Inflammation grading and sialoendoscopic treatment of 131I radioiodine-induced sialadenitis / 北京大学学报(医学版)

OBJECTIVE@#To investigate the inflammation grading of 131I radioiodine-induced sialadenitis based upon sialoendoscopic and sialographic appearances, and to evaluate the results of sialoendoscopic intervention.@*METHODS@#The patients diagnosed with 131I radioiodine-induced sialadenitis and underwent sialoendoscopic exploration and intervention procedures in Peking University Hospital of Stomatology from Nov. 2012 to Oct. 2018 were included in this study. The appearances of sialogaphy and sialoendoscopy were analyzed and classified. The treatment options included irrigation with saline and dexamethasone and mechanical dilatation by sialoendoscope. The patients were followed up after treatment.@*RESULTS@#Forty-two patients with 131I radioiodine-induced sialadenitis were included. There were 5 males and 37 females, with a male-to-female ratio of 1 ∶7.4. Symptoms included recurrent swelling and pain in the parotid glands, and dry mouth. Sialography showed stenosis in the main duct,and in some cases nonvisua-lization of the branches. Sialoendoscopy showed narrowing of the main duct, and the branch duct atresia was seen. The appearances of sialogaphy and sialoendoscopy were analyzed and classified into 3 groups: (1) Mild inflammation: stenosis and ectasia occurred in the main duct, whereas the 0.9 mm sialoendoscope could pass through easily. (2) Moderate inflammation: one point of severe stricture could be seen in the main duct where 0.9 mm sialoendoscope could not be passed through. (3) Severe inflammation: two points or more of severe strictures or diffused strictures occurred in the main duct. Thirty-three patients with 65 affected glands were examined by both sialography and sialoendoscopy. Eight glands were classified as mild inflammation, 23 glands moderate inflammation, and 34 glands severe inflammation. The duration of follow-up ranged from 3-72 months. The clinical results were evaluated as good in 22 glands, fair in 22 glands, and poor in 19 glands, with an overall effective rate of 69.8% (44/63).@*CONCLUSION@#The clinical, sialographic and sialoendoscopic appearances of 131I radioiodine-induced sialadenitis showed their characteristics. We proposed an inflammation grading standard for the 131I radioiodine-induced sialadenitis based on the appearances of sialography and sialoendoscopy. Sialoendoscopy can significantly alleviate the clinical symptoms, which is an effective therapy, and better for early lesions.

Power Doppler ultrasound-guided sialography using the phenomenon of increased blood flow: A technical report

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.

Quantitative Analysis of Parotid Gland Secretion Function in Sjögren's Syndrome Patients with Dynamic Magnetic Resonance Sialography

OBJECTIVE: To evaluate the secretory function of parotid glands by dynamic magnetic resonance (MR) sialography and determine the clinical performance of this technique in diagnosing and evaluating Sjögren's syndrome (SS) patients. MATERIALS AND METHODS: This study enrolled 29 healthy volunteers (25 women and 4 men; mean age, 34.8 ± 6.3 years; age range, 26–47 years) and 25 primary SS (pSS) patients (23 women and 2 men; mean age, 37.7 ± 7.9 years; age range, 25–50 years) with decreased secretory function. The volume of the parotid gland ducts was precisely measured for both groups at single pre- and 6 post-gustatory-stimulated phases. Time-dependent volume change ratio curves were generated, four parameters were derived from the curves: the slope of the increase in the first post-stimulation phase (slope(1st)), the peak value, the time-to-peak, the total saliva secretion post-stimulation. All values were used to quantitatively evaluate the secretory function of the parotid gland. The repeated measurement analysis, Mann-Whitney U test and receiver operating characteristic curve were applied. RESULTS: Time-dependent volume change ratio curves demonstrated that there is a statistically significant difference between the two groups (F = 8.750; p = 0.005). A quickly increasing curve was shown in the volunteer group, whereas a slowly increasing curve was shown in the pSS patient group. The slope(1st), peak value and total saliva secretion post-stimulation of the patient group were significantly lower than those of the volunteer group (p = 0.005, p = 0.003, and p = 0.002, respectively). The time-to-peak between the two groups was not significantly different (p = 0.383). The slope(1st) can be used as a discriminator to diagnose SS patients (p = 0.015; odds ratio = 4.234; area under the curve = 0.726). CONCLUSION: Dynamic MR sialography is proven to be an effective method in evaluating salivary gland function and has a great potential in diagnosing and evaluating pSS patients.

