OBJECTIVE: To compare the accuracy of ultrasound (US)-guided and non-US-guided botulinum toxin (BTX) injection into the salivary glands (parotid and submandibular glands) of cadavers. METHODS: Two rehabilitation physician injected dye into three sites in the salivary glands (two sites in the parotid gland and one site in the submandibular gland) on one side of each cadaver (one was injected on the right side, while the other was injected on the left side), using either a non-US-guided injection procedure based on superficial landmarks or a US-guided procedure. Orange dye was used for the US-guided procedure, and green dye was used for the blind procedure. Two physicians uninvolved with the injection procedures and who were blinded to the method of injection dissected the cadavers to identify whether the dye was accurately injected into each target site. RESULTS: The accuracies of the blind and US-guided injections into the parotid gland were 79.17% and 95.83%, respectively. In the submandibular gland, the accuracies of the blind and US-guided injections were 50.00% and 91.67%, respectively. The difference in accuracy between the two procedures was statistically significant only in the submandibular gland (p=0.025). There were no significant differences in the accuracy of US-guided and non-US-guided injections between the two physicians for the two sites in the parotid gland (p=0.278 and p=0.146, respectively). CONCLUSION: US-guided BTX injection into the submandibular gland offers significantly greater accuracy over blind injection. For the treatment of drooling by injecting BTX into the submandibular gland, clinicians should consider using US guidance for improved accuracy.
Botulinum Toxins* ; Cadaver* ; Citrus sinensis ; Methods ; Parotid Gland ; Rehabilitation ; Salivary Glands* ; Sialorrhea ; Submandibular Gland ; Ultrasonography

No abstract available.
Diagnosis, Differential ; Female ; Humans ; Middle Aged ; Neck/diagnostic imaging ; Parotid Gland/*pathology ; Parotid Neoplasms/diagnosis/diagnostic imaging/pathology ; Sarcoidosis/*diagnosis/diagnostic imaging ; Tomography, X-Ray Computed ; Ultrasonography

BACKGROUND AND OBJECTIVES: The parotid abscess is a rare disease. It occurs mainly in patients with poor oral hygiene, dehydration, and immune compromised. This study aims to analyze clinical presentations of the parotid abscess treated with ultrasonography and fluoroscopy guided percutaneous drainage. SUBJECTS AND METHOD: A retrospective review of medical records were carried out for nine patients with parotid abscess treated with percutaneous drainage during the period from March 2007 to May 2013. RESULTS: Of the nine patients identified with parotid abscess, there were seven males and two females who were in the age range of 41 to 85 years (mean age of 61.8). The mean level of the serum amylase was 167.4 IU/L (ranging from 52 to 343). Of the nine patients, two were found with intra-parotid cystic tumor, one was infected with the Tuberculosis, and six were found with an unidentifed parenchymal infection. All except one patient were improved after percutaneous drainage. One patient, who suffered underlying diabetes, chronic renal failure and liver cirrhosis, died due to sepsis that rapidly progressed from parotid abscess despite percutaneous drainage. The mean period of hospitalization was 16.1 days. Bacteria isolations resulted in identification for 4 patients (44.4%). CONCLUSION: Parotid abscess could be successfully treated with ultrasonography and fluoroscopy guided percutaneous drainage unless it involved multiple regions or progressing rapidly.
Abscess* ; Amylases ; Bacteria ; Catheters ; Dehydration ; Drainage* ; Female ; Fluoroscopy ; Hospitalization ; Humans ; Kidney Failure, Chronic ; Liver Cirrhosis ; Male ; Medical Records ; Methods ; Oral Hygiene ; Parotid Gland ; Rare Diseases ; Retrospective Studies ; Sepsis ; Tuberculosis ; Ultrasonography

