Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.587
Filtrar
1.
Radiother Oncol ; 172: 42-49, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35537605

RESUMO

PURPOSE: To assess the impact of prospectively sparing the parotid ducts via MRI sialography on patient reported xerostomia for those receiving definitive radiotherapy (RT) for oropharyngeal squamous cell carcinoma. METHODS AND MATERIALS: Thirty-eight patients with oropharynx cancer to be treated with definitive RT underwent pre-treatment MRI sialograms to localize their parotid ducts. The parotid ducts were maximally spared during treatment planning. Patients reported symptoms (PRO-CTCAE and QLQ-H&N35) were collected at 6 and 12 months post-RT and compared to a historical cohort who underwent conventional parotid gland mean dose sparing. Regression models were generated using parotid and submandibular gland doses with and without incorporating the dose to the parotid ducts to determine the impact of parotid duct dose on patient reported xerostomia. RESULTS: At 6 months post-RT, 12/26 (46%) patients reported ≥moderate xerostomia when undergoing parotid ductal sparing compared to 43/61 (70%) in the historical cohort (p = 0.03). At 12 months post-RT, 8/22 (36%) patients reported ≥moderate xerostomia when undergoing parotid ductal sparing compared to 34/68(50%) in the historical cohort (p = 0.08). Using nested logistic regression models, the mean parotid duct dose was found to significantly relate to patient reported xerostomia severity at 6 months post-RT (p = 0.04) and trended towards statistical significance at 12 months post-RT (p = 0.09). At both 6 and 12 months post-RT, the addition of mean parotid duct dose significantly improved model fit (p < 0.05). CONCLUSIONS: MRI sialography guided parotid duct sparing appears to reduce the rates of patient-reported xerostomia. Further, logistic regression analysis found parotid duct dose to be significantly associated with patient reported xerostomia. A significant improvement in model fit was observed when adding mean parotid duct dose compared to models that only contain mean parotid gland dose and mean contralateral submandibular gland dose.


Assuntos
Neoplasias de Cabeça e Pescoço , Xerostomia , Neoplasias de Cabeça e Pescoço/diagnóstico por imagem , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Imageamento por Ressonância Magnética , Glândula Parótida/diagnóstico por imagem , Medidas de Resultados Relatados pelo Paciente , Estudos Prospectivos , Sialografia , Xerostomia/diagnóstico , Xerostomia/etiologia , Xerostomia/prevenção & controle
2.
Eur Arch Otorhinolaryngol ; 279(1): 493-499, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34117898

RESUMO

PURPOSE: No standardized treatment regimen exists for juvenile recurrent parotitis (JRP). The investigators hypothesized that irrigation with saline only without local anesthesia will be an effective and beneficial option. METHODS: Using a retrospective study design, a series of children with typical symptoms of JRP who were treated with at least one irrigation therapy were evaluated. This treatment consisted of irrigation of the affected gland with 3-10 ml saline solution without any type of anesthesia. The outcome variables were patient/parent satisfaction, frequency and duration of acute JRP episodes, and the need for antibiotics before and after irrigation therapy. RESULTS: The case series was composed of six boys aged 3.3-7.7 years who experienced one to eight sessions of irrigation therapy. The period of follow-up was 9-64 months. We observed a total resolution of symptoms in two children and an improvement in the other four. No relevant side effects were seen. CONCLUSION: Our results suggest that irrigation therapy is a reasonable, simple, and minimally invasive treatment alternative for JRP. In contrast to sialendoscopy or sialography, there is no need for general anesthesia or radiation exposure.


Assuntos
Anestesia , Parotidite , Criança , Endoscopia , Humanos , Masculino , Parotidite/terapia , Satisfação do Paciente , Estudos Retrospectivos , Sialografia
3.
J Oral Maxillofac Surg ; 80(1): 137.e1-137.e6, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34656513

RESUMO

Salivary gland and duct complications following surgical approaches to condylar fractures are well known, particularly in approaches requiring parotid tissue dissection. We report a rare case of a parotid duct wound caused by the fracture itself and due to a lateral displacement of the condylar fragment. Four days after the surgical management of a trifocal mandibular fracture (head fracture on the left side, laterally displaced condylar base and angular fracture on the right side) the patient presented with a fluctuating subcutaneous swelling in the right cheek, evoking a sialocele. The sialography showed a massive leak of iodinated contrast medium just in front of the parotid hilum, joining the subcutaneous undermining made during the approach and confirmed the diagnosis of a parotid duct wound. A pressure dressing was applied to the right mandibular angle for 2 weeks, allowing for complete remission. In conclusion, this unusual clinical case illustrates the fact that the parotid duct may be endangered in the event of condylar base fractures, not only by the surgical approach but also by the fracture itself, especially when there is severe lateral displacement.


