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[A study of absorbed x-ray doses and protection to critical organs of the head and neck during siaglography]

A tissue equivalent phantom was used in the study and absored x-ray doses.It measuring for some important organs of head and neck by four routive sialography methods (panoramic conventional x-ray radioagraphy,tomography,fluoroscope,CT) and also the X-ray absorbed doses of thyroid and len when lead containing loop and spectacles of head containing glass were used for prevention.All the data were processed statistically and a compartive study of absorbed x-ray doses of four sialography methods:Doses of submandibular gland were higher in CT,tomography and fluoroscope among them,CT was the highest indicating that it was superior to other methods for accurately locating that it was superior to other methods for accurately locating the within-gland tumor.Fluoroscope will be use more frequently in clinic,because it can observe the living gland panoramic and normal radiography can be used routinely because they had the minimum doses in measured organs.2.The absorbed x-ray doses of len and thyroid decreased by 93%-% when prevention was taken in CT or fluoroscope,65%-85% doses was decreased in normal radiography or panoramic with prevention.

Journal Article↗

Stafne bone cavity: a retrospective study of 11 cases.

OBJECTIVE: To describe the clinical and radiological characteristics of patients with Stafne bone cavity. STUDY DESIGN: A retrospective, observational study of 11 cases of Stafne bone cavity. After finding an imagine compatible with Stafne bone cavity in the Orthopantomograph(r) of 11 patients, a sialography of the mandibular gland was made in 3 cases, computerized tomography (CT) in 6 cases, and in 4 cases surgical intervention to confirm the diagnosis. RESULTS: The average age was 51.5 years, predominantly males. The entity was diagnosed incidentally during a routine radiology in all cases. The sialography revealed glandular tissue within the defect, and the CT demonstrated the conservation of the lingual cortical and the peripheral origin of the lesion. Glandular tissue was found within the lesions of two of the patients who underwent surgery, and in the other two the cavity was empty. No progressive changes were found in any of the 11 cases. CONCLUSIONS: Stafne bone cavity was an incidental finding, presenting no evolutionary changes, and as such conservatory therapy based on periodic controls was indicated. Currently, complementary techniques such as CT are sufficient to establish a certain diagnosis.

Adult↗

[Obstructive sialoadenitis: update of diagnosis and therapy issues].

In head and neck district, major salivary gland diseases seem to have a considerable epidemiological and clinical impact, especially in obstructive disease. Major salivary glands, in fact, having a ductal system can develop several diseases: sialoadenitis, sialodochitis and sialoceles. Particularly, the obstructive sialoadenitis, with or without sialolithiasis, are the most frequent inflammatory disorder, especially for submandibular gland. In the clinical practice, the diagnostic approach for obstructive sialoadenitis up to now consisted of traditional Rx, ultrasonographic technique, scintigraphy technique, C.T., sialography technique with contrast or sialography M.R. Since '90 years, lithotripsy and, later, sialendoscopy have been introduced as gold standard diagnostic procedures in case of obstructive sialoadenitis and also as therapeutic tool when possible. In this way, it has been possible to offer a valid alternative in place of traditional surgical techniques, with a less invasive and more efficacious approach.

Endoscopy↗

[Salivary gland ultrasonography].

Many pathologic conditions of the salivary gland are diagnosed clinically. Until a few years ago, supplementary radiographic methods have only included plain film radiography and sialography. Both methods vary in usefulness, and the indications are controversial. During the last two decades other imaging methods, both radiographic and non-radiographic, have been used, and have provided clinically useful information. Probably the most useful of these is ultrasonography. Because the salivary glands are superficial structures they lend themselves well to ultrasonographic evaluation. Although sialography should still be the method of choice for some conditions, ultrasonography alone will often give the correct diagnosis. The purpose of this article is to describe the role of sonography for imaging pathologic conditions of the salivary glands.

Aged↗

Pediatric recurrent sialectasis: case report.

A 2 1/2-year-old female presented to the Department of Paediatrics with a fever (38.2 degrees C) and bilateral swelling of the parotid salivary glands. A month later, she presented with similar signs and symptoms. Three months later the patient had a third attack and was referred to the Paediatric Dental Department. A clinical examination and sialography showed a normal Stensen's duct. The parenchyma of the right parotid had a combination of punctate lesions (1-2 mm in diameter) and globular lesions (3 mm in diameter). In the left parotid there were punctate lesions approximately 1 mm in diameter. The patient was managed with antipyretics (acetaminophen) and penicillin. This condition should be referred to as sialadenitis pediatrica as it presents as a clinical entity with signs and symptoms of swelling and pyrexia in the absence of sialography and histological findings. It is referred to as sialectasis after histological and sialographic observations detect lesions affecting the parenchyma of the salivary glands.

Child, Preschool↗

Ultrasonography of the salivary glands.