Diagnóstico e tratamento de Sialolitíase: relato de caso / Diagnosis and treatment of Sialolithiasis: Case Report

Sialolitos são estruturas calcificadas, que se desenvolvem no interior do sistema ductal salivar, em decorrência da deposição de sais de cálcio ao redor de um acúmulo de restos orgânicos no lúmen do ducto glandular. Acometem, com mais assiduidade, a glândula submandibular e são a causa mais comum de inflamações agudas ou crônicas nas glândulas salivares maiores. Manifestam-se, com maior frequência, em indivíduos adultos de meia-idade, e os sinais e sintomas mais comuns são a dor e a tumefação local. Podem ser evidenciados por radiografias convencionais, tomografia computadorizada, ressonância magnética, ultrassonografia, cintilografia, sialoendoscopia e sialografia. O tratamento inclui a eliminação espontânea mediante orientações ou uso de medicamentos, ou a remoção cirúrgica do sialolito, sendo necessária, em alguns casos, a exérese da própria glândula. Este trabalho tem como objetivo relatar o caso clínico do paciente S.L.M, 44 anos de idade, sexo feminino, caucasiana, atendida na clínica de Cirurgia Bucal da Universidade Federal Fluminense, apresentando um sialolito no sistema ductal da glândula submandibular do lado esquerdo. A paciente foi submetida à remoção cirúrgica do sialolito sob anestesia local, sem maiores intercorrências... (AU)

Sialolites are calcified structures that develop inside the salivary ductal system, due to the deposition of calcium salts around an accumulation of organic remains in the lumen of the glandular duct. They have a more frequent involvement of the submandibular gland and are the most common cause of acute or chronic inflammation in the major salivary glands. They occur more frequently in middle-aged adult patients and the most common signs and symptoms are local pain and swelling. They can be evidenced by conventional radiography, computed tomography, MRI, ultrasonography, scintigraphy, sialoendoscopy and sialography. Treatment includes spontaneous elimination, from guidelines or use of medications, or surgical removal of sialolite, in some cases, the excision of the gland itself. This study aims to report the clinical case of the patient S.L.M, 44 years old, female, Caucasian, attended at the Oral Surgery Clinic of the Federal Fluminense University, presenting a sialolite in the ductal system of the left submandibular gland. The patient was submitted to surgical removal of the sialolite, under local anesthesia, without major intercurrences... (AU)

Treatment of intractable parotid sialocele occurred after open reduction-fixation of mandibular subcondylar fracture

A sialocele is a subcutaneous cavity containing saliva, most often caused by facial trauma or iatrogenic complications. In subcondylar fractures, most surgeons are conscious of facial nerve injury; however, they usually pay little attention to the parotid duct injury. We report the case of a 41-year-old man with a sialocele, approximately 5×3 cm in size, which developed 1 week after subcondylar fracture reduction. The sialocele became progressively enlarged despite conservative management. Computed tomography showed a thin-walled cyst between the body and tail of the parotid gland. Fluid leakage outside the cyst was noted where the skin was thin. Sialography showed a cutting edge of the inferior interlobular major duct before forming the common major duct that seemed to be injured during the subcondylar fracture reduction process. We decided on prompt surgical treatment, and the sialocele was completely excised. A duct from the parotid tail, secreting salivary secretion into the cyst, was ligated. Botulinum toxin was administrated to block the salivary secretion and preventing recurrence. Treatment was successful. In addition, we found that parotid major ducts are enveloped by the deep lobe and extensive dissection during the subcondylar fracture reduction may cause parotid major duct injury.