Assuntos
Fraturas Mandibulares , Fixação Interna de Fraturas , Humanos , Mandíbula , Côndilo Mandibular/diagnóstico por imagem , Côndilo Mandibular/cirurgia , Fraturas Mandibulares/diagnóstico por imagem , Fraturas Mandibulares/cirurgia , Glândula Parótida/diagnóstico por imagem , Glândula Parótida/cirurgia , Ductos Salivares/diagnóstico por imagem , Ductos Salivares/cirurgia , Sialografia
4.
Quintessence Int ; 52(8): 728-740, 2021 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-34076380

RESUMO

Sialography combined with cone beam computerized tomography (sialo-CBCT) is an imaging technique that demonstrates the ductal system of the major salivary glands and allows evaluation of gland function. This review describes the sialo-CBCT technique, terminology, common pitfalls and limitations, as well as radiographic features and suggested pathogenicity of various salivary gland disorders, based on 1,758 sialo-CBCT examinations conducted over the last decade in one institution, and the current literature. The adoption of standardized terminology is proposed to prevent miscommunication, facilitate formulation of differential diagnoses, and thereby promote patient management: (1) Sialo-CBCT requires specific training, and operator experience is required for adequate glandular filling with minimal extravasation; (2) Limit injection-to-scan time to avoid pre-mature emptying; (3) The sialo-CBCT report should include a description of the morphology of the primary duct as well as the secondary, tertiary, and descending branches, the maximal branching level, the presence of sialectasis, overall glandular size, and parenchymal findings; (4) Functional evaluation is based on assessment of iodine clearance in the post evacuation image; (5) Sialectasis and ductopenia are the main findings in Sjogren syndrome and recurrent juvenile parotitis; (6) Sialodochitis with or without fillings defects or hyperdense calcifications characterize obstructive sialadenitis and sialolithiasis; (7) The findings following radioactive-iodine-induced damage are similar to obstructive sialadenitis, with atrophy in late stages; (8) In chronic graft-versus-host disease (cGVHD), variable presentations of ductopenia, sialectasis, and sialodochitis may be evident; (9) The red flags indicating a space-occupying lesion include areas of no filling, splaying of ducts, and primary duct deviation.


Assuntos
Sialadenite , Tomografia Computadorizada de Feixe Cônico Espiral , Humanos , Padrões de Referência , Glândulas Salivares , Sialadenite/diagnóstico por imagem , Sialografia
5.
Laryngoscope ; 131(9): 2030-2035, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33710620

RESUMO

OBJECTIVES/HYPOTHESIS: To explore the clinically feasible diagnosis criteria and treatment outcomes of allergy-related sialodochitis (ARS). STUDY DESIGN: Prospective Cohort Study. METHODS: Ninety-six consecutive patients were enrolled by the following criteria: 1) recurrent swelling of ≥2 large salivary glands that lasted for ≥3 months; 2) with mucus plug exudations; 3) with atopic diseases; 4) ductal stenosis and/or ectasia. Sixty-four patients with elevation of peripheral blood eosinophil (PBE) and/or serum IgE level comprised group A (highly-suspected ARS group), while the remaining 32 comprised group B (patients without confirmed evidence of ARS). These patients were treated with interventional endoscopy. A chronic obstructive sialadenitis symptom (COSS) questionnaire was used to quantify the treatment outcomes. RESULTS: In group A, Serum IgE was elevated in 84.4% of patients and PBE was elevated in 34.4% of patients. Percentage of submandibular gland involvement was higher in group A than group B (48.4% vs. 18.8%). On sialograms, the snowflake changes of branch ducts were seen in higher percentage of group A compared with group B (59% vs. 35% for parotid glands, 27% vs. 8% for submandibular glands, respectively). Mucus plug smears showed abundant eosinophils in 14 group A patients. Biopsy of five group A patients revealed significant eosinophil infiltration around the main and interlobular ducts. During follow-up, the COSS scores were significantly decreased in both groups, and group B was improved better than group A. CONCLUSION: PBE and serum IgE are important diagnostic indexes of ARS. Mucus plug smear or histopathology verifies the diagnosis. Interventional endoscopy is helpful for ARS cases. LEVEL OF EVIDENCE: 3 Laryngoscope, 131:2030-2035, 2021.


