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Bertin H, Bonnet R, Le Thuaut A, Huon JF, Corre P, Frampas E, Langlois EM, Chesneau ASD. A comparative study of three-dimensional cone-beam CT sialography and MR sialography for the detection of non-tumorous salivary pathologies. BMC Oral Health 2023; 23:463. [PMID: 37420227 PMCID: PMC10329379 DOI: 10.1186/s12903-023-03159-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 12/07/2022] [Accepted: 06/21/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND Imaging of the salivary ductal system is relevant prior to an endoscopic or a surgical procedure. Various imaging modalities can be used for this purpose. The aim of this study was to compare the diagnostic capability of three-dimensional (3D)-cone-beam computed tomography (CBCT) sialography versus magnetic resonance (MR) sialography in non-tumorous salivary pathologies. METHODS This prospective, monocenter, pilot study compared both imaging modalities in 46 patients (mean age 50.1 ± 14.9 years) referred for salivary symptoms. The analyses were performed by two independent radiologists and referred to identification of a salivary disease including sialolithiasis, stenosis, or dilatation (primary endpoint). The location and size of an abnormality, the last branch of division of the salivary duct that can be visualized, potential complications, and exposure parameters were also collected (secondary endpoints). RESULTS Salivary symptoms involved both the submandibular (60.9%) and parotid (39.1%) glands. Sialolithiasis, dilatations, and stenosis were observed in 24, 25, and 9 patients, respectively, with no statistical differences observed between the two imaging modalities in terms of lesion identification (p1 = 0.66, p2 = 0.63, and p3 = 0.24, respectively). The inter-observer agreement was perfect (> 0.90) for lesion identification. MR sialography outperformed 3D-CBCT sialography for visualization of salivary stones and dilatations, as evidenced by higher positive percent agreement (sensitivity) of 0.90 [95% CI 0.70-0.98] vs. 0.82 [95% CI 0.61-0.93], and 0.84 [95% CI 0.62-0.94] vs. 0.70 [95% CI 0.49-0.84], respectively. For the identification of stenosis, the same low positive percent agreement was obtained with both procedures (0.20 [95% CI 0.01-0.62]). There was a good concordance for the location of a stone (Kappa coefficient of 0.62). Catheterization failure was observed in two patients by 3D-CBCT sialography. CONCLUSIONS Both imaging procedures warrant being part of the diagnostic arsenal of non-tumorous salivary pathologies. However, MR sialography may be more effective than 3D-CBCT sialography for the identification of sialolithiasis and ductal dilatations. TRIAL REGISTRATION NCT02883140.
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Affiliation(s)
- Hélios Bertin
- Service de chirurgie maxillo-faciale et stomatologie, Nantes Université, CHU Nantes, Nantes, F-44000 France
- Nantes Université, UnivAngers, CHU Nantes, INSERM, CNRS, Nantes, CRCI2NA, F-44000 France
| | - Raphael Bonnet
- Chirurgie maxillo-faciale et stomatologie, private practitioner, Clinique Brétéché, 3 rue de la Béraudière, Nantes, 44046 France
| | - Aurélie Le Thuaut
- Plateforme de méthodologie et biostatistique, direction de la recherche et de l’innovation, Nantes Université, CHU Nantes, Nantes, F-44000 France
| | - Jean-François Huon
- Nantes Université, CHU Nantes, Pharmacie, F-44000 France
- Nantes Université, Univ Tours, CHU Nantes, CHU Tours, INSERM, MethodS in Patients- centered outcomes and HEalth Research, SPHERE, Nantes, F-44000 France
| | - Pierre Corre
- Service de chirurgie maxillo-faciale et stomatologie, Nantes Université, CHU Nantes, Nantes, F-44000 France
- Nantes Université, UnivAngers, CHU Nantes, INSERM, Regenerative Medicine and Skeleton, RMeS, UMR 1229, Oniris, Nantes, F-44000 France
| | - Eric Frampas
- Service d’imagerie médicale, Nantes Université, CHU Nantes, Nantes, F-44000 France
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Zhao Y, Zheng D, Zhang L, Xie X, Liu D, Yu G. Recovery of gland function after endoscopy-assisted removal of impacted hilo-parenchymal stones in the Wharton's duct. Int J Oral Maxillofac Surg 2023; 52:553-559. [PMID: 36210232 DOI: 10.1016/j.ijom.2022.09.035] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/01/2022] [Accepted: 09/29/2022] [Indexed: 04/09/2023]
Abstract
The aim of this study was to evaluate the gland function of patients following endoscopy-assisted removal of impacted hilo-parenchymal stones in the Wharton's duct. The study cohort comprised 115 patients who had undergone successful endoscopy-assisted lithotomy for hilo-parenchymal stones (mean diameter 7.7 mm). Gland function was evaluated at a mean 12 months after surgery using ultrasonography, sialography, and/or sialometry. Postoperative ultrasonography of 51 affected glands revealed a regular gland size in 58.8%, normal parenchyma density in 51.0%, and ductal ectasia in 80.4%. Postoperative sialograms of 109 affected glands were scored as type I (approximately normal) in 13 cases, type II (saccular ectasia of the hilo-parenchymal duct with/without stenosis, and no contrast retention) in 64, type III (saccular ectasia of the hilo-parenchymal duct with/without stenosis, and mild contrast retention) in 23, and type IV (poor shape of the main duct with evident contrast retention) in nine cases. The existence of ductal ectasia corresponded well to larger stone cases (P = 0.002). In the postoperative sialometry of 35 patients with unilateral stones, differences between the two sides were insignificant (P > 0.05). For patients with hilo-parenchymal submandibular gland stones, endoscopy-assisted surgery and extended postoperative follow-up help preserve the gland with good function.