Endoscopy-assisted sialodochoplasty for the treatment of severe sialoduct stenosis / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the effects of endoscopy-assisted sialodochoplasty for the treatment of severe sialoduct stenosis with concurrent megaducts.@*METHODS@#From Jul.2010 to Dec. 2016, 8 patients presenting with severe parotid duct stenosis and 3 patients with occlusion of the Wharton's duct underwent endoscopy-assisted sialodochoplasty.All these patients had concurrent severe ductal ectasiaand manifested a painful swelling of the involved salivary glands.The diameter of ectasia and length of stenosis of the sialoducts were measured preoperatively by sialography, computed tomography, or ultrasonography. The megaducts were opened transorally and sutured to the buccal or oral floor mucosa, therefore creating a neo-ostium. All the patients were followed up periodically after operation. The treatment effects were evaluated by clinical signs, sialogram and sialometry.@*RESULTS@#The length of the Stensen's duct stenosis was 5-12 mm, and the diameter of the concurrent ectasia was 8-16 mm. The length of the Wharton's duct stenosis was 10-20 mm, and the diameter of the concurrent ectasia was 6-8 mm.The neo-ostiums healed uneventfully 2 weeks after operation. The duration of the follow-up varied from 6 to 78 months (median: 24 months). Among the 8 patients with Stensen's duct stenosis, two experienced re-obliteration of the neo-ostium, but the buccal bulge and clinical symptoms disappeared; one reported recurrent clinical symptoms after initial alleviation, which could be controlled with self-massaging; the remaining 5 patients had satisfactory clinical results, i.e., disappearance of the obstruction symptoms and buccal bulge, patent ostium,clean saliva and improvement of the ductal ectasia on sialogram. Three patients with Wharton's duct occlusion were asymptomatic with clear saliva and patent ostium;two exhibited approximately normal appearance and one showed improvement of the sialogram.Sialometry was performed in 9 patients with patent neo-ostium of the involved glands,the resting saliva flow rate of the affected glands showed no differences compared with the normal side, and stimulated flow rate showed a significant increase, though less than the control side.The clinical results included good in 5 patients, fair in 4 patients, and poor in 2 patients, with a total effective rate of 82% (9/11).@*CONCLUSION@#Endoscopy-assisted sialodochoplasty appears to be effective and can be a viable option for patients presenting with severe sialoducts tenosis and concurrent ectasia.

Therapeutic effect of intraductal irrigation of the salivary gland: A technical report

PURPOSE: Obstructive and inflammatory disease often occurs in the major salivary glands, and no predictive treatment has yet been developed for this condition. The aim of this report was to introduce an intraductal irrigation procedure and to illustrate its application to practical patient cases. MATERIALS AND METHODS: Two patients complaining of pain and swelling in the parotid gland during meals who underwent sialography were diagnosed as having sialodochitis with sialadenitis. Intraductal irrigation was then performed on the parotid gland on the side of the complaint. The irrigation procedure was conducted in the same manner as the sialography procedure, except that saline was used as the filling solution. Symptom severity was evaluated with a numerical rating scale (NRS) at the initial visit and a month after the irrigation. RESULTS: The initial NRS value of patient 1 was 10. The value decreased to 6 and then to 0 after 2 irrigation procedures. The NRS value of patient 2 regarding the symptoms involving the left parotid gland decreased from 4-5 to 1 after 4 irrigation procedures performed at 1-month intervals. CONCLUSION: Intraductal irrigation of the salivary gland may be a simple, safe, and effective treatment option for patients with obstructive and inflammatory disease of the salivary gland that is capable of resolving their symptoms.

Usefulness of Magnetic Resonance Sialography for Diagnosis of Idiopathic Chronic Sialadenitis / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The symptoms of salivary diseasess are often nonspecific, and a variety of investigative methods can be employed. Conventional sialography, which is still widely used for diagnosis of salivary ductal pathologies, has the withdrawback of invasiveness and radiation exposure, and thus ultrasound and magnetic resonance (MR) sialography can replace the conventional tools. This study was performed to evaluate the usefulness of MR sialography for the diagnosis of idiopathic chronic sialadenitis. SUBJECTS AND METHOD: From November 2013 to June 2014, we have retrospectively analyzed 26 patients who have had swelling and pain of salivary glands and undergone MR sialography for further diagnosis of the idiopathic salivary obstructive symptom. We analyzed the symptom scores, salivary flow rate (SFR) and parameters of salivary gland scintigraphy. Then we evaluated correlation among MR sialography findings (duct visualization, grade of stenosis at main duct, degree of sialectasis and glandular volume size). RESULTS: Among the 26 patients, stenosis of salivary duct was observed in 14 patients (53.8%), chronic sialadenitis without stenosis in 6 patients (23.1%), Sjogren's syndrome in 3 patients (11.5%), Juvenile reccutent parotitis in 1 patient (3.8%), and 2 patients were norma (7.7%). The degree of sialectasis was significantly correlated with Tmin (time interval, in minutes, from stimulation to minimum count), maximum secretion (p<0.05), and glandular volume size was also significantly correlated with unstimulated SFR (p<0.05). But others did not show any significant correlations. From these findings, we report three cases that were useful to diagnose the gland disease using MR sialography. CONCLUSION: Resutls show that MR sialogarphy indirectly reflects the salivary gland function. Therefore MR sialography can be helpful when the differential diagnosis of idiopathic chronic sialadenitis is difficult with conventional tools.

