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At least 613 records · Page 34Linked to original sources
PubMed1992

Quantitative evaluation of sialograms.

RATIONALE AND OBJECTIVES: The authors developed and evaluated a quantitative analytic method for interpreting clinical sialograms. METHODS: Images were obtained by digital subtraction sialography and transformed into binary form. The duct width of the image was calculated and represented as a normalized histogram. The effects of the volume of contrast medium injected and of the inclination angle of the objects on the histogram were examined. RESULTS: In model studies, the normalized histogram was affected insignificantly by these factors. Clinical sialograms of 18 patients with normal results, 12 patients with parotitis, and 5 patients with Sjögren syndrome were preliminarily analyzed by the histogram method and four representative parameters of the histogram. Discriminant analysis showed a relatively high correct-predictive rate in the distinction between patients with normal and abnormal results. CONCLUSIONS: This method reduces the effect of observer variation in diagnosing sialograms, and improves diagnostic accuracy for assessing the presence of inflammatory diseases of the parotid gland.

Animals↗
PubMed1982

Salivary gland function and changes in patients with oral lichen planus.

Saliva analysis, sialography and histopathologic examination of labial salivary glands were performed on patients with oral lichen planus. Diseases connected with salivary gland function were also recorded. Saliva analysis regarding secretion rate, pH and buffer capacity in unstimulated and stimulated saliva was performed on 39 patients. 87% of the patients exhibited a low or very low unstimulated secretion rate, the mean value being 0.14 ml/min. The rate of stimulated saliva, pH and buffer capacity did not deviate from normal reference values. Sialographic examination was performed on 18 patients, corresponding to 36 major salivary glands. Radiologic changes were seen in 89% of the patients. Histopathologic examination was performed on 15 patients. Lymphocytic infiltration, acinar atrophy, fibrosis, fatty degeneration or ductal changes were observed in the minor glands of all patients. Different degrees of acinar atrophy were present in 93% of the patients. Lymphocytic infiltration was seen in 12 patients (80%) of whom three exhibited focal accumulation as in Sjögren's syndrome. Since decreased salivary secretion and symptoms of joint diseases and keratoconjunctivitis sicca were frequently present, over a third of the patients showed clinical signs comparable to those of Sjögren's syndrome. A high frequency of gastrointestinal and endocrine diseases was also recorded, which suggests that a general exo and endocrine influence may be present in patients with oral lichen planus.

Adult↗
PubMed1979

Recurrent unilateral swelling of the parotid gland.

The clinical features of 109 patients with recurrent unilateral parotid swelling (24 patients with Sjögren's disease were excluded) have been analysed to explore the best system of management. The cause was definitely a parotid duct calculus in 36 patients, and evidence is presented that the same diagnosis probably applied to another 59 patients. Features suggesting a diagnosis of calculus included age (greater than 29 years); duration of the attacks of pain (less than 24 hours); cessation of salivation on the affected side; and a spurt of saliva heralding the relief of symptoms. Only three patients in the definite calculus group (8.3%) had no physical signs. However, had physical examination not included inspection and palpation of the parotid duct and its orifice from within the mouth 75% of the proven calculi would have been missed. The intraoral and anteroposterior plain radiographs are likely to be helpful, and sialography even more so. A sialographic appearance of a stricture in the main duct with proximal dilatation is usually due to a claculus. It would appear that calculi are the cause of recurrent unilateral parotid swelling (after exclusion of Sjögren's disease) in an overwhelming proportion of patients with this symptom.

Adult↗
PubMed1981

Manifestations of parotid gland enlargement: radiographic, pathologic, and clinical correlations. Part I: The autoimmune pseudosialectasias.

Histologic, clinical, and radiographic presentations of the autoimmune salivary gland diseases are reviewed. The punctate and globular sialographic changes observed actually reflect penetration of contrast material through the uniquely diseased glandular ducts and not sialectasis, as was previously thought. "Pseudosialectasis" is suggested as a more accurate term. The progressive cavitary and destructive patterns seen on sialography appear to reflect complications of secondary infection rather than the specific pathology of these diseases. Conditions causing recurrent enlargement of the parotid gland or development of a multinodular gland include chronic sialadenitis, the sialoses, the granulomatous diseases, primary neoplasms, and metastatic tumors. Although they appear similar clinically, many of these diseases can be differentiated sialographically, and such a radiographic approach is presented.