Assuntos
Eosinofilia/sangue , Hipersensibilidade/complicações , Imunoglobulina E/sangue , Ductos Salivares/imunologia , Sialadenite/etiologia , Adulto , Idoso , Biópsia , Estudos de Casos e Controles , Doença Crônica , Estudos de Coortes , Endoscopia/métodos , Eosinofilia/patologia , Feminino , Humanos , Hipersensibilidade/diagnóstico , Hipersensibilidade/imunologia , Masculino , Pessoa de Meia-Idade , Muco/imunologia , Estudos Prospectivos , Ductos Salivares/patologia , Sialadenite/diagnóstico , Sialadenite/imunologia , Sialadenite/cirurgia , Sialografia/métodos , Inquéritos e Questionários , Resultado do Tratamento
6.
Anat Sci Int ; 96(3): 427-442, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33555557

RESUMO

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.


Assuntos
Búfalos/anatomia & histologia , Glândulas Salivares/anatomia & histologia , Animais , Masculino , Glândulas Salivares/diagnóstico por imagem , Sialografia
7.
Int J Pediatr Otorhinolaryngol ; 142: 110617, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33421670

RESUMO

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.


Assuntos
Parotidite , Algoritmos , Criança , Endoscopia , Humanos , Parotidite/diagnóstico , Parotidite/terapia , Qualidade de Vida , Recidiva , Sialografia , Ultrassonografia
8.
Laryngoscope ; 131(1): E83-E89, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32413167

RESUMO

OBJECTIVES/HYPOTHESIS: To compare the results of magnetic resonance imaging with magnetic resonance sialography (MRSIAL) and the clinical and laboratory characteristics in a well-characterized cohort of patients with primary or secondary Sjögren's syndrome (SS) meeting the American-European Consensus Group criteria. STUDY DESIGN: Retrospective, observational, monocentric study. METHODS: Thirty-six patients (81% female, mean age = 48 ± 35 years) with primary or secondary SS who underwent MRSIAL were included in the study. RESULTS: MRSIAL revealed characteristic radiological signs in the parotid, sublingual, and submandibular salivary glands in 35/36 patients (97%). Patients presenting with anti-Sjögren's syndrome-related antigen A (SSA) autoantibodies showed more often fatty infiltration, a "pepper-and-salt" appearance, ductal stenosis, and/or ductal dilation of the parotid gland (88%, 88%, and 72% respectively) than patients negative for anti-SSA (12%, 4%, and 28% respectively). MRSIAL demonstrated signs characteristic of SS in all 11 patients with negative minor salivary gland biopsy. For 15 patients undergoing ultrasound examination only, 11 (73%) had SS findings, but all 15 had SS findings on MRSIAL. Two cases of parotid lymphoma were detected by MRSIAL (6%). CONCLUSIONS: MRSIAL is a reliable technique to detect glandular anomalies in patients with SS, and seems to provide a valuable aid in the diagnosis of SS. LEVEL OF EVIDENCE: 4 Laryngoscope, 131:E83-E89, 2021.


Assuntos
Imageamento por Ressonância Magnética , Doenças das Glândulas Salivares/diagnóstico por imagem , Glândulas Salivares/diagnóstico por imagem , Sialografia/métodos , Síndrome de Sjogren/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Doenças das Glândulas Salivares/etiologia , Síndrome de Sjogren/complicações , Síndrome de Sjogren/diagnóstico , Adulto Jovem
9.
Laryngoscope ; 131(6): 1404-1409, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33098313

