and Milic et al. on 85 pSS patients. Patients with inhomogeneity/hypoechoic areas with scores ≥2 in parotid and submandibular glands were classified as severe parotid or severe submandibular involvements, respectively. Disease activity and patient-reported severity were evaluated using the European League Against Rheumatism Sjögren's Disease Activity Index (ESSDAI) and the European League Against Rheumatism Sjögren's Patient Reported Index (ESSPRI). Salivary gland functional capacity was investigated by unstimulated whole saliva flow rate (U-WSFR). RESULTS Of the activity scores, ESSPRI dryness component was higher in pSS patients who had scores above the cut-off values for Hocevar (6.1±2.3 vs. 4.9±2.6, p=0.026). The patients with any type of systemic involvement more frequently showed higher SGUS scores, according to both Hocevar (72.4 vs. 44.6%, p=0.013) and Milic (75.9 vs. 51.8%, p=0.026). These patients also showed a higher percentage of severe parotid/submandibular changes on US imaging (65.5 vs. 33.9%, p=0.005 and 75.9 vs. 51.8%, p=0.026 respectively). Higher SGUS scores according to cut-off values of both scoring systems and severe parotid/submandibular involvements were associated with both anti-Ro or double anti-Ro/La autoantibodies and inversely associated with U-WSFR. CONCLUSIONS SGUS may be a useful imaging modality for the selection of patients with more severe disease status or who may require a tight follow-up schedule.
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Affiliation(s)
- Nevsun Inanc
- Division of Rheumatology, Marmara University, School of Medicine, Istanbul, Turkey.
| | - Yasemin Şahinkaya
- Division of Rheumatology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Gonca Mumcu
- Department of Health Management, Marmara University Faculty of Health Sciences, Istanbul, Turkey
| | - Filiz Türe Özdemir
- Division of Immunology, Marmara University, School of Medicine, Istanbul, Turkey
| | | | - Zeynep Ertürk
- Division of Rheumatology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Haner Direskeneli
- Division of Rheumatology, Marmara University, School of Medicine, Istanbul, Turkey
| | - George A Bruyn
- Department of Rheumatology, MC Groep Hospitals, Leystad, The Netherlands
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Zabotti A, Zandonella Callegher S, Gandolfo S, Valent F, Giovannini I, Cavallaro E, Lorenzon M, De Vita S. Hyperechoic bands detected by salivary gland ultrasonography are related to salivary impairment in established Sjögren's syndrome. Clin Exp Rheumatol 2019; 37 Suppl 118:146-152. [PMID: 31365337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 07/02/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES In primary Sjögren's syndrome (pSS) dryness of eye and mouth is the cardinal referred symptom. Assessing the rate of activity and damage in the salivary glands of pSS patients is essential to improve disease management. Up to now, a differentiation of activity and damage ultrasonographic (US) lesions is an open issue. The aim of this preliminary study was to identify US lesions which better correlate with loss of function of salivary glands in pSS. METHODS Salivary glands ultrasonography of consecutive patients with established pSS, fulfilling AECG and ACR/EULAR criteria was performed. The association between sialometry and Visual Analogue Scale (VAS) oral dryness and SGUS lesions was assessed trough univariate and multivariate analysis. RESULTS In 75 established pSS patients, mean disease duration 12.4±7.2 years, the hyperechoic bands of parotid gland (PG) and submandibular gland (SMG) were significantly associated with sialometry (p<0.001) and VAS oral dryness (PG p=0.002, SMG p<0.001). The global glandular involvement (scored according to De Vita et al., 1992) was associated with sialometry (PG p=0.025, SMG p<0.001) and with VAS oral sicca (PG p=0.015, SMG p<0.001). The multivariate analysis selected the hyperechoic bands of PG and SMG as the variables independently associated with sialometry and the hyperechoic bands and the homogeneity in the SMG as associated with VAS oral dryness. CONCLUSIONS These results indicate that salivary impairment in pSS, as objectively evaluated by sialometry, could be mainly associated with damage (i.e., hyperechoic bands) in established pSS. Additional follow-up studies and improved scoring tools are needed.