Sonography and computed tomography play complementary roles in imaging mass lesions in the salivary glands and their surroundings. Ninety per cent of parotid tumors originate from the superficial lobe, and we consider sonography to be the method of choice for imaging these lesions. The sensitivity of high-resolution sonography in detecting intraparotid tumors approaches 100 per cent, and ultrasound is therefore an excellent method to evaluate patients with parotid swelling. It may provide clinically useful information by precisely outlining the tumor borders or by detecting multiple or bilateral lesions. We restrict our use of CT to tumors that appear to extend beyond the borders of the parotid gland with possible invasion of surrounding soft tissues or bone. CT is also the method of choice for differentiating lesions of the deep lobe from parapharyngeal tumors and for staging carcinomas. Although ultrasound supplemented with computed tomography should replace conventional sialography in the work-up of parotid neoplasms, sialography remains the method of choice for evaluating patients with chronic sialadenitis, autoimmune diseases, and sialolithiasis. The role of sonography in these conditions is limited to ruling out a parotid neoplasm, assessing the extent of abscess formation, or assisting in localizing calculi in selected patients.

Adenocarcinoma↗

[Stomatological manifestations in Sjögren's disease and syndrome].

For diagnosis of SS and SD and the detection of early stages of disease one should necessarily take into account the symptom complex of "major" (salivary gland enlargement, xerostomia, exacerbation of parotitis) and "minor" stomatological signs (multiple cervical caries, dry lips, perlèche, mycotic and herpetic stomatitis, lymphadenopathy). The initial, marked and late stages were defined according to a degree of expression of stomatological manifestations. The initial stage prevailed in SS, the late stage in SD. The chief method of examination were sialometry, sialography and minor salivary gland biopsy. Sialography was widely used as a less traumatic diagnostic procedure. In addition to common signs with SD, salivary gland involvement was characterized by changes typical of SS combined with rheumatic disease (sclerosis in sclerodermia, vasculitis in RA and SLE, nuclear pathology in SLE).

Adult↗

[Ultrasonic findings of parotid tumours in 40 patients].

Ultrasonic findings of 40 parotid tumours are presented in this paper. After a technical description proceeding they show the ultrasonic pattern of the three main types of parotid tumours: mixed tumours, adenolymphomas and carcinomas. The differential diagnosis between malignancy and non malignancy is carried out in 87,5% of cases. This rate of success is, according to literature data, similar to that of sialography. Since it is non invasive, the authors recommend sonography in the assessment of parotid tumours, rather than sialography.

Adenolymphoma↗

Parotid area swelling caused by a prominent transverse process of atlas.

Among 1,500 parotid sialography examinations, the diagnosis of a parotid mass caused by a prominent transverse process of the atlas was made in 18 patients. The diagnosis was confirmed in one patient who insisted on surgical exploration. The remaining 17 patients required no surgical procedure. Many head and neck surgeons have unwittingly operated on such cases with frustrating results. Hopefully, roentgenographic findings will assist in the confirmation of the diagnosis and eliminate the need for such operations.

Adolescent↗

Submandibular accessory salivary gland causing Warthin's duct obstruction.

BACKGROUND: Submandibular masses are mostly secondary to sialolithiasis. Salivary gland tumors should be considered in the differential diagnosis. In this case report, an unusual cause of Warthin's duct obstruction caused by an accessory salivary gland tissue is presented. METHODS: Sialography revealed the submandibular accessory salivary gland. RESULTS: Submandibular gland excision was performed and histopathologic investigation showed the accessory salivary tissue, which was narrowing the Warthin's duct. CONCLUSIONS: In cases of a symptomatic submandibular accessory gland, excision extirpation of the submandibular gland and accessory salivary tissue should be undertaken.

Adult↗

Postnatal development of the duct system in the mouse parotid gland.

The morphology of the parotid gland in adult mice is mouse strain-specific. C57BL/6 and C3H/He strains of mouse are representatives of two types of the morphology identified previously. The postnatal development of such morphologic differences was investigated by sialography of excised glands of these strains of mouse. It was observed that the mouse strain-dependent morphological characteristics were already present at birth, except for the branching pattern of the peripheral duct system, which became differentiated at 3 weeks of age. These results indicate that the C3H/He mouse-specific branching pattern of the peripheral ducts reflects the profile of matured secretory units and ducts, and that the C57BL/6 mouse-specific pattern resembles that of an immature C3H/He mouse.

Animals↗

Sjögren's syndrome in a child.

Sjögren's syndrome is a relatively uncommon condition in the paediatric age group. The youngest child reported thus far was a 5-year-old girl. This article reports the case of a 2-year-old girl admitted for recurrent infections of the respiratory tract with diffuse pulmonary interstitial infiltrations and a progressive swelling of the parotid glands. The clinical features and the results of laboratory investigations, including parotid and hepatic biopsies, chest X-rays and sialography helped to establish the diagnosis of Sjögren's syndrome. Clinical, immunological and genetic characteristics of Sjögren's syndrome are reviewed.

Biopsy↗

Sjoegren's syndrome: MR imaging of the parotid gland.