Sjogren's syndrome: An underdiagnosed condition in mixed connective tissue disease

OBJECTIVE: To determine the prevalence of sicca symptoms, dry eye, and secondary Sjögren's syndrome and to evaluate the severity of dry eye in patients with mixed connective tissue disease. METHODS: In total, 44 consecutive patients with mixed connective tissue disease (Kasukawa's criteria) and 41 healthy controls underwent Schirmer's test, a tear film breakup time test, and ocular surface staining to investigate dry eye. In addition, the dry eye severity was graded. Ocular and oral symptoms were assessed using a structured questionnaire. Salivary gland scintigraphy was performed in all patients. Classification of secondary Sjögren's syndrome was assessed according to the American-European Consensus Group criteria. RESULTS: The patients and controls had comparable ages (44.7±12.4 vs. 47.2±12.2 years) and frequencies of female gender (93 vs. 95%) and Caucasian ethnicity (71.4 vs. 85%). Ocular symptoms (47.7 vs. 24.4%) and oral symptoms (52.3 vs. 9.7%) were significantly more frequent in patients than in controls. Fourteen (31.8%) patients fulfilled Sjögren's syndrome criteria, seven of whom (50%) did not have this diagnosis prior to study inclusion. A further comparison of patients with mixed connective tissue disease with or without Sjögren's syndrome revealed that the former presented significantly lower frequencies of polyarthritis and cutaneous involvement than did the patients without Sjögren's syndrome. Moderate to severe dry eye was found in 13 of 14 patients with mixed connective tissue disease and Sjögren's syndrome (92.8%). CONCLUSIONS: Sjögren's syndrome, particularly with moderate to severe dry eye, is frequent in patients with mixed connective tissue disease. These findings alert the physician regarding the importance of the appropriate diagnosis of this syndrome in such patients. .

Treatment of Botulinum Toxin Type A in Parotid Fistula after Face Lifting

Botulinum toxin type A has an inhibitory action not only on neuromuscular junctions, but also postganglionic sympathetic and cholinergic autonomic parasympathetic acetylcholine release at the secretary end of the salivary gland. Use of botulinum toxin to treat sialorrhea was first reported in 1997 by Bushara. Parotid duct or gland injuries with parotid fistula are uncommon but troublesome complications of surgical trauma. Here, we report two patients with constant leakage of serous fluid and a swelling cheek after facelift surgery. Each patient underwent an amylase test, starch iodine test, and sialography. After diagnosis of parotid fistula, a total of 50 units botulinum toxin was injected into the parotid gland. Facial bandage, scopolamine, and minimizing temporomandibular joint motion were instructed. Leakage volume decreased gradually, and symptoms subsided within 2 weeks. Neither functional problems nor complications occurred. In conclusion, a parotid fistula after facial surgery can be treated effectively with botulinum toxin; this treatment option should be considered before proceeding with invasive surgical treatment.

Assessment of the role of cone beam computed sialography in diagnosing salivary gland lesions

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.

Topografia da papila parotídea em cães da raça Dachshund / Parotid papilla topography in dog Dachshund

A topografia da papila parotídea e do seu ducto excretor têm sido objeto de estudos, devido à necessidade deste conhecimento para o seu acesso em procedimentos em exames clínicos e cirúrgicos. O presente trabalho visou determinar a localização de abertura do ducto parotídeo, por meio da identificação da papila parotídea em cães da raça Dachshund, estabelecendo sua sintopia com os dentes da arcada superior. Foram examinados 50 animais adultos, 25 machos e 25 fêmeas, da raça Dachshund, onde 84% destes animais apresentaram a papila parotídea ao nível do 4º dente pré- molar superior, 12% entre o 4º dente pré-molar superior e 1º dente molar superior e 4% ao nível do 1º dente molar superior. Diante dos resultados foi possível concluir que a papila parotídea em cães da raça Dachshund ocorreu com maior freqüência ao nível do 4º dente pré-molar superior, apresentando simetria bilateral em todos os casos.

The topography of the parotid papilla and its excretory duct have been objective research, due to the need for this knowledge to their access to procedures in clinical and surgical. This study aims to determine the location of parotid duct opening through the identification of the parotid papilla in dogs Dachshund, establishing its syntopy with the teeth of upper jaw. We examined 50 adult animals, 25 males and 25 females, the Dachshund, where 84% of animals showed the papilla parotid at the 4th tooth premolar, 12% between the 4th tooth premolar and 1st molar tooth top and 4 % at the 1st molar tooth. From the results it was concluded that the parotid papilla in dogs Dachshund occurred frequently at the 4th premolar tooth was still observed bilateral symmetry in all animals studied.