RESUMO

OBJECTIVE/HYPOTHESIS: Current literature has confirmed the benefits of sialendoscopy for the treatment of juvenile recurrent parotitis (JRP). However, this procedure is often performed unilaterally, although the disease can affect both sides. This article investigated the clinical course of the contralateral parotid (CL) gland in children requiring unilateral sialendoscopy with the goal of clarifying the necessity of primary bilateral sialendoscopy. STUDY DESIGN: Prospective cohort study in a tertiary center. METHODS: Over an eight-year period, 77 children with JRP underwent unilateral sialendoscopy. We observed the clinical course of the CL parotid over a minimum follow-up period of 24 months. New episodes of sialadenitis were recorded on both sides along with the need for a second sialendoscopy. These data were correlated with the preoperative symptoms of the contralateral side as well as ultrasound (U/S) findings at baseline assessment. RESULTS: In total, six children required sialendoscopy on the CL side (7.8%), 62 children remained asymptomatic or with scarce swellings (80.5%), and nine children improved (11.7%). The preoperative U/S findings on the CL side positively correlated with the number of postoperative swellings. The proportion of children needing CL sialendoscopy was higher (21.4%) among children needing a second sialendoscopy on the operated side. CONCLUSIONS: In the long term, the vast majority of children needing unilateral sialendoscopy do not require similar treatment of the CL parotid gland. However, a history of bilateral swellings along with U/S findings of parenchymal disorganization on the CL side significantly increases the risk of needing further sialendoscopy at a later time. LEVEL OF EVIDENCE: 4 Laryngoscope, 131:1404-1409, 2021.


Assuntos
Endoscopia/métodos , Glândula Parótida/cirurgia , Parotidite/cirurgia , Reoperação/estatística & dados numéricos , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Glândula Parótida/diagnóstico por imagem , Parotidite/diagnóstico por imagem , Estudos Prospectivos , Sialografia/métodos , Resultado do Tratamento , Ultrassonografia/métodos
10.
Laryngoscope ; 131(5): E1450-E1456, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33200832

RESUMO

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.


Assuntos
Radioisótopos do Iodo/efeitos adversos , Doenças Parotídeas/diagnóstico , Lesões por Radiação/diagnóstico , Sialadenite/diagnóstico , Sialografia/estatística & dados numéricos , Doenças da Glândula Submandibular/diagnóstico , Adulto , Idoso , Relação Dose-Resposta à Radiação , Feminino , Humanos , Radioisótopos do Iodo/administração & dosagem , Masculino , Pessoa de Meia-Idade , Doenças Parotídeas/etiologia , Glândula Parótida/diagnóstico por imagem , Glândula Parótida/efeitos da radiação , Lesões por Radiação/etiologia , Dosagem Radioterapêutica , Estudos Retrospectivos , Ductos Salivares/diagnóstico por imagem , Ductos Salivares/efeitos da radiação , Sialadenite/etiologia , Glândula Submandibular/diagnóstico por imagem , Glândula Submandibular/efeitos da radiação , Doenças da Glândula Submandibular/etiologia , Doenças da Glândula Tireoide/radioterapia , Adulto Jovem
11.
Beijing Da Xue Xue Bao Yi Xue Ban ; 52(3): 586-590, 2020 Jun 18.
Artigo em Chinês | MEDLINE | ID: mdl-32541997

RESUMO

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.


Assuntos
Lesões por Radiação , Sialadenite , Endoscopia , Feminino , Humanos , Inflamação , Radioisótopos do Iodo , Masculino , Ductos Salivares , Sialadenite/etiologia , Sialografia
12.
Georgian Med News ; (300): 17-25, 2020 Mar.
Artigo em Russo | MEDLINE | ID: mdl-32383696

RESUMO

The purpose of the research was to study the structure of diseases of the submandibular salivary gland, to improve the diagnosis and effectiveness of the surgical treatment of patients with diseases of the submandibular salivary glands. A survey and treatment of 1094 patients with diseases of the submandibular salivary glands was performed. It was revealed that the most common disease of the submandibular salivary gland is calculous submaxillitis in the exacerbated and chronic stages of the inflammatory process (82.1%). Tumors and tumor-like formations of the submandibular glands account for 15.3% (167 patients), among which tumor-like formations were detected in 6.0%, and benign and malignant tumors of the submandibular glands were found in 94.0% of cases. Postoperative tumor relapses were detected in 2.1% of cases. The reason for them was a violation of the technique of surgical intervention. According to our observations, only the joint use of different diagnostic methods for examining patients with pathology of the submandibular glands (sialography, orthopantomosialography, computed tomosialography, CT, MRI, ultrasound) can significantly increase the diagnostic value of the methods used. The operation must be carried out by simultaneously removing the detected neoplasm with extirpation of the submandibular gland.