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Affiliation(s)
- Y Zhao
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Beijing, PR China; Department of Radiology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, Shandong, PR China
| | - D Zheng
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - L Zhang
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - X Xie
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Beijing, PR China
| | - D Liu
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Beijing, PR China.
| | - G Yu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, PR China
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Cetinkaya V, Bonnet R, Le Thuaut A, Corre P, Mourrain-Langlois E, Delemazure-Chesneau AS, Bertin H. A comparative study of three-dimensional cone beam computed tomographic sialography and ultrasonography in the detection of non-tumoral salivary duct diseases. Dentomaxillofac Radiol 2023:20220371. [PMID: 37052400 DOI: 10.1259/dmfr.20220371] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Abstract
OBJECTIVES To compare the overall diagnostic outcomes of 3D-CBCT sialography and ultrasonography (US) in the detection of sialolithiasis, ductal dilatation, and ductal stenosis. METHODS This retrospective monocentric study compared the two imaging modalities carried out in the same patients referred for salivary symptoms of the parotid and submandibular glands. The primary endpoint was the capacity of the imaging procedure to diagnose a lesion. The secondary objectives were the detection rates according to the type of lesion, analysis of the causes of failure, and the parameters of radiation exposure and safety (for 3D-CBCT sialography). RESULTS Of the 236 patients who received a 3D-CBCT sialography in our institution, 157 were ultimately included in the per-protocol analysis. 3D-CBCT sialography allowed detection of ductal lesions in 113 patients versus 86 with US. The two imaging modalities yielded congruent interpretations in 104 out of 157 subjects (66.2%). Higher sensitivity and negative predictive value were observed with 3D-CBCT sialography compared with US, irrespective of the lesions studied: 0.85 vs 0.65 and 0.70 vs 0.44, respectively. Regarding the sialolithiasis, both 3D-CBCT sialography and US allowed identification of lesions with high sensitivity and negative predictive value (0.80 vs 0.75 and 0.88 vs 0.78, respectively). CONCLUSIONS US remains the first-line examination for exploration of the salivary lesions. 3D-CBCT sialography is an alternative in case of inconclusive US, and prior to any endoscopic procedure.
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Affiliation(s)
- Volkan Cetinkaya
- Service de chirurgie maxillo-faciale et stomatologie, CHU de Nantes, Nantes, France
| | - Raphael Bonnet
- Chirurgie maxillo-faciale et stomatologie, Private practicioner, Clinique Brétéché, Nantes, France
| | - Aurélie Le Thuaut
- Plateforme de méthodologie et biostatistique, Direction de la recherche et de l'innovation, CHU de Nantes, Nantes, France
| | - Pierre Corre
- Service de chirurgie maxillo-faciale et stomatologie, CHU de Nantes, Nantes, France
- Regenerative medicine and skeleton (RMeS), Faculté de Chirurgie Dentaire, Nantes, France
| | | | | | - Hélios Bertin
- Service de chirurgie maxillo-faciale et stomatologie, CHU de Nantes, Nantes, France
- 6Centre de recherche en cancérologie et immunologie intégrée Nantes Angers (CRCI NA), équipe 9 (CHILD), Faculté de médecine, Nantes, France
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Kandula S, Nagi R, Nagaraju R. Sialography: a pictorial review. Oral Radiol 2023; 39:225-34. [PMID: 36562930 DOI: 10.1007/s11282-022-00668-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Abstract
Non-tumour inflammatory and obstructive salivary gland pathologies such as sialadenitis, sialolithiasis, sialadenosis, ductal strictures, etc. require precise radiological evaluation and mapping of salivary gland ductal system for better treatment outcome. Conventional sialography is considered as a useful and reliable technique in evaluation of salivary glands especially intrinsic and acquired abnormalities involving the ductal system and is useful for detection of non-radiopaque sialoliths which are invisible on routine plain radiographs. Primarily sialography is used as a diagnostic tool, additionally it plays an important therapeutic role as salivary gland lavage in cases of recurrent salivary gland infections and in obstructive salivary gland disorders by helping in clearance of mucous plugs or small sialoliths within the ducts. Recently, diagnostic performance of computed tomography (CT) sialography is being explored and has been reported to have high sensitivity in detection of small sialoliths and allows differentiation of sialoliths from other calcifications in glandular ductal system. Multiplanar three dimensional (3D) reconstructed CT images have been reported to play a key role in determination of anatomical location or extent of salivary gland disease without superimposition or distortion of structures. This review aims to discuss the disease specific applications of sialography and CT Sialography in particular for visualization of salivary gland disorders.