Autoimmune Diseases↗
PubMed1984

Metastatic malignant melanoma in the parotid gland.

3 cases of metastatic malignant melanoma to the parotid gland are reported. Diagnosis before surgery was not possible because of the particular characteristics of the primary lesions. Neither physical examination nor sialography or ultrasonography provided any differential diagnostic assistance. A thorough case history allowed us to trace a pigmented lesion in 2 cases: in the first case it had been removed about 1 year prior to our examination, whereas in the second case it had regressed spontaneously leaving no trace. In the 3rd case the presence of multiple surgical scars, due to reconstructive plastic surgery for multiple burns of the scalp contracted 30 years earlier, might have concealed a primary malignant melanoma. The path of diffusion (either direct or retrograde) towards the parotid gland as well as treatment procedures are discussed on the basis of recently published data. Moreover, the authors underline the value of thorough case histories aimed at identifying suspect cutaneous lesions of the head and neck, in all cases of parotid swellings, where the possibility of metastases is considered.

Adult↗
PubMed1988

Sialographic images of pathological changes in the mouse parotid gland.

In order to correlate pathological changes of mouse parotid glands with their sialographic images, we conducted studies on mice with known pathological changes: mice with Stensen's duct ligated, NZB mice with a systemic auto-immune disease, and aged mice. The sialographic images were found to be specific for the pathological changes: The glands after ligation of Stensen's duct were characterized by dilated, large excretory ducts with a reduced system of peripheral ducts; the glands of NZB mice showed lobular leakage of the contrast medium from small excretory ducts; and the glands of aged mice showed a great reduction in the ductal system. It is concluded that sialography yields useful information on the pathological changes of the ductal systems in the mouse parotid gland.

Aging↗
PubMed1994

Radiological and histological analysis of the structural changes in the rat parotid gland following release of Stensen's duct obstruction.

Sialography is the preferred method for diagnosis and treatment planning in obstructive sialadenitis. Although many experimental studies have reported changes following duct obstruction, those following release of obstruction have not been examined. The present study was undertaken to clarify: (1) the relationship between sialographic and histological changes; (2) the effects of duration and pressure of obstruction on gland recovery; (3) the possibility of establishing those sialographic features which indicate the prognosis for gland recovery. Stensen's ducts of rat parotid glands were obstructed for two different periods and at three different pressures in order to induce varying degrees of degenerative changes in the gland. The structural alterations resulting from release of obstruction were investigated by means of qualitative and quantitative microsialography and histology. Gland structure was assessed visually from the latter and classified into six groups: normal, recovery, and slight, moderate and severe degeneration and fibrous. Microsialograms were evaluated based on these groups. Qualitatively, microsialograms of the operated glands had a stricture in the obstructed region and dilation of the major ducts. Histological differences between recovery and degeneration glands were reflected in the morphology of peripheral ducts. The former showed a branch-like morphology similar to that of the normal group, and the latter contained small granule-like structures. Quantitatively, dilation of major ducts in the recovery group decreased compared with the other operated groups. There were no distinct sialographic features in the degeneration and fibrous groups which correlated with the degree of degeneration observed histologically. Duration and pressure of obstruction were highly predictive for prognosis for recovery.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1996

Orofacial radiological manifestations of systemic sclerosis.

OBJECTIVE: To ascertain the orofacial radiological manifestations of systemic sclerosis. METHODS: Twenty-one patients with known systemic sclerosis underwent panoramic, and where appropriate periapical, radiography parotid sialography and a labial gland biopsy. RESULTS: The prevalence of periodontal ligament space widening was 33%, bone resorption 9.5% and abnormal parotid gland sialographic findings 43%. Root resorption affected 4 (33%) of the 12 dentate patients. CONCLUSIONS: Orofacial radiological manifestations occur commonly in systemic sclerosis. Root resorption has not previously been reported.

Adult↗
PubMed1996

Interventional radiology for the non-surgical removal of sialoliths.

OBJECTIVES: To clarify the usefulness and limitations of interventional radiology for sialolithiasis. METHODS: Sixteen patients (5 with parