Transcript Sialography - El Camino College

Spring 2012
FINAL
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Parotid Gland
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Sublingual gland
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Submandibular gland
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Largest of the glands
Consists of flattened
superficial portion
Wedge shaped deep
portion
Parotid duct
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Conduct saliva from
gland to the mouth
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Irregularly shaped
Extends posteriorly
from first molar to
almost angle of
mandible
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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
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Term applied to radiographic exam of salivary
glands
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Only one gland done at a time
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CT and MRI have largely replaced this exam for
 Salivary stone or lesion is suspected
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Used when a definitive diagnosis is necessary for a
problem with one of the salivary ducts
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Tumors
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Inflammatory lesions
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Determine extent of salivary fistulae
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Localize diverticulae strictures and calculi
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Salivary duct obstruction
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Oil based
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When tomography may be used
Contraindicated if there is a chance of stones
Water Soluble Iodine based
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Stones and strictures
1-2ml
Obtain preliminary radiographs
1.
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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
Most manually inject contrast
1.
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Others use hydrostatic pressure
2.
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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
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Have shields for PT’s, DR and yourself
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Question LMP and the possibility of being pregnant
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Use cardinal rules
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Time
Distance
Shielding
ALARA
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Use pulse if possible
Save the last image on screen when possible
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Rotate pt head toward side being
examined so that parotid gland is
perp to plane of IR
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Rest head on occipitus
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Center IR to parotid area
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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
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Rotate pt’s head away from
side being examined
Rest pt’s head on chin
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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
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Soft tissue dentisy
Most of parotid gland
lateral to and clear of
ramus
Mastoid overlapping
only the upper
portion of parotid
gland
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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
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Mandibular Rami
free from overlap of
c-spine
Parotid gland SI over
the ramus
Axiolateral oblique of
mandible can be used
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Center IR to inferior
margin of angle
PT head in true
lateral
CR at inferior margin
of angle
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Rami free from
overlap of C-spine
SI mandibular rami if
no angualtion is used
Axiolateral oblique of
mandible for better
demonstration
A
B
E
C
F
D
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http://www.youtube.com/watch?v=crp5BFwp5
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Visipaque
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http://www.youtube.com/watch?v=j511ttKP8C
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