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Thomas N, Kaur A, Reddy SS, Nagaraju R, Nagi R, Shankar VG. Three-dimensional cone-beam computed tomographic sialography in the diagnosis and management of primary Sjögren syndrome: Report of 3 cases. Imaging Sci Dent 2021; 51:209-216. [PMID: 34235067 PMCID: PMC8219457 DOI: 10.5624/isd.20200313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/16/2021] [Accepted: 01/18/2021] [Indexed: 11/18/2022] Open
Abstract
Sjögren syndrome is a chronic autoimmune inflammatory disease characterized by lymphocytic infiltration of exocrine glands, predominantly the parotid and lacrimal glands, thereby resulting in oral and ocular dryness. It has been reported to occur most frequently in women between 40 and 50 years of age. Sjögren syndrome has an insidious onset, is slowly progressive, and presents a wide range of clinical manifestations, leading to delays or challenges in the diagnosis. Early diagnosis of this condition is essential to prevent the associated complications that affect patients' quality of life. This report presents 3 cases of Sjögren syndrome in female patients aged between 40 and 75 years who presented with complaints of persistent dry mouth and burning sensation. The cases highlight the diagnostic value of 3-dimensional cone-beam computed tomographic sialography in the detection of salivary gland pathologies at an early stage.
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Affiliation(s)
- Nithin Thomas
- Department of Oral Radiology, Maxillofacial Diagnostics, Cochin, India
| | - Aninditya Kaur
- Department of Oral Radiology, DMD Imaging, Gurgaon, India
| | - Sujatha S Reddy
- Department of Oral Medicine and Radiology, Faculty of Dental Sciences, M.S. Ramaiah University of Applied Sciences, Bangalore, Karnataka, India
| | - Rakesh Nagaraju
- Department of Oral Medicine and Radiology, Faculty of Dental Sciences, M.S. Ramaiah University of Applied Sciences, Bangalore, Karnataka, India
| | - Ravleen Nagi
- Department of Oral Medicine and Radiology, Swami Devi Dyal Hospital and Dental College, Panchkula, Haryana, India
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Wood J, Toll EC, Hall F, Mahadevan M. Juvenile recurrent parotitis: Review and proposed management algorithm. Int J Pediatr Otorhinolaryngol 2021; 142:110617. [PMID: 33421670 DOI: 10.1016/j.ijporl.2021.110617] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 12/31/2020] [Accepted: 12/31/2020] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Despite being the second most common salivary disease in childhood, the aetiology and appropriate management of juvenile recurrent parotitis (JRP) remains uncertain. Consequently patients may be misdiagnosed, or even undergo indeterminate or potentially invasive procedures without benefit. This article reviews the current understanding of the epidemiology and pathophysiology of JRP, and to appraise the management options available. METHODS AND RESULTS Medline and Google Scholar databases were searched and peer reviewed journal articles assessed. The epidemiology of JRP remains uncertain, and the clinical presentation of JRP can vary widely in frequency and severity. Diagnosis is still largely based on clinical signs and symptoms including parotid swelling, pain and fever. Investigation typically focuses on the exclusion of other diseases and immunodeficiencies, however there are noted typical radiological findings on both ultrasound and magnetic resonance imaging. The ideal management of this condition still remains unclear, however symptoms typically resolve by puberty. Treatment focuses on minimally invasive procedures such as sialography and sialendoscopy to reduce the frequency and severity of acute episodes. CONCLUSIONS Acute episodes of JRP can occur up to 30 times per year and have a significant impact on the quality of life of an affected child. Consequently a management algorithm is proposed based on the exclusion of other pathology. There is increasing evidence for non-ablative, minimally invasive approaches such as sialography and sialendoscopy to reduce the impact of this disease.