To date, myoepithelial sialoadenitis (Sjoegren's syndrome) has been diagnosed with sialography and other techniques. First results of MR imaging offer new possibilities in the diagnostic imaging of this disease. Thirty-six patients with immunohistologically and serologically confirmed Sjoegren's syndrome and 25 patients suffering from other diseases, included as a control group, were examined by MR in transverse and coronal orientation. T-2-weighted sequences (TR/TE 1600/25/90) and T1-weighted sequences (TR/TE 500/25 ms) plain and after Gd-DTPA administration were obtained. In all patients the parotid gland showed characteristic internal patterns and abnormalities in gland size. There was a nonhomogeneous internal pattern with a characteristic speckled, honeycomb-like appearance visible especially on T2-weighted sequences. Enhancement with Gd-DTPA yielded no additional information. A staging system with four stages of Sjoegren's syndrome (no characteristic changes to a nodular and swollen gland) was developed. Magnetic resonance has become an important new tool in assessing parotid gland changes in patients suffering from Sjoegren's syndrome, and could well replace the more invasive and unpleasant diagnostic methods in the near future.

Acute Disease↗

Ultrasonographic features of recurrent parotitis in childhood.

Six children with recurrent parotitis were studied by ultrasound. Of the 12 parotid glands thus observed, 5 were swollen and 7 were not enlarged. Multiple round hypoechoic areas measuring 2-4 mm in diameter were seen in all 5 enlarged parotid glands and in 5 non-enlarged glands. These small hypoechoic areas were larger than the punctate pools of contrast medium shown by sialography. We consider that these hypoechoic areas represented both peripheral sialectasis and surrounding lymphocytic infiltration. We propose that ultrasonography may be useful for the diagnosis and follow-up of recurrent parotitis in childhood.

Child↗

Balloon dilatation of salivary duct strictures: report on 36 treated glands.

PURPOSE: This paper describes the technique for balloon dilatation of salivary duct strictures and evaluates the clinical and radiographic findings in a consecutive series of 36 affected glands. METHODS: Thirty-four patients (36 glands) had balloon dilatation of their salivary duct strictures performed under fluoroscopic control. They were evaluated immediately afterwards and at review by sialography. RESULTS: In 36 cases attempted, 33 (92%) strictures were dilated. The immediate post-treatment sialogram was available in 28 cases, of which 23 (82%) demonstrated complete and four (14%) partial elimination of stricture. In one case the appearance was unchanged (4%). Review data (mean 6.8 months) were available on 25 glands: 12 were asymptomatic (48%), 12 (48%) had reduced symptoms and one (4%) failed to improve. Sialographic data were available on 21 glands: in 10 (48%) the duct remained patent, in one (5%) the stricture was partially eliminated, in seven (33%) the strictures had returned and in the remaining three (14%) cases there was complete obstruction. CONCLUSIONS: Balloon dilatation is an effective treatment of salivary duct stenosis. In half the cases the stricture recurred but symptomatic improvement was achieved and maintained in the majority of cases.

Catheterization↗

Salivary gland function in patients on chronic lithium treatment.

Salivary gland function was studied in 14 manic-depressive patients treated with lithium carbonate (Li) for 4 to 120 months. Function level was evaluated by means of sialometry, dynamic salivary scintigraphy, and sialography. Daily Li dose, serum Li concentration, duration of Li therapy, and caries activity index were correlated with the salivary function parameters studied. Hyposalivation was noted in 71% of the patients, showing good correlation with the scintigraphic (r = 0.94) and sialographic (r = 0.87) results. Duration of Li therapy was poorly correlated with the degree of salivary gland dysfunction and with the caries activity index, whereas the correlation between duration of therapy and each of the three salivary function parameters was erratic. Because four of the patients exhibited normal salivation, we suggest that there are some additional factors (e.g., genetic or thyroid function level) that might be involved in salivary dysfunction connected with Li therapy.

Adult↗

Diagnostic imaging in salivary gland disease.

A review of the current status of salivary gland imaging is presented. The potentials and limitations of sialography, scintigraphy, ultrasonography, computed tomography, and magnetic resonance imaging are discussed so that a rational approach to their use can be adopted.

Diagnostic Imaging↗

Relationship between sialographic findings of parotid glands and histopathologic finding of labial glands in Sjögren's syndrome. Relation to clinical and immunologic findings.

We investigated a relationship between sialographic findings of parotid glands and histopathologic changes of labial glands, in relation to Sjögren's syndrome. We examined 107 patients, suspected to have Sjögren's syndrome because of dry mouth and dry eyes, in whom no other autoimmune diseases were diagnosed. Parotid sialography identified 37 patients with punctate, globular, cavitary, or destructive sialectasia (S-positive group). These sialographic findings were not seen in the other 70 patients (S-negative group). Among these patients, 54 demonstrated periductal lymphocytic infiltration in the labial glands (H-positive group), whereas the other 53 patients did not demonstrate this histologic finding (H-negative group). Significant differences in stimulated parotid salivary flow rate and incidence of keratoconjunctivitis sicca were observed between patients in the S-positive and the S-negative groups. Differences in the salivary flow rate and the incidence of keratoconjunctivitis sicca were also seen between patients in the H-positive and the H-negative groups, although the differences were not statistically significant. The rate of incidence of serum rheumatoid factor, anti-SS-A, and anti-SS-B antibodies were significantly higher in the S-positive and the H-positive groups than in their negative counterparts.

Antibodies, Antinuclear↗