El uso de la sialografía en el diagnóstico y tratamiento de la parotiditis recurrente juvenil: presentación de un caso / The use of sialography in the diagnosis and treatment of juvenile recurrent parotitis: case report

La parotiditis recurrente juvenil (PRJ) es una enfermedad inflamatoria de la glándula parótida, generalmente se caracteriza por episodios recurrentes de hinchazón, dolor y fiebre. Después de la parotiditis epidémica, es la PRJ en los niños, la segunda enfermedad más frecuente de las glándulas salivales. La aparición de PRJ se produce alrededor de 6 años de edad y hay una ligera predilección por los varones. La etiología de la enfermedad sigue siendo poco clara y los síntomas tienden a desaparecer con la pubertad. Este estudio reporta el caso de un joven de 12 años que se presentó a la Facultad de Odontología de la Universidad Estadual Paulista, Sao José dos Campos, con una historia de episodios recurrentes de hinchazón de la glándula parótida izquierda asociada con dolor, fiebre y secreción purulenta en los primeros eventos. Terminada la anamnesia, se decidió por obtener sialografías de las dos glándulas parótidas con el uso de material de contraste Lipiodol UF 38% y radiografías panorámicas, seguidas por las evaluaciones morfológicas y funcionales. El paciente se encuentra hoy sin presentar recurrencia de la enfermedad y está bajo seguimiento clínico

The Juvenile Recurrent Parotitis (JRP) is an inflammatory disease of the parotid gland, usually characterized by recurrent episodes of swelling, pain and fever. After mumps, the PRJ in children is the second most prevalent disease of salivary glands. The emergence of PRJ occurs around 6 years old and there is a slight predilection for males.The etiology of the disease remains unclear and the symptoms tend to disappear with puberty. This study reports the case of a twelve years old boy who presented to the Dentistry School of São Paulo State University - campus São José dos Campos- with a history of recurrent episodes of swelling of the left parotid gland associated with pain, fever and purulent discharge in the early events . Finished the anamnesis, sialography were performed with the use of Lipiodol UF 38% contrast material and panoramic radiographs on both parotid glands, followed by morphological and functional assessments. There was no recurrence of the disease and the patient is under follow-up

value of magnetic resonance sialography and magnetic resonance imaging versus conventional sialography of the parotid gland in the diagnosis and staging of Sjogren's syndrome

The conventional sialography [CS] and minor salivary gland biopsy have been considered the cornerstones of the diagnosis of Sjogren's syndrome [SS]. However, they are invasive and with risk of complications to the patient. Magnetic resonance imaging [MRI] has been widely replacing conventional invasive examinations. They provide insufficient data for diagnosing and staging SS, because while they address the detection and diagnosis of parenchymal salivary gland disease they do not assess duct abnormalities. The introduction of magnetic resonance sialography [MRS] protocol was the first step towards non-ionizing non-invasive technique enables a more accurate assessment of the duct system. Moreover, it is postulated that the combined use of MRI and MRS is useful for the assessment of damaged salivary glands in SS. This preliminary study aimed to assess the role and efficacy of MRS and MRI in imaging the parotid gland in SS patients' and to compare their results with that of CS in the diagnosis and staging of SS. The parotid gland was examined by MRS, MRI and CS in 15 SS patients. Scoring system for overall branching pattern, ductal system staging, sialectasis for both CS and MRS was used. MRI scoring system for glandular parenchymal pattern, size and contour and lymph node was used. This revealed non-significant difference between CS and MRS findings in the diagnosis and staging of SS. Furthermore, no statistically significant correlation was found between the clinical and SS stage in both CS and MRS. On the other hand, a statistically significant positive correlation was found between the clinical findings and the MRI parenchymal stages. Moreover, MRS showed higher sensitivity and diagnostic accuracy values than CS. Combining the MRS and MRI abnormalities, 100% sensitivity diagnostic accuracy values were achieved in the diagnosis and staging of SS. The inter-observer agreement was higher in MRS than in CS and was perfect in MRI. In this preliminary study, MRS showed a higher sensitivity and accuracy in diagnosing and staging SS and may safely and securely replace CS. MRI and MRS give information on different aspects of glandular and duct pathology; therefore, both should be performed when examining the parotid glands in SS patients

Three Cases of Surgical Repair of Traumatic Parotid Duct Injury / 대한이비인후과학회지

It is important to both recognize parotid duct injuries and immediately repair them to prevent complications that accompany these injuries. Although there have been some reports of successful conservative treatments of the parotid duct injury, many authors recommend early surgical repair of the parotid duct and, when possible, primary anastomosis as the best treatment. Sialography is very useful for the diagnosis of parotid duct injury and can also support the information of parotid duct system. We present three cases of successful treatment of parotid duct injury with surgical repair. Also, we discuss about the effectiveness of surgical repair of parotid duct injury and how to assess it preoperatively.