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Nourinezhad J, Moarabi A, Ahkalani MSR. Detailed gross anatomic and sialographic characteristics of major salivary glands in water buffaloes (Bubalus bubalis). Anat Sci Int 2021; 96:427-42. [PMID: 33555557 DOI: 10.1007/s12565-021-00609-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 01/25/2021] [Indexed: 10/22/2022]
Abstract
To clarify the detailed general architecture and topography of major salivary glands and demonstrate a fine anatomy of the ductal system of the glands in water buffaloes, we conducted gross anatomic and sialographic investigations of glands in 14 half heads from seven water buffaloes. The position of the mandibular gland, course of mandibular duct relative to monostomatic gland, a rostral extension of polystomatic gland, and site of origin of monostomatic duct in buffaloes essentially differed from those of various ruminants. The shape of the parotid and mandibular glands, and origin of their ducts, lacking filling of retromandibular fossa by parotid gland, the topography of mandibular gland relative to the parotid gland and mandibular lymph node, caudal extension of polystomatic gland, rostral extension of monostomatic gland, and location of polystomatic gland relative to monostomatic gland in buffaloes were very similar to those in ox. However, several considerable differences in morphology of glands in buffaloes and ox were recognized. Major salivary glands in buffaloes almost show 'grazing ruminants' morphological and morphometrical characteristics. Within parotid, mandibular, and monostomatic glands in buffaloes, there was a ductal arborization pattern in lateral sialograms. Whereas the main parotid duct was formed by a union of two central branches of the intraglandular duct, main mandibular, and monostomatic ducts were consisted of one central branch. The pattern of peripheral branches from the central branch of intraglandular duct in buffaloes was significantly different among the glands. Our detailed sialography of ductal morphology and morphometry can be helpful in accurate diagnosis of gland diseases in live water buffaloes.
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Thorpe RK, Foggia MJ, Marcus KS, Policeni B, Maley JE, Hoffman HT. Sialographic Analysis of Radioiodine-Associated Chronic Sialadenitis. Laryngoscope 2020; 131:E1450-E1456. [PMID: 33200832 PMCID: PMC10049839 DOI: 10.1002/lary.29279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 09/30/2020] [Accepted: 11/06/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVES/HYPOTHESIS To apply a novel sialography classification system to identify parotid and submandibular ductal findings following I-131 therapy and to assess correlates to dose and duration of symptoms. STUDY DESIGN Retrospective single-center case series. METHODS Patients who underwent sialography between February 2008 and February 2019 after previously receiving I-131 treatment were identified via a retrospective chart review. Their sialograms were systematically evaluated and scored by applying the Iowa parotid sialogram scale to also include submandibular gland analysis. RESULTS From 337 sialograms, 30 (five submandibular, 25 parotid) underwent analysis. Ductal stenosis was identified in all sialograms and was graded as moderate (>50%-75%) in 7/30 cases and severe (>75%) in 15/30 cases. The distal (main) duct was narrowed in 23/30 cases. No association was identified between degree of ductal stenosis and I-131 dose (P = .39), age (P = .81), or time from I-131 therapy to sialogram (P = .97). CONCLUSIONS The Iowa parotid sialogram scale was successfully applied to report abnormalities of the parotid and submandibular ductal system. The most common manifestation of I-131-associated sialadenitis was a severe stenosis within the distal salivary duct. No statistically significant association was found between degree of ductal stenosis and dose of I-131, age, or duration of symptoms. LEVEL OF EVIDENCE 4 Laryngoscope, 131:E1450-E1456, 2021.
