1 sialography & the salivary glands a radiographic examination of the salivary glands and ducts...
TRANSCRIPT
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SIALOGRAPHY & THE SALIVARY
GLANDS
A radiographic examination of the salivary glands and ducts
using contrast media
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Injection of contrast media into salivary ducts
OIL BASED CONTRASTSINOGRAPHIN
WATER BASED (IONIC)
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INDICATIONS FOR EXAM
Stones (Calculi) sialolithiasis Obstruction / Strictures Pain & Swelling Infection Masses / Tumors
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CONTRAINDICATIONS:
History of contrast media allergies Parotits (mumps) Severe inflammation of the
salivary ducts
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SIALOGRAPHYSNOPEK – CH 21 & BALLINGER – VOL. 2 CH. 14
3 SALIVARY GLANDS –PAROTID – LARGEST – LOCATED BY EAM -
MANDIBULAR RAMUS
SUBMANDIBULAR / SUBMAXILLARY – 1st molar to Gonion
SUBLINGUAL – LOCATED BEHIND THE MENTUM under the sublingual fold SMALLEST-
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9DUCTS
Parotid duct – located by maxillary bone– 2nd upper molar) Stensen’s duct PAROTID GLAND
Submandibular Duct – located on end of sublingual ridge to fill submandibular
Wharton’s duct SUBMAXILLARY
Sublingual duct (several small) located alongside submandibular duct to SUBLINGUAL GLAND
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1. Parotid Gland2. Submandibular Gland
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EQUIPMENT NEEDS RAD/ FLUORO ROOM
Mostly replaced now by MRI & CT
Safe and simple but difficult to perform – hard to located and catheterize ducts
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PROCEDURESialogram Tray – Gauze, Sterile towels, Spot Light,
Magnifying glasses, Gloves, Eyewear, mask
LEMONS - cut into wedges Lacrimal Probes Hemostats 5 cc syringes Sialogram Catheter (Rabinov) needles or canulas
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PATIENT PREP
(No specific prep = oral mouthwash in nice)
Remove any metal – bridgework, tongue piercing
Get History – present to radiologist BEFORE setting up tray
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32 gauge Sialogram needle
“Rabinov” catheter
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RADIOGRAPHS
1. SCOUT FILMS – important to r/o stone for SOFT TISSUE (LIGHT EXPOSURE)
Like mandible series = AP (OML) (Grid ) Both Obliques (Ext. cassette) True Lateral (x-table) (Grid or extremity cassette) Tangential films may be required Mentum or Parotid 2. Give lemon - contast injected 3. SPOT FILMS – taken by DR during fluoro 4. Post films – taken 10 min after injections – check
drainage
16SUBMANDIBULAR GLAND
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PAROTID GLAND
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SUBMANDIBULAR GLAND
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Contrast media Water based iodinated
(ionic or nonionic)
Less dense – absorbed faster –no residue
Conray, Hypaque, Isovue, Renographin (60/76)
Oil-based
More dense, absorb slower –
can cause granuloma (stones)
hard to completely excrete
Ethiodol, Sinographin
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DUCTS
Parotid duct – located by maxillary bone– 2nd upper molar) - PAROTID GLAND Stensen’s duct
Submandibular Duct – located on end of sublingual ridge to fill submandibular / SUBMAXILLARY Wharton’s duct
Sublingual duct (several small) located alongside submandibular duct to SUBLINGUAL GLAND
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Tangential parotid gland, supine position.
CR - “skims” – side of face
Cr is directed along lateral side for unobstructed image of parotid gland
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“True” Lateral Parotid gland is
superimposed Over the
mandibular rami
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THE END
Questions?