Transcript Sialography - El Camino College

Sialography
Spring 2011
FINAL
Salivary Glands
Parotid Gland
 _______ of the glands
 Consists of ________
superficial portion
 ___________ shaped
deep portion
 Parotid duct
– ___________________
Submandibular Gland
 ____________ shaped
 Extends posteriorly
from ________molar
to almost _________
of mandible
Sublingual Gland
 _________________pair
 Located at floor of mouth
beneath _____________
 In contact with the
mandible laterally
 Extends posteriorly from
the side of _________ to
_________________duct
 Main sublingual duct
opens beside the orifice
of the submandibular duct
Sialography
 Term applied to radiographic exam of
salivary glands
– Only __________________done at a time
– CT 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 of Salivary Glands
Ranula
Infections
Strictures
Salivary Gland Calculi
Salivary Stones
Sialogram Tray and supplies
Contrast Media
 ________________________
– When tomography may be used
– Contraindicated if there is a chance of stones
 ________________________
– Stones and strictures
– 1-2ml
Procedure
1. Obtain preliminary radiographs
•
•
Any condition that is visibe w/o contrast
Optimum technique obtained
2. _____ before procedure give patient ____
3. Contrast media injected into main duct
4. After procedure _______ to clear contrast
5. _____min after procedure take radiograph
Procedure Differences
1. Most manually inject contrast
– ________________________
2. Others use hydrostatic pressure
– __________________________________
– __________________________________
– __________________________________
3. 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
Tangential Supine

Rotate pt head toward side being
examined so that parotid gland is
perp to plane of IR

Rest head on occipitus

Center IR to parotid area

Mandibular ramus parallel with
longitudinal axis of the IR

Fill mouth with air and puff cheeks

CR perp to plane of IR along lateral
surface of the ramus
 Rotate pt’s head away from
side being examined
 Rest pt’s head on chin
– Forehead and nose if parotid
duct does not need to be
seenRotate pt head toward
side being examined so that
parotid gland is perp to plane
of IR
 Center IR to parotid area
 Mandibular ramus parallel with
longitudinal axis of the IR
 Fill mouth with air and puff
cheeks
 CR perp to plane of IR along
lateral surface of the ramus
Tangential
Prone
Tangential Radiograph
 Soft tissue dentisy
 Most of parotid gland
lateral to and clear of
ramus
 Mastoid overlapping
only the upper portion
of parotid gland
 Affected side close to the
IR
 Extend mandible to clear
c-spine
 Center IR 1” superior to
angle
 Head 15 degrees from
MSP toward IR
 CR 1” superior to angle
 Oblique often used as
well
Lateral Parotid
Lateral Parotid Radiograph
 Mandibular Rami free
from overlap of c-spine
 Parotid gland SI over
the ramus
 Axiolateral oblique of
mandible can be used
Lateral
Submandibular
 Center IR to inferior
margin of angle
 PT head in true lateral
 CR at inferior margin
of angle
Lateral Submandibular Radiograph
and Lateral oblique
 Rami free from overlap
of C-spine
 SI mandibular rami if
no angualtion is used
 Axiolateral oblique of
mandible for better
demonstration
Axiolateral Oblique for
Submandibular
Sialograms