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Affiliation(s)
- Ryan K Thorpe
- Department of Otolaryngology - Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, U.S.A
| | - Megan J Foggia
- Department of Otolaryngology - Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, U.S.A
| | - Kathryn S Marcus
- Department of Otolaryngology - Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, U.S.A
| | - Bruno Policeni
- Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, U.S.A
| | - Joan E Maley
- Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, U.S.A
| | - Henry T Hoffman
- Department of Otolaryngology - Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, U.S.A
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Oh SH, Seo YK, Kim GT, Choi YS, Hwang EH. Power Doppler ultrasound-guided sialography using the phenomenon of increased blood flow: A technical report. Imaging Sci Dent 2019; 49:301-306. [PMID: 31915616 PMCID: PMC6941833 DOI: 10.5624/isd.2019.49.4.301] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 07/12/2019] [Accepted: 08/11/2019] [Indexed: 11/18/2022] Open
Abstract
Purpose This report presents a procedure for performing power Doppler ultrasound-guided sialography using the phenomenon of increased blood flow and illustrates its application to practical patient cases. Materials and Methods The salivary gland was scanned using ultrasound equipment (GE LOGIQ5 Expert® device; GE Medical Systems, Milwaukee, WI, USA) to identify pathological findings related to the patient's chief complaint. To identify the orifice of the main duct, it should be cannulated using a lacrimal dilator. After inserting the catheter into the cannulated main duct, the position of the catheter within the duct was confirmed by ultrasound. A contrast agent was injected until the patient felt fullness, and ultrasound (B-mode) was used to confirm whether the contrast agent filled the main canal and secondary and tertiary ducts. Then, power Doppler ultrasound was performed to determine whether the salivary gland had increased blood flow. Results In 2 cases in this report, a power Doppler ultrasound scan showed a significant increase in blood flow after contrast medium injection, which was not observed on a preoperative scan. Conclusion Power Doppler ultrasound was found to be a simple, safe, and effective tool for real-time sialography monitoring.
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Affiliation(s)
- Song Hee Oh
- Department of Oral and Maxillofacial Radiology, Graduate School, Kyung Hee University, Seoul, Korea
| | - Yu-Kyeong Seo
- Department of Oral and Maxillofacial Radiology, Graduate School, Kyung Hee University, Seoul, Korea
| | - Gyu-Tae Kim
- Department of Oral and Maxillofacial Radiology, Graduate School, Kyung Hee University, Seoul, Korea
| | - Yong-Suk Choi
- Department of Oral and Maxillofacial Radiology, Graduate School, Kyung Hee University, Seoul, Korea
| | - Eui-Hwan Hwang
- Department of Oral and Maxillofacial Radiology, Graduate School, Kyung Hee University, Seoul, Korea
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Tucci FM, Roma R, Bianchi A, De Vincentiis GC, Bianchi PM. Juvenile recurrent parotitis: Diagnostic and therapeutic effectiveness of sialography. Retrospective study on 110 children. Int J Pediatr Otorhinolaryngol 2019; 124:179-184. [PMID: 31202035 DOI: 10.1016/j.ijporl.2019.06.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 05/19/2019] [Accepted: 06/04/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Juvenile recurrent parotitis (JRP) is characterized by recurrent episodes of painful parotid swelling, generally associated with non-obstructive sialectasia of the parotid gland. The aim of this study was to evaluate the diagnostic and therapeutic effectiveness of sialography in children affected by JRP. METHODS Clinical records of 110 outpatients with a diagnosis of JRP followed up from 2008 to 2017 at the Unit of Paediatric Otorhinolaryngology, Surgery Department of the Bambino Gesù Children's Hospital of Rome, were retrospectively reviewed. Data on demographics, number of acute episodes/year, course of disease, site of symptoms and duration of follow up were collected. The inclusion criteria were: at least two or more episodes of intermittent swelling of the parotid glands on one side or both sides during the last 6 months, age <16 years. Exclusion criteria were: obstructive lesions, dental malocclusion, Sjogren syndrome, congenital IgA immunodeficiency, and relevant systemic diseases. Outcome of the procedure was measured by evaluating number and degree of episodes of parotid swelling before and after sialography. RESULTS Sialography has been shown in all cases to be a valid method in the diagnosis of JRP. Following the execution of the sialography, in 98 patients (89% of cases) there was a statistically significant improvement of disease with a mean reduction of 67.4% of episodes of parotid swelling (p < 0.05). In 75 patients there was marked improvement of the symptomatology (p < 0.05). In 23 patients partial resolution occurred (p < 0.05); in 12 patients there was no resolution or a reduction less than 30% of episodes (p > 0.05). There was a statistically significant relationship between the number of attacks/year and the degree of glandular function, pre and post-sialography in 2-way ANOVA test (p < 0.05). CONCLUSION Sialography is effective method not only as a diagnostic procedure but also as a therapeutic procedure in treatment of JRP. It is a method that can be carried out in ambulatory setting, without anaesthesia, with a minimum cost and with a very low rate of complications. In a disease with tendency to spontaneous resolution like JRP, sialography represent a therapeutic option alternative to more invasive treatment.