Although renal calcium crystal deposits (nephrocalcinosis) may occur in acute phosphate poisoning as well as type 1 renal tubular acidosis (RTA), hyperphosphatemic hypocalcemia is common in the former while normocalcemic hypokalemia is typical in the latter. Here, as a unique coexistence of these two seperated clinical entities, we report a 30-yr-old woman presenting with carpal spasm related to hypocalcemia (ionized calcium of 1.90 mM/L) due to acute phosphate poisoning after oral sodium phosphate bowel preparation, which resolved rapidly after calcium gluconate intravenously. Subsequently, type 1 RTA due to Sjogren's syndrome was unveiled by sustained hypokalemia (3.3 to 3.4 mEq/L), persistent alkaline urine pH (> 6.0) despite metabolic acidosis, and medullary nephrocalcinosis. Through this case report, the differential points of nephrocalcinosis and electrolyte imbalances between them are discussed, and focused more on diagnostic tests and managements of type 1 RTA.
Acidosis, Renal Tubular/*diagnosis/etiology ; Acute Disease ; Adult ; Antibodies, Antinuclear/blood ; Calcium Gluconate/therapeutic use ; Chronic Disease ; Female ; Humans ; Hydrogen-Ion Concentration ; Hypocalcemia/*chemically induced/complications/drug therapy ; Nephrocalcinosis/complications/*diagnosis/ultrasonography ; Parotid Gland/ultrasonography ; Phosphates/*adverse effects ; Salivary Glands/radionuclide imaging ; Sjogren's Syndrome/complications/*diagnosis/metabolism ; Submandibular Gland/ultrasonography

The formation of the salivary glands begins between the 6th and the 12th week of development of the embryo. The submandibular gland develops from the endoderm of the floor of the mouth and begins forming later than the parotid gland. The congenital absence of major salivary glands is uncommon; aplasia of both submadibular glands, in particular, is extremely rare. It's major symptoms are dryness of the mouth, dysphagia and dental caries. The diagnosis of aplasia of the salivary glands should be achieved by imaging methods such as technetium-99m pertechnetate radionuclide scan, ultrasonography, sialography or computerized tomography. We report with relative literature on the case of a 50 year old woman suffering from dryness of the mouth due to aplasia of both submandibular glands.
Deglutition Disorders ; Dental Caries ; Diagnosis ; Embryonic Structures ; Endoderm ; Female ; Humans ; Middle Aged ; Mouth ; Parotid Gland ; Salivary Glands ; Sialography ; Sodium Pertechnetate Tc 99m ; Submandibular Gland* ; Ultrasonography

Background: Parotid gland tumor is a quite common pathology in salivary gland tumor. The exact diagnosis for parotid gland tumors has an important significance because it will help to plan appropriate surgical strategies. Objective: To remark some characteristics of ultrasonographic image of the parotid gland tumors and evaluate the role of ultrasonography in diagnosis of the parotid gland tumors. Subject and methods: A cross-sectional, descriptive study was conducted on 24 patients with parotid gland tumors, operated on at the Department of Plastic and Maxilofacial Surgery of Hospital 103 and the Department of Odonto - Stomatology of Ha Dong General Hospital, Hanoi from January, 2007 to July, 2008. Results: The size of tumors was 2-4cm (58.33%), 21/24 of tumors were in superficial lobe areas. 46.66% of pleomorphic adenomas had a lobulated shape. 2/3 of Warthin\u2019s tumors had an oval shape. 79.17% of the benign lesions were well-defined. 87.5% of all tumors had echogenicity decreased. Almost equal percentages of Warthin\u2019s tumors were echogenicity decreased and structure in heterogeneous. Conclusion: Ultrasonography is a useful method in the diagnosis of the parotid gland tumors, helping to determine clearly the natural basis of some tumors and contributing to early screening for acute parotid gland tumors.
Parotid gland tumor ; ultrasonography

Tuberculous parotitis is a rare disease even in the endemic areas. Clinically it is usually presented as a slowly growing local mass over the parotid area, mimicking a benign neoplasm of parotid gland. Also it rarely accompanies respiratory or systemic symptoms such as fever, night sweat, or weight loss, which make the preoperative diagnosis of tuberculous parotitis even more difficult. Preoperative diagnostic studies such as sialography, ultrasonography or CT scan also provides nonspecific findings that have little contribution to the diagnosis. Less than 100 cases of tuberculous parotitis has been reported in the worldwide literatures and moreover, cases that were diagnosed tuberculous parotitis before pathologic confirmation are hard to find. In our department, superficial parotidectomy was performed on a patient with a mass over her right parotid area, and the mass was pathologically diagnosed tuberculous parotitis.
Diagnosis ; Fever ; Humans ; Parotid Gland ; Parotitis* ; Rare Diseases ; Sialography ; Sweat ; Tomography, X-Ray Computed ; Tuberculosis ; Ultrasonography ; Weight Loss