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Affiliation(s)
- Alen Zabotti
- Rheumatology Clinic, Department of Medical Area, Azienda Sanitaria Universitaria Integrata di Udine, Italy
| | - Sara Zandonella Callegher
- Rheumatology Clinic, Department of Medical Area, Azienda Sanitaria Universitaria Integrata di Udine, Italy
| | - Saviana Gandolfo
- Rheumatology Clinic, Department of Medical Area, Azienda Sanitaria Universitaria Integrata di Udine, Italy
| | - Francesca Valent
- Institute of Hygiene and Clinical Epidemiology, Azienda Sanitaria Universitaria Integrata di Udine, Italy
| | - Ivan Giovannini
- Rheumatology Clinic, Department of Medical Area, Azienda Sanitaria Universitaria Integrata di Udine, Italy
| | - Elena Cavallaro
- Rheumatology Clinic, Department of Medical Area, Azienda Sanitaria Universitaria Integrata di Udine, Italy
| | - Michele Lorenzon
- Institute of Radiology, Department of Medical Area, Azienda Sanitaria Universitaria Integrata di Udine, Italy
| | - Salvatore De Vita
- Rheumatology Clinic, Department of Medical Area, Azienda Sanitaria Universitaria Integrata di Udine, Italy.
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Rahatli FK, Turnaoglu H, Iyidir OT, Kirnap NG, Haberal KM, Aydın E, Uslu N. Assessment of Parotid and Submandibular Glands With Shear Wave Elastography Following Radioactive Iodine Therapy for Papillary Thyroid Carcinoma. J Ultrasound Med 2019; 38:357-362. [PMID: 30027680 DOI: 10.1002/jum.14695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 04/18/2018] [Accepted: 04/19/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy. Radioactive iodine (RAI) therapy is used for remnant ablation following thyroidectomy. Side effects such as dysphagia, xerostomia, and sialoadenitis may occur. We aimed to determine the differences in the parotid and submandibulary glands between healthy patients and patients with PTC who had undergone RAI therapy and have dry mouth symptoms using both shear wave elastography and ultrasonography. METHODS We enrolled 30 patients with PTC who had undergone RAI therapy following surgery and 30 healthy controls. Ultrasonography and shear wave elastography of submandibular and parotid glands were performed. The volume of the submandibular glands and the thickness of parotid glands were determined. Ten independent measurements were obtained from each gland, with the region of interest placed at different points on the glands. The mean shear wave velocities (SWVs) were calculated and compared between the patients and controls. RESULTS In the PTC group, there was a significant reduction in the volume of the submandibular glands (P < .05) and in the thickness of the parotid glands (P < .05) compared with the control group. The mean SWVs of the parotid glands and submandibular glands were significantly higher in the PTC group compared with the control group (P < .0001). The SWVs of the parotid glands were higher than the SWVs of the submandibular glands (P < .0001). CONCLUSIONS Shear wave elastography could be a noninvasive and easy assessment method of parotid and submandibular glands in patients who had undergone RAI therapy and experience dry mouth.