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Affiliation(s)
- Filippo Maria Tucci
- Surgery Department, Otorhinolaryngology Unit, Bambino Gesù Children's Hospital, Scientific Research Institute, 00100, Rome, Italy.
| | - Rocco Roma
- Surgery Department, Otorhinolaryngology Unit, Bambino Gesù Children's Hospital, Scientific Research Institute, 00100, Rome, Italy
| | - Alessandra Bianchi
- Surgery Department, Otorhinolaryngology Unit, Bambino Gesù Children's Hospital, Scientific Research Institute, 00100, Rome, Italy
| | - Giovanni Carlo De Vincentiis
- Surgery Department, Otorhinolaryngology Unit, Bambino Gesù Children's Hospital, Scientific Research Institute, 00100, Rome, Italy
| | - Pier Marco Bianchi
- Surgery Department, Otorhinolaryngology Unit, Bambino Gesù Children's Hospital, Scientific Research Institute, 00100, Rome, Italy
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Abstract
Background Chronic recurrent non-specific parotitis is characterized by recurrent episodes of swelling and pain of unknown etiology in the parotid gland. Sialography is a hallmark in the diagnosis of salivary gland disorders; newer imaging modalities like CT-Sialography, sialoendoscopy and MRI can be used. Various treatment modalities have been tried, from conservative approach to surgical excision depending on the recurrence rate and severity of the condition. Although symptomatic treatment with antibiotics and analgesic, injection of intraductal medicament, aggressive treatment like duct ligation or excision of gland are some of the treatment modalities, there is no established algorithm as to which treatment method should be opted in such clinical situation. Case Detail A 20 years old male patient reported with pain and salty taste in the mouth that had began before a week. Examination revealed an elevated right parotid papilla; ropy, cloudy appearing saliva was oozing out on milking the gland. Unstimulated and stimulated whole salivary flow rate was assessed using drooling method. Sialography was used as a diagnostic and a therapeutic aid. In our case, sialography as a treatment showed a good response with no recurrence after two years of follow-up. We highlighted the role of sialography as a therapeutic aid. Conclusion Recurrent attacks significantly affect the quality of life and also lead to progressive gland destruction. Preventing or reducing the frequency of recurrence remains the goal of therapeutic procedure. Hence, conventional sialography is useful in the diagnosis and also effective as a therapeutic aid in recurrent parotitis.
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Affiliation(s)
- Saibaba Mahalakshmi
- Department of Oral Medicine and Radiology, Sri Siddhartha Dental College & Hospital, Sri Siddhartha Academy of Higher Education, Tumkur
| | - Srinivas Kandula
- Department of Oral Medicine and Radiology, Kalinga Institute of Dental Science, KIIT University, Bhubneshwar
| | - Patil Shilpa
- Department of Oral Medicine and Radiology, AECS Maaruti College of Dental Sciences & Research Centre, Bangalore
| | - Ganganna Kokila
- Department of Oral Pathology and Microbiology, Sri Siddhartha Dental College & Hospital, Sri Siddhartha Academy of Higher Education, Tumkur
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Pniak T, Štrympl P, Staníková L, Zeleník K, Matoušek P, Komínek P. Sialoendoscopy, sialography, and ultrasound: a comparison of diagnostic methods. Open Med (Wars) 2016; 11:461-464. [PMID: 28352836 PMCID: PMC5329868 DOI: 10.1515/med-2016-0081] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 10/03/2016] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To compare the accuracy of ultrasound, sialography, and sialendoscopy for examining benign salivary gland obstructions. METHODS In this prospective study, patients with symptoms of obstruction of the major salivary gland duct system presenting at the ENT Clinic University Hospital, Ostrava, from June 2010 to December 2013 were included. All patients (n=76) underwent ultrasound, sialography, and sialoendoscopy. The signs of sialolithiasis, ductal stenosis, or normal findings were recorded after the examinations. Statistical analysis of the sensitivity and specificity of all the methods was performed, as well as a comparison of the accuracy of each method for different kinds of pathology (sialolithiasis or stenosis). RESULTS The sensitivity of ultrasound, sialography, and sialoendoscopy for sialolithiasis findings were 71.9%, 86.7 %, and 100%, respectively. The sensitivity of sialography and sialoendoscopy for stenosis of the duct was 69.0%, and 100%, respectively. The study showed impossibility of ultrasonic diagnostics of ductal stenosis. The sensitivity of sialoendoscopy for both pathologies was significantly higher than that from ultrasound or sialography (p<0.05). The specificity of sialoendoscopy was significantly higher than that from by ultrasound or sialography (p<0.05). CONCLUSION Sialoendoscopy was the most accurate method for examination ductal pathology, with significantly higher sensitivity and specificity than by ultrasound or sialography.