Assuntos
Sialografia , Glândula Submandibular , Humanos , Imageamento por Ressonância Magnética , Ultrassonografia
13.
BMC Oral Health ; 20(1): 86, 2020 03 24.
Artigo em Inglês | MEDLINE | ID: mdl-32204705

RESUMO

BACKGROUND: The aim of the present study was to evaluate the effectiveness of intraductal irrigation using normal saline in chronic obstructive sialadenitis. METHODS: Patients who had one of the following symptoms were recruited: pain, swelling, stiffness, and dry mouth. A total of 58 salivary glands in 33 patients were diagnosed as having sialadenitis using sialography and ultrasonography. The patients were divided into two groups (swelling group and dry mouth group), according to the major complaint. Repeated intraductal irrigation was performed on each gland. Difference of symptom severity evaluated using numerical rating scale (NRS), and ductal width measured using ultrasonography were compared between the two groups. RESULTS: The average NRS score was significantly decreased from 6.0 to 3.3 after 3-5 visits of intraductal irrigation (P < 0.05). The reduction in NRS was greater in the swelling group than in the dry mouth group, although the difference between the groups was not statistically significant. There was no change of ductal width before and after the irrigation. CONCLUSIONS: Intraductal irrigation according to this study method using normal saline is a simple treatment for the patients with chronic obstructive sialadenitis. It provides a conservative treatment option reducing the subjective symptoms.


Assuntos
Solução Salina/uso terapêutico , Glândulas Salivares/diagnóstico por imagem , Sialadenite/tratamento farmacológico , Sialografia/métodos , Irrigação Terapêutica , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença Crônica , Humanos , Pessoa de Meia-Idade , Sialadenite/diagnóstico , Resultado do Tratamento , Ultrassonografia , Xerostomia/etiologia
14.
Oral Dis ; 26(5): 912-919, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32031309

RESUMO

OBJECTIVES: To analyze the location and degree of parotid ductal abnormalities associated with Sjogren's syndrome (SS) and to correlate findings with the duration of the disease. To develop a classification system based on contemporary sialography techniques and employ the system to grade findings on sialograms. To assess the role for therapeutic intervention in patients with SS. METHODS: Retrospective chart review of a consecutive series of 337 sialograms done by the senior investigator over a 10-year period identified 26 sialograms in patients who met the criteria for SS as defined by the American-European Consensus Group (2002). A classification system was developed to grade the degree of ductal abnormalities identified on the sialograms. Individual, initial blinded review of these sialograms was performed by two head and neck radiologists to identify and grade abnormalities. Radiographic findings were correlated with patient history including symptom duration. RESULTS: All patients with SS had stenoses within the ductal system. About 73.1% of patients had stenoses in each branch of the ductal system (primary, secondary, and tertiary ducts). In 19% of patients, the main duct was of normal caliber despite the presence of stenosis in the more proximal ducts (secondary and tertiary ducts). Peripheral (proximal) duct dilation was characterized among those affected in patterns classified as destructive (34.6%), cavitary (26.9%), globular (11.5%), or punctate (11.5%). A statistically significant positive correlation (p = .0360) was identified between symptom duration and degree of main ductal stenosis. CONCLUSION: Sialography may be useful to objectively assess the degree of parotid ductal damage in SS employing a newly proposed classification system. This assessment may assist clinicians in tailoring management to selectively include ductal dilation.


Assuntos
Glândula Parótida , Sialografia , Síndrome de Sjogren , Humanos , Glândula Parótida/patologia , Estudos Retrospectivos , Ductos Salivares/diagnóstico por imagem , Síndrome de Sjogren/complicações , Síndrome de Sjogren/diagnóstico por imagem
15.
Eur Arch Otorhinolaryngol ; 277(3): 909-915, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31845035

RESUMO

PURPOSES: To explore the feasibility of 3D printed salivary duct models for the sialendoscopic skills training. METHODS: Healthy volunteers and patients affected by obstructive salivary gland disorders were submitted to 3 Tesla MR sialography. The MR data underwent an image segmentation process to produce the 3D printed salivary duct prototypes. Sialendoscopies were carried out by three groups of investigators with different levels of endoscopic experience. Realism, usefulness of the training process and potential advantages of the 3D printed models in the preoperative surgical planning were evaluated by means of a specific survey. RESULTS: Four cases were included in our study: one healthy parotid, one submandibular gland, one case of lithiasis and one of stenosis involving the parotid gland. In all cases, the three groups of investigators successfully explored the salivary ducts up to the tertiary branches, detected the cause of obstruction and correctly treated it. Seven untoward events occurred during the operative sialendoscopies. Overall, the questionnaire score was about 79.3%, reflecting a positive impression regarding the models on behalf of all the investigators. CONCLUSIONS: 3D printed salivary duct models resulted feasible for the sialendoscopic skills training. The opportunity to reproduce the patient-specific anatomy may add further information useful in the preoperative decision making. These positive results should be verified by further researches and experiences.