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Affiliation(s)
- Feride Kural Rahatli
- Department of Radiology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Hale Turnaoglu
- Department of Radiology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Ozlem Turhan Iyidir
- Department of Endocrinology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Nazli Gulsoy Kirnap
- Department of Endocrinology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Kemal Murat Haberal
- Department of Radiology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Erdinç Aydın
- Department of Ear, Nose, and Throat, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Nihal Uslu
- Department of Radiology, Faculty of Medicine, Baskent University, Ankara, Turkey
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Rajput BS, Merita S, Parihar AS, Vyas T, Kaur P, Chansoria S. Assessment of Lingual Concavities in Submandibular Fossa Region in Patients requiring Dental Implants-A Cone Beam Computed Tomography Study. J Contemp Dent Pract 2018; 19:1329-1333. [PMID: 30602636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
AIM The present study was aimed at assessing the lingual concavities in the submandibular fossa region in patients requiring dental implants with the help of cone beam computed tomography (CBCT). MATERIALS AND METHODS The present study included 140 patients who visited the department with the missing mandibular posterior teeth. CBCT images were obtained using planmeca machine. Cross sections of 1 mm of submandibular fossa in the region of 1st and 2nd molar were studied and Type I to III lingual concavities were analyzed by a radiologist. RESULTS Type I lingual concavity (< 2 mm) was seen in 23%, type II (2-3 mm) in 62% and Type III (> 3 mm) in 15% of patients. The difference was significant (p < 0.05). Males had slightly higher mean ± S.D value at 1st molar (2.6 mm ± 0.94) and 2nd molar (2.8 mm ± 0.90) on the left side and (2.7 mm ± 0.92) at 1st molar and (2.9 mm ± 0.93) at 2nd molar on the right side. The difference was nonsignificant (p > 0.05). Females had mean ± S.D value at 1st molar (2.3 mm ± 0.90) and (2.5 mm ± 0.92) at 2nd molar on the left side and (2.4 mm ± 0.91) at 1st molar and (2.8 mm ± 0.93) at 2nd molar. The difference was nonsignificant (p > 0.05. The difference between both genders was statistically nonsignificant (p > 0.05). CONCLUSION Type I bone is the best for placing an implant. The chances of complications are more in type II and III bone. CBCT provides necessary information before planning implant in the edentulous area. CLINICAL SIGNIFICANCE Cone beam computed tomography (CBCT) is the best radiographic aid which is effective in delineating different types of bone in the mandibular posterior region.
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Affiliation(s)
- Bhoopendera S Rajput
- Department of Oral and Maxillofacial Surgery, RR Dental College, Udaipur, Rajasthan, India, Phone: +919501544877, e-mail:
| | - Sandeep Merita
- Department of Periodontology, JCD Dental College, Sirsa, Haryana, India
| | - Anuj S Parihar
- Department of Periodontology, RKDF Dental College and Research Centre, Bhopal, Madhya Pradesh, India
| | - Tarun Vyas
- Department of Oral Medicine and Radiology, RR Dental College and Hospital, Udaipur, Rajasthan, India
| | - Prabhjot Kaur
- Department of Oral Pathology and Microbiology, Desh Bhagat Dental College and Hospital, Mandi Gobindgarh, Punjab, India
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AIUM-ACR-SPR-SRU Practice Parameter for the Performance and Interpretation of a Diagnostic Ultrasound Examination of the Extracranial Head and Neck. J Ultrasound Med 2018; 37:E6-E12. [PMID: 30308087 DOI: 10.1002/jum.14830] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Douglas JE, Thomas WW, Kejner AE, Rassekh CH. Sialendoscopy for Definitive Management of a Submandibular Abscess following Radiotherapy for Oropharyngeal Squamous Cell Carcinoma. ORL J Otorhinolaryngol Relat Spec 2018; 80:223-226. [PMID: 30380549 DOI: 10.1159/000492967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 08/16/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS Sialendoscopy has as yet been shown to be ideal for the management of sialolithiasis and chronic inflammatory diseases of the salivary gland. However, its applicability to the management of a broad range of salivary gland disease is continually growing. METHODS Here we present a case report where sialendoscopy was used to successfully manage an intraparenchymal submandibular gland abscess in a patient with oropharyngeal squamous cell carcinoma managed with primary chemoradiation. RESULTS The use of sialendoscopy enabled visualization of the patency of salivary ducts, drainage of abscess, and irrigation of antibiotic-impregnated fluid. In this particular patient, we were able to avoid a transcervical approach through a previously irradiated field, which would have necessitated concurrent tracheostomy and placed undue risk to surrounding neurovascular structures. CONCLUSION Sialendoscopy should thus, in select patients, be considered as an initial intervention for patients with intraparenchymal salivary gland abscesses in which prior therapy creates an increased risk of complication from an open transcervical approach.