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Affiliation(s)
- Tomáš Pniak
- Department of Otolaryngology, University Hospital Ostrava, Czech Republic
| | - Pavel Štrympl
- Department of Otolaryngology, University Hospital Ostrava, Czech Republic
| | - Lucia Staníková
- Department of Otolaryngology, University Hospital Ostrava, Czech Republic
| | - Karol Zeleník
- Department of Otolaryngology, University Hospital Ostrava, Czech Republic
| | - Petr Matoušek
- Department of Otolaryngology, University Hospital Ostrava, Czech Republic
| | - Pavel Komínek
- Department of Otolaryngology, University Hospital Ostrava, 17. listopadu 1790, 708 52 Ostrava, Czech Republic, Tel. 00420597375801
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Nagi R, Kantharaj YBR, Nagaraju R, Reddy SJ. Sialocele of Parotid Duct: Report of Case with Review of Literature. J Clin Diagn Res 2016; 10:ZD04-5. [PMID: 27042592 DOI: 10.7860/jcdr/2016/16650.7224] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Accepted: 12/02/2015] [Indexed: 11/24/2022]
Abstract
Parotid duct sialocele is a salivary cavity arising at the expense of parotid duct. Facial trauma is the most common cause of this rare condition. If left untreated, a sialocele may develop into a significantly large facial swelling. Fistula formation may occur, often draining extraorally. We report a case of Parotid duct sialocele that was assessed by sialography and ultrasonogarphy and was managed by placement of intraductal cannula for fifteen days till duct was found patent. We also discuss various treatment options of this condition in this case report.
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Affiliation(s)
- Ravleen Nagi
- Senior Lecturer, Department of Oral Medicine and Radiology, New Horizon Dental College and Research Institute , Sakri, Bilaspur, Chhattisgarh, India
| | - Yashoda Bhoomi Reddy Kantharaj
- Senior Professor, Department of Oral Medicine and Radiology, Faculty of Dental Sciences, MS Ramaiah University of Applied Sciences , Bangalore, Karnataka, India
| | - Rakesh Nagaraju
- Reader, Department of Oral Medicine and Radiology, Faculty of Dental Sciences, MS Ramaiah University of Applied Sciences , Bangalore, Karnataka, India
| | - Sujatha Janardhan Reddy
- Professor and Head, Department of Oral Medicine and Radiology, Faculty of Dental Sciences, MS Ramaiah University of Applied Sciences , Bangalore, Karnataka, India
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Sharouny H, Omar RB. Iatrogenic submandibular duct rupture complicating sialography: a case report. Iran Red Crescent Med J 2015; 16:e7882. [PMID: 25593739 PMCID: PMC4270643 DOI: 10.5812/ircmj.7882] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Revised: 12/21/2013] [Accepted: 08/19/2014] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Sialolithiasis is the most common disease of salivary glands. Sialography is particularly important for the assessment of the outflow tract and in diagnosing obstructive salivary gland lesions including calculi. CASE PRESENTATION We report on a 38-year-old female with sialolithiasis whom had Wharton's duct perforation, complicating the sialography. She was treated conservatively with a course of co-amoxiclav, oral prednisolone for three days and pain-killers. The patient was clinically well on follow-up reassessments at the end of the first week and three weeks post procedure. CONCLUSIONS Perforation of salivary duct complicating the sialography is rare. Awareness of this potential complication and utilizing a good sialography technique need to be advocated amongst radiologists. Response to treatment by conservative management is preferred as illustrated in this case.
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Affiliation(s)
- Hadi Sharouny
- Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran
- Corresponding Author: Hadi Sharouny, Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel: +98-9171056044, E-mail:
| | - Rahmat Bin Omar
- Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Woo SH, Kim JP, Kim JS, Jeong HS. Anatomical recovery of the duct of the submandibular gland after transoral removal of a hilar stone without sialodochoplasty: evaluation of a phase II clinical trial. Br J Oral Maxillofac Surg 2014; 52:951-6. [PMID: 25239734 DOI: 10.1016/j.bjoms.2014.08.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 08/13/2014] [Indexed: 10/24/2022]
Abstract
Transoral removal of stones for the treatment of submandibular sialolithiasis has been popularised, even for stones in the hilum. Without sialodochoplasty after surgical retrieval, the affected glands seem to recover well functionally, even without sialodochoplasty. However, the anatomical changes of structural recovery have not been fully studied. We investigated the outcomes and the changes to the salivary duct system after transoral removal of hilar stones using postoperative sialography. We enrolled 28 patients (29 sides) who had transoral removal of stones for submandibular hilar sialolithiasis without sialodochoplasty, and prospectively analysed the structural outcomes 3 months and 12 months postoperatively using sialography. We found 23 ducts (79%) recovered with a normal size, while 4 ducts (14%) developed saccular dilatation and one duct (3%) partially stenosed. Saccular dilatation developed after removal of stones larger than 10mm in diameter, but patients had no recurrent symptoms. By the 12 months' follow up, one stone had formed severe adhesions to the salivary duct that caused stenosis, and this patient had recurrent symptoms. Transoral removal of submandibular hilar stones without sialodochoplasty is an effective treatment with good anatomical restoration of the salivary duct and flow.
