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.
Salivary Ducts ; Sialography

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.
Catheters ; Humans ; Salivary Glands ; Sialography ; Ultrasonography ; Vasodilation

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.
Humans ; Meals ; Parotid Gland ; Salivary Glands* ; Sialadenitis ; Sialography ; Therapeutic Irrigation

The purpose of this study was to established the characteristic radiographic features in salivary gland diseases by means of sialography and scintigraphy. Sialograms and scintigrams with diseases of salivary gland were examined. In this group were 5 salivary stones, 14 sialadenitis, 17 Sj gren's syndromes and 8 benign tumors. The obtained results were as follows; 1. In the configuration of the shape of main duct, those revealed that modified curvilinear and curvilinear types were predominant in Sj gren's syndromes but reverse sigmoid and angular types were in sialolithiasis and sialadenitis combined with sialodochitis. 2. In the configuration of the course of main duct, those revealed that smooth types were predominant in sialadenitis and irregular types were predominant in Sj gren's syndromes and benign tumors and irregular types were seen in all salivary stones and sialadenitis combined with sialodochitis, 3. In the type of intraglandular pattern, those revealed that destructive changes of salivary duct system and parenchyma were severe in sialadenitis and salivary stones and predominantly severe in Sj gren's syndromes. 4. The function of salivary gland was decreased severely in Sj gren's syndrome. and also decrease in salivary stone and sialadenitis. In benign tumor, the uptake of radioisotope was not seen in lesion and the function of salivary gland decreased in its remaining normal parenchyma.
Colon, Sigmoid ; Radionuclide Imaging ; Salivary Ducts ; Salivary Gland Calculi ; Salivary Gland Diseases ; Salivary Glands ; Sialadenitis ; Sialography*

PURPOSE: To describe the normal sonographic anatomy of the submandibular duct and to assess the value of sonography in the diagnosis of sialolithiasis of the submandibular gland. MATERIALS AND METHODS: Using continuous injection of saline via a sialography needle, we evaluated the normal sonographic anatomy of the submandibular duct in healthy volunteers (n=5). We also reviewed sonographic findings in 47 patients with (n=29) or without (n=18) stones. In each case, the presence or absence of stone was proved by sialography or surgery. RESULTS: In control subjects, sonography accurately depicted the ductal anatomy of the submandibular glands and its relationship with adjacent tissues. For the detection of stones, sonography had a sensitivity of 86%, a specificity of 100%, and an accuracy of 91%. For ductal dilatation, its sensitivity was 91%, its specificity, 100%, and its accuracy, 94%. In 68% of cases with stones, a circumferential low echoic rim surrounding the stone ("rim sign") was present on sonogram. CONCLUSION: Ultrasound is a useful procedure and could replace sialography in most patients with sialolithiasis of the submandibular gland.
Diagnosis* ; Dilatation ; Healthy Volunteers ; Humans ; Needles ; Salivary Gland Calculi* ; Sensitivity and Specificity ; Sialography ; Submandibular Gland* ; Ultrasonography*

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.
Cone-Beam Computed Tomography ; Constriction, Pathologic ; Dilatation ; Salivary Gland Diseases ; Salivary Glands ; Sialography

OBJECTIVETo study the sialographic changes and to compare the changes with sialoendoscopic and irrigation fluid findings in chronic obstructive parotitis (COP).

METHODSThis study involved 27 patients with a long history of parotid swelling. All patients were examined by X-ray, sialography, and were diagnosed as COP without sialolithiasis. Sialoendoscopy was used to observe the ductal system and irrigation treatment performed. The irrigated liquid was centrifuged and the deposits of fluid were stained and observed under microscopy. The sialographic changes were classified as previous studies and compared with sialoendoscopic and irrigation fluid findings.

RESULTSThe sialographic changes of COP in 27 patients included 9 cases with type I, 5 cases with type II, 9 cases with type III and 3 cases with type IV changes, 1 case was normal. Marked obstructive factors such as stricture of ductal system were revealed in 21 cases on the sialogram. Sialoendoscopic examination showed that the ductal system was filled with fiber-like substances and hyperaemia of ductal wall in all cases. While few and thin fiber-like substances were found in the COP with sialographic type I and type II changes, many thick wadding or mass fiber-like substances were revealed in COP with sialographic type III and IV changes. Microstones were found in 2 COP with sialographic type III changes which were stained and identified by microscopy. Foreign body (drug bar) was found in one COP with sialographic type I changes with sialoendoscopy. Irrigation fluid examination showed fiber-like substance was composed of desquamative duct epithelial cells, neutrophil, lymphocytes, acidophile. Some epithelial cells were found in two microliths.

CONCLUSIONSThe pathological basis of fiber-like substance on sialoendoscopy is desquamative duct epithelial cells. Fiber-like substance in the lumen of ductal system is considered as one of the obstructive factors in COP. Sialoendoscopic findings is related to sialographic changes.

Adult ; Aged ; Chronic Disease ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Parotitis ; diagnosis ; pathology ; Sialography ; Therapeutic Irrigation

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.
Endoscopy ; Female ; Humans ; Inflammation ; Iodine Radioisotopes ; Male ; Radiation Injuries ; Salivary Ducts ; Sialadenitis/etiology* ; Sialography

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.
Constriction, Pathologic/surgery* ; Endoscopy ; Humans ; Reconstructive Surgical Procedures ; Salivary Ducts/surgery* ; Sialography

A dermoid cyst of the head and neck region is a relatively infrequent occurrence and accounts for only 6.9% of all dermoid cysts. Its anatomical distribution is the orbit, floor of the mouth, other midline and nose in the order of frequency. A dermoid cyst of the parotid gland is extremely rare, and due to this and the absence of pathognomonic findings, it is often difficult to diagnose preoperatively. Thus thorough and careful examination including ultrasonic study is needed to evaluate this lesion. It must be differentiated from malignant tumors and other cystic lesions. Dermoid cysts usually recur after simple excision, so it is mandatory to excise it completely with a parotidectomy. This paper presents two cases of parotid gland dermoid cyst with a brief review of the literature.
Adult ; Case Report ; Dermoid Cyst/*diagnosis/surgery ; Human ; Male ; Parotid Gland/pathology/radiography ; Parotid Neoplasms/*diagnosis/surgery ; Sialography ; Ultrasonography