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Affiliation(s)
- Jennifer E Douglas
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
| | - W Walsh Thomas
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA
| | - Alexandra E Kejner
- Department of Otolaryngology, Head and Neck Surgery, University of Kentucky, Lexington, Kentucky, USA
| | - Christopher H Rassekh
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA,
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Ebnöther E, Storck C. [CME-ORL 28/Answer: Submandibular Swelling Left]. Praxis (Bern 1994) 2018; 107:989-991. [PMID: 30131032 DOI: 10.1024/1661-8157/a003043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Frank SJ, Koenigsberg T, Gutman D, Koenigsberg M. Applications of 3-Dimensional Ultrasonography in the Neck, Excluding the Thyroid. J Ultrasound Med 2018; 37:1791-1806. [PMID: 29288583 DOI: 10.1002/jum.14514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 09/27/2017] [Accepted: 09/30/2017] [Indexed: 06/07/2023]
Abstract
Ultrasonography (US) of the neck is an accepted, useful imaging modality for many applications beyond its usefulness in thyroid disease. Two-dimensional US has been effectively used for evaluation of many types of neck conditions, and now, 3-dimensional US can be added to the imaging armamentaria. Three-dimensional US is useful in the evaluation of cervical lymph nodes, recurrent/residual thyroid neoplasia, parathyroid glands, parotid and submandibular glands, as well as thyroglossal duct cysts and other assorted palpable and visible abnormalities because of its unique capabilities, including multiplanar reconstruction, accessibility of the coronal view, volume calculation, and regularly spaced incremental slice evaluation.
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Affiliation(s)
- Susan J Frank
- Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Tova Koenigsberg
- Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - David Gutman
- Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Mordecai Koenigsberg
- Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA
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Haas OL, Scolari N, da Silva Meirelles L, Favoretto AX, de Oliveira RB. Sialolith removal in the submandibular region using surgical diode laser: report of two cases and literature review. Oral Maxillofac Surg 2018; 22:105-111. [PMID: 29356906 DOI: 10.1007/s10006-018-0674-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 01/09/2018] [Indexed: 06/07/2023]
Abstract
PURPOSE Sialolithiasis is defined as the presence of one or more calcified structures within the duct of a major or minor salivary gland. It occurs as a result of deposition of calcium salts around an accumulation of organic debris in the duct lumen. The main signs and symptoms are edema and bacterial infection with abscess formation. METHODS This study aimed to report two cases of submandibular sialolithiasis treated surgically with diode laser and conduct a review of the literature by means of a systematic search. In the two cases, the calculi were located in the distal part of the submandibular duct and could be palpated intraorally. Surgery was performed in an outpatient setting under local anesthesia. A linear incision was made in the floor of the mouth, in the region of the opening of Wharton's duct, to expose and remove the calculi. Laser cutting was performed using a diode laser module coupled to a 400-μm optical fiber emitting at a wavelength of 980 nm (infrared), 2.5 W output power, and in continuous pulse mode. RESULTS The use of diode laser is a safe and minimally invasive option for this type of procedure. CONCLUSION Offering advantages such as enhanced coagulation properties and high-quality incision, absence of bleeding, low risk of nerve damage, and few comorbidities.
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Affiliation(s)
- Orion Luiz Haas
- Department of Oral and Maxillofacial Surgery, Pontificial Catholic University of Rio Grande do Sul, PUC/RS, Av. Ipiranga, n.6681, Building 6, Porto Alegre, Rio Grande do Sul, 91530-001, Brazil
| | - Neimar Scolari
- Department of Oral and Maxillofacial Surgery, Pontificial Catholic University of Rio Grande do Sul, PUC/RS, Av. Ipiranga, n.6681, Building 6, Porto Alegre, Rio Grande do Sul, 91530-001, Brazil
| | - Lucas da Silva Meirelles
- Department of Oral and Maxillofacial Surgery, Pontificial Catholic University of Rio Grande do Sul, PUC/RS, Av. Ipiranga, n.6681, Building 6, Porto Alegre, Rio Grande do Sul, 91530-001, Brazil.
| | - André Xavier Favoretto
- Department of Oral and Maxillofacial Surgery, Pontificial Catholic University of Rio Grande do Sul, PUC/RS, Av. Ipiranga, n.6681, Building 6, Porto Alegre, Rio Grande do Sul, 91530-001, Brazil
| | - Rogério Belle de Oliveira
- Department of Oral and Maxillofacial Surgery, Pontificial Catholic University of Rio Grande do Sul, PUC/RS, Av. Ipiranga, n.6681, Building 6, Porto Alegre, Rio Grande do Sul, 91530-001, Brazil
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