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Affiliation(s)
- Seung Hoon Woo
- Department of Otolaryngology, Gyeongsang National University, Jinju, South Korea; Institute of Health Sciences, Gyeongsang National University, Jinju, South Korea
| | - Jin Pyeong Kim
- Department of Otolaryngology, Gyeongsang National University, Jinju, South Korea
| | - Jong Sei Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Han-Sin Jeong
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
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Gheisari R, Mohamadinezhad C, Mehravaran R, Ziaei M. Parotid Duct Repair by Facial Vein Graft versus Gore-Tex, A Sialographic Evaluation. J Dent (Shiraz) 2013; 14:53-56. [PMID: 24724119 PMCID: PMC3977551] [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] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
STATEMENT OF PROBLEM The most common method for parotid duct anastomosis is suturing. A ductal defect of greater than 1cm may prevent a direct anastomosis. PURPOSE The goal of this study was a sialographic evaluation to compare repairing a parotid duct with facial vein graft versus Gore-Tex tub in 19 dogs. MATERIAL AND METHODS Nineteen dogs were studied in this experimental trial. Extra oral transverse incisions were made in buccal regions bilaterally to expose parotid ducts and a defect (2 cm) was performed in similar areas (right and left). The right resected duct was repaired with facial vein graft and the left anastomosis was performed by using the Gore-Tex tube microscopically. Sialography was used to evaluate the ductal leakage. Statistical analysis was performed, using SPSS software and McNemar's test. RESULTS Based on the sialography evaluation; the ductal leakage was seen in five cases (26.31%) on the right side and in seven cases (36.84%) in the left side. Statistical analysis using McNemar's test suggested no statistically significant difference between ductal leakages in right and left parotid ducts (p> 0.05). CONCLUSION The results of this study suggest that the efficacies of Gore-Tex tube and vein graft in parotid duct anastomosis are similar, but the use of Gore-Tex tube had a number of advantages, including reduced morbidity of the graft and short operation time.
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Affiliation(s)
- R Gheisari
- Dept. of Oral and Maxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz Iran
| | - C Mohamadinezhad
- Dept. of Oral and Maxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz Iran
| | - R Mehravaran
- Dept. of Oral and Maxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz Iran
| | - M Ziaei
- Dept. of Oral and Maxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz Iran
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Abdel-Wahed N, Amer ME, Abo-Taleb NSM. Assessment of the role of cone beam computed sialography in diagnosing salivary gland lesions. Imaging Sci Dent 2013; 43:17-23. [PMID: 23524990 PMCID: PMC3604366 DOI: 10.5624/isd.2013.43.1.17] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2012] [Revised: 09/03/2012] [Accepted: 10/13/2012] [Indexed: 11/18/2022] Open
Abstract
Purpose The purpose of this study was to assess cone-beam computed (CBCT) sialography imaging in the detection of different changes associated with lesions of salivary glands. Materials and Methods This study consisted of 8 cases with signs and symptoms from salivary gland lesions. Conventional sialography using digital panoramic and lateral oblique radiographs and CBCT sialography were performed for each subject. The radiographs were evaluated by 3 radiologists independently of each other. The results were compared between conventional sialography and CBCT sialography in the evaluation of various lesions associated with the salivary glands. Results There was an agreement between the radiologists in interpreting the lesions that affected salivary glands with both techniques. The detection of the presence of stones or filling defects, stenosis, ductal evagination, dilatation, and space occupying lesions was 83% for conventional sialography compared with CBCT sialography. CBCT sialography was superior to conventional sialography in revealing stones, stenosis, and strictures, especially in the second and third order branches. Conclusion It would be advisable to perform CBCT sialography in cases of obstructive salivary gland diseases for better demonstration of the ductal system of the gland.
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Affiliation(s)
- Nagla'a Abdel-Wahed
- Oral and Maxillofacial Radiology, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt
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