Tuberculous parotitis is a rare disease even in the endemic areas. Clinically it is usually presented as a slowly growing local mass over the parotid area, mimicking a benign neoplasm of parotid gland. Also it rarely accompanies respiratory or systemic symptoms such as fever, night sweat, or weight loss, which make the preoperative diagnosis of tuberculous parotitis even more difficult. Preoperative diagnostic studies such as sialography, ultrasonography or CT scan also provides nonspecific findings that have little contribution to the diagnosis. Less than 100 cases of tuberculous parotitis has been reported in the worldwide literatures and moreover, cases that were diagnosed tuberculous parotitis before pathologic confirmation are hard to find. In our department, superficial parotidectomy was performed on a patient with a mass over her right parotid area, and the mass was pathologically diagnosed tuberculous parotitis.
Diagnosis ; Fever ; Humans ; Parotid Gland ; Parotitis* ; Rare Diseases ; Sialography ; Sweat ; Tomography, X-Ray Computed ; Tuberculosis ; Ultrasonography ; Weight Loss

PURPOSE: Warthin's tumor is a slow growing tumor found exclusively either in the parotid gland or the periparotid lymph nodes. Although surgical resection is the treatment of choice, the extent of surgery which is most beneficial has remained contraversial. We performed a comparative study of the results between enucleation and parotidectomy groups to evaluate the effectiveness of the enucleation procedure for the surgical management of parotid Warthins tumor. METHODS: Between January 1981 and July 2001, 74 patients underwent surgical resection of parotid Warthin's tumor. We reviewed the clinicopathological characteristics retrospectively and compared the operation time, postoperative complication rate, duration of postoperative hospital stay and recurrence between the enucleation group and the parotidectomy group. RESULTS: The mean age was 57.0 years (19~86 years) and the male to female ratio was 5.7: 1. The majority of the tumors were situated in the lower region of the superficial lobe (89.2%). Bilateral simultaneous involvements of the parotid gland was found in 5 patients (6.8%) and therefore a total of 79 parotid glands were involved. Four (5.4%) of the 79 parotid glands featured multifocal tumors of two or three lumps. Tumor sizes varied from 0.5 to 13.0 cm with a mean diameter of 3.5 cm. Of the 74 patients, 51 (68.9%) were diagnosed preoperatively or perioperatively by means of CT scans, ultrasound, 99m-Tc. scan, fine needle aspiration cytology or intraoperative frozen section biopsy. Of the 79 glands, 46 underwent a superficial (n=39), partial (n=2) or total (n=5) parotidectomy, while enucleation was performed for the remaining 33 cases with single Warthin's tumor. Only one case of recurrence was identified during the follow up period. However the operation time, the postoperative complication rate, and the duration of postoperative hospital stay were all significantly reduced in the enucleation group (P<0.05). CONCLUSION: The enucleation procedure may represent a safe and appropriate surgical method for patients with single Warthin's tumor that is diagnosed preoperatively.
Biopsy ; Biopsy, Fine-Needle ; Female ; Follow-Up Studies ; Frozen Sections ; Humans ; Length of Stay ; Lymph Nodes ; Male ; Parotid Gland ; Postoperative Complications ; Recurrence ; Retrospective Studies ; Tomography, X-Ray Computed ; Ultrasonography

L-asparaginase is an essential chemotherapeutic agent in the treatment of the acute lymphoblastic leukemia or non-Hodgkin lymphoma with its unique mechanism of action. It has many toxic effects involving multiple organs. The acute parotitis associated with L-asparaginase has been rarely reported. In this report, acute parotitis developed in the 4 acute lymphoblastic leukemia patients who were treated with the induction chemotherapy regimen including L-asparaginase. Mumps was excluded in 3 patients and the evidence of coexisting pancreatitis was observed in 2 patients. The parotid ultrasonography revealed diffuse enlargement in all patients. The symptoms were spontaneously resolved with no specific treatment, and in all cases there was no recurrence of the same disease with later maintenance chemotherapy including L-asparaginase. The possible mechanism of the acute parotitis is not yet clearly understood. But considering its histologic similarity with the pancreas, the depletion of L-asparagine may damage the acinar cells of parotid gland. The acute parotitis is not a well-known side effect of L-asparaginase but it needs to be promptly recognized in order to consider the discontinuation of the L-asparaginase and to exclude any viral infection requiring isolation.
Acinar Cells ; Asparagine ; Humans ; Induction Chemotherapy* ; Lymphoma, Non-Hodgkin ; Maintenance Chemotherapy ; Mumps ; Pancreas ; Pancreatitis ; Parotid Gland ; Parotitis* ; Precursor Cell Lymphoblastic Leukemia-Lymphoma* ; Recurrence ; Ultrasonography