Management of a parotid sialocelein a young patient: case report and literature review

Sialocele is a subcutaneous cavity containing saliva, caused by trauma or infection in the parotid gland parenchyma, laceration of the parotid duct or ductal stenosis with subsequent dilatation. It is characterized by an asymptomatic soft and mobile swelling on the parotid region. Imaging studies are useful and help establishing the diagnosis, such as sialography, ultrasonography, computed tomography and magnetic resonance imaging. This paper describes a recurrent case of a parotid sialocele in a young female patient. She presented a 6 cm x 5 cm swelling on the left parotid region. The ultrasonographic scan of the area revealed a hypoechoic ovoid well defined image suggesting a cyst. A sialography of the left parotid showed a cavitary sialectasia in a panoramic and anteroposterior view. A conservative management was adopted by percutaneous needle aspiration of the swelling, which was useful to provide material for analysis and helped healing. Dentists should be aware of this pathology and the importance in adopting a conservative treatment whenever it is possible.

Sialography: Report of 3 cases.

Salivary gland examination is an important part of oral examination, especially because of it's involvement in most of the systemic diseases. Patients most commonly seek medical attention when the major salivary glands like parotid and submandibular gland become enlarged or painful. The various imaging modalities practiced to check the salivary gland disorders include conventional radiography, sialography, ultrasonography, computerized tomography, radionuclide imaging and magnetic resonance imaging. Sialography is one of the oldest imaging procedures and still most commonly practiced, as it is a chair side procedure, simple to perform, and cost effective. We report the role of sialography as an adjuvant in the diagnosis of bacterial sialadenitis and sialadenosis and as a diagnostic and therapeutic aid in a case of juvenile recurrent parotitis.

Application of 3D FIESTA sequence in magnetic resonance sialography for obstructive salivary diseases / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the value of 3D FIESTA sequence in magnetic resonance sialography (MRS) in the diagnosis of obstructive salivary diseases.</p><p><b>METHODS</b>Eleven patients with obstructive salivary diseases underwent MRS, and three-dimensional (3D) reconstruction and virtual endoscopic images of the salivary gland ducts were obtained after MRS data post-processing for comparison with those of sialoendoscopy.</p><p><b>RESULTS</b>The diagnostic accuracy of MRS was 72.7% for obstructive salivary diseases. The virtual endoscopy provided a visual field highly consistent with that by sialoendoscopy.</p><p><b>CONCLUSION</b>MRS is capable of visualizing the tracts of salivary glands. MR virtual endoscopy can provide sufficient morphological and pathological data for preoperative assessment of salivary operations with sialoendoscopy.</p>

Caso clínico: un tratamiento alternativo a la parotiditis crónica / Clinical case: an alternative treatment for chronic parotitis

La parotiditis crónica conocida también como parotiditis juvenil recurrente, se define como la inflamación recurrente de la glándula parótida, asociada a la aparición de sialectasias o dilataciones no obstructivas de los conductos glandulares. Como tratamiento se emplea habitualmente la sialografía que tiene una tasa de éxito que va de 62 por ciento a 94 por ciento. Se presenta aquí un caso de un niño de 4 años de edad con parotiditis crónica, que persiste con episodios de parotiditis, pese a la realización de dos sialografías con un intervalo de 1 año entre ambas. Se decide inyectar violeta genciana, procedimiento que no tuvo complicaciones, después de la inyección remitió la enfermedad

Chronic parotitis, also known as juvenile recurrent parotits, is defined as the recurrent inflammation of the parotid gland, associated to the appearance of sialectasis or non-obstructive dilation of the glandular ducts. Sialography is regularly employed as a treatment, with success rates ranging between 62 and 94 percent. Here we present the case of a 4 year old child with chronic parotitis, that persisted with parotitis episodes despite having two sialographies performed, with one year interval between them. We decided to inject methyl violet, a procedure that was carried out without any complications; and the disease resolved shortly after the injection