Assuntos
Ductos Salivares , Doenças das Glândulas Salivares , Endoscopia , Estudos de Viabilidade , Humanos , Impressão Tridimensional , Ductos Salivares/diagnóstico por imagem , Ductos Salivares/cirurgia , Doenças das Glândulas Salivares/diagnóstico por imagem , Doenças das Glândulas Salivares/cirurgia , Sialografia
16.
J Stomatol Oral Maxillofac Surg ; 121(1): 80-83, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30769109

RESUMO

Stafne bone cysts (SBC) are defined as pseudocysts of the jaw in the literature. These lesions are typically localized at lingual cortical surface of the mandible and generally included normal salivary gland tissue; but they do not contain an epithelial lining. They may contain fat, muscle, connective tissue, lymphatic tissue, nerve bundles, blood vessels or air. In the literature, unlike posterior variant of SBC, anterior type of SBC (aSBC) is almost seven times less common (0.009%-0.3%). Usually, SCBs are identified at dental examination randomly. Since these lesions are mostly asymptomatic, some additional imagining modalities such as magnetic resonance imaging (MRI), computed tomography (CT) or sialography may be useful to confirm the diagnosis for atypical lesions. The aim of this report is to present a new case of aSBC and focuses on differential diagnosis along with alternative diagnostic imaging resources and review current literature.


Assuntos
Cistos Ósseos , Cistos Maxilomandibulares , Doenças Mandibulares , Humanos , Radiografia Panorâmica , Sialografia
17.
Laryngoscope ; 130(10): 2360-2365, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-31691983

RESUMO

OBJECTIVES/HYPOTHESIS: To suggest a strategy for transoral removal of hilar and intraparenchymal submandibular stones. STUDY DESIGN: Retrospective case series. METHODS: Retrospective evaluation was performed for 514 consecutive patients with hilar and intraparenchymal submandibular stones treated via endoscopy-assisted surgery from January 2006 to June 2018. Three patients had bilateral stones. The stones were classified as: hilar (type I), posthilar (type II), intraparenchymal (type III), and multiple stones (type IV). RESULTS: The affected glands included 311 with type I, 84 with type II, 65 with type III, and 57 with type IV stones. Stones were successfully removed in 478 glands (92.5%, 478/517). Main treatment techniques included hilum ductotomy in 311 glands, intraparenchymal ductotomy in 68, submandibulotomy in 14, intraductal retrieval in 74, and hilum ductotomy accompanied by intraductal retrieval in 11. At a mean 40-months follow-up of 478 successful cases, clinical outcomes were good in 425, fair in 27, and poor in 26 glands. Postoperative sialograms in 75 stone-free patients were categorized as: type I, normal (n = 6); type II, ectasia or stenosis in the main duct and no persistent contrast on functional films (n = 44); type III, ectasia or stenosis in the main duct and mild contrast retention (n = 15); and type IV, poor shape of the main duct and evident contrast retention (n = 10). Postoperative sialometry of 32 patients revealed no significant differences of the gland function between the two sides. CONCLUSIONS: Appropriate use of various endoscopy-assisted approaches helps preserve the gland and facilitates recovery of gland function in patients with different depths of hilo-parenchymal submandibular stones. LEVEL OF EVIDENCE: 4 Laryngoscope, 130:2360-2365, 2020.


Assuntos
Endoscopia/métodos , Cálculos dos Ductos Salivares/cirurgia , Glândula Submandibular/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Cálculos dos Ductos Salivares/classificação , Sialografia
18.
Int J Pediatr Otorhinolaryngol ; 124: 179-184, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31202035

RESUMO

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.


Assuntos
Parotidite/diagnóstico por imagem , Parotidite/cirurgia , Sialografia , Criança , Pré-Escolar , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Estudos Retrospectivos
20.
Korean J Radiol ; 20(3): 498-504, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30799581

RESUMO

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 (slope1st), 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 slope1st, 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 slope1st 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.


Assuntos
Imageamento por Ressonância Magnética/métodos , Glândula Parótida/diagnóstico por imagem , Síndrome de Sjogren/diagnóstico , Adulto , Área Sob a Curva , Estudos de Casos e Controles , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Glândula Parótida/metabolismo , Estudos Prospectivos , Curva ROC , Sialografia , Síndrome de Sjogren/diagnóstico por imagem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...