SIALOGRAPHY Spring 2013 FINAL Salivary Glands Parotid Gland

SIALOGRAPHY Spring 2013 FINAL

Salivary Glands Parotid Gland Sublingual gland Submandibular gland

Parotid Gland Largest of the glands Consists of flattened superficial portion Wedge shaped deep portion Parotid duct Conduct saliva from gland to the mouth

Submandibular Gland Irregularly shaped Extends posteriorly from first molar to almost angle of mandible

Smallest pair Located at floor of mouth beneath sublingual fold In contact with the mandible laterally Extends posteriorly from the side of frenulum to submandibular duct Main sublingual duct opens beside the orifice of the submandibular duct Sublingual Gland

Sialography Term applied to radiographic exam of salivary glands Only CT one gland done at a time and MRI have largely replaced this exam for Salivary stone or lesion is suspected Used when a definitive diagnosis is necessary for a problem with one of the salivary ducts

Indications Tumors Inflammatory lesions Determine extent of salivary fistulae Localize diverticulae strictures and calculi Salivary duct obstruction

Tumors of Salivary Glands

Ranula

Infections

Strictures

Salivary Gland Calculi

Salivary Stones

Sialogram Tray and supplies

Contrast Media Oil based When tomography may be used Contraindicated if there is a chance of stones Water Soluble Iodine based Stones 1 -2 ml and strictures

Procedure Obtain preliminary radiographs 1. • • 2. 3. 4. 5. Any condition that is visibe w/o contrast Optimum technique obtained 2 -3 min before procedure give patient lemon Contrast media injected into main duct After procedure suck on lemon to clear contrast 10 min after procedure take radiograph

Procedure Differences 1. Most manually inject contrast 2. Others use hydrostatic pressure 3. Using cannula or catheter Contrast solution barrel plunger removed Attached to drip stand 28” above pt’s mouth Some inject under fluoro and obtain spot radiographs

Radiation Safety Have shields for PT’s, DR and yourself Question LMP and the possibility of being pregnant Use cardinal rules Time Distance Shielding ALARA Use pulse if possible Save the last image on screen when possible

Lateral Parotid Radiograph

Submandibular

Sialograms

REVIEW

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