SIALOGRAPHY THE SALIVARY GLANDS A radiographic examination of
- Slides: 31
SIALOGRAPHY & THE SALIVARY GLANDS A radiographic examination of the salivary glands and ducts using contrast media 1
Injection of contrast media into salivary ducts OIL BASED CONTRAST SINOGRAPHIN WATER BASED (IONIC) 2
3 INDICATIONS FOR EXAM n n n Stones (Calculi) sialolithiasis Obstruction / Strictures Pain & Swelling Infection Masses / Tumors
4 CONTRAINDICATIONS: n n n History of contrast media allergies Parotits (mumps) Severe inflammation of the salivary ducts
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6 SIALOGRAPHY SNOPEK – CH 21 & BALLINGER – VOL. 2 CH. 14 3 SALIVARY GLANDS – PAROTID – LARGEST – LOCATED BY EAM MANDIBULAR RAMUS SUBMANDIBULAR / SUBMAXILLARY – 1 st molar to Gonion SUBLINGUAL – LOCATED BEHIND THE MENTUM under the sublingual fold SMALLEST-
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9 DUCTS Parotid duct – located by maxillary bone– 2 nd 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
10 1. Parotid Gland 2. Submandibular Gland
11 EQUIPMENT NEEDS n n RAD/ FLUORO ROOM Safe and simple but difficult to perform – hard to located and catheterize ducts Mostly replaced now by MRI & CT
12 PROCEDURE Sialogram Tray – n Gauze, Sterile towels, Spot Light, Magnifying glasses, Gloves, Eyewear, mask n LEMONS - cut into wedges n Lacrimal Probes n Hemostats n 5 cc syringes n Sialogram Catheter (Rabinov) needles or canulas
13 PATIENT PREP (No specific prep = oral mouthwash in nice) n Remove any metal – bridgework, tongue piercing n Get History – present to radiologist BEFORE setting up tray
14 n 32 gauge Sialogram needle n “Rabinov” catheter n
15 n n n n 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
16 SUBMANDIBULAR GLAND
17 PAROTID GLAND
18 SUBMANDIBULAR GLAND
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24 Contrast media n n Water based iodinated (ionic or nonionic) Less dense – absorbed faster –no residue n n n Conray, Hypaque, Isovue, Renographin (60/76) n Oil-based More dense, absorb slower – can cause granuloma (stones) hard to completely excrete Ethiodol, Sinographin
25 DUCTS n n n Parotid duct – located by maxillary bone– 2 nd 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
26 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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28 “True” Lateral n n Parotid gland is superimposed Over the mandibular rami
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THE END Questions? 31
- Saliva formation
- Sialography
- Submandibular gland excision
- Phadebas paper
- Webers glands
- Colon
- Minor salivary glands
- Git organs
- Parotid gland microscope labeled
- Httpv://www.youtube.com/watch?v=gvuiltwlel8
- Salivary glands anatomy
- Testing cranial nerves
- Sialactasis
- Ercp images
- Mucous acini
- Surface of parotid gland
- Millers right angle technique
- Neutrophelia
- Cherry blossom sialography
- Aniogap
- Branchless fruit laden tree appearance
- Spill of dye
- Sialography
- Geometric unsharpness of margins in radiographic image
- Off level grid error
- What is recorded detail in radiography
- Light fog artifact
- Xray dark room layout
- Reverse towne projection
- Mandible x ray positioning towne's
- Dental radiography techniques ppt
- Notching of the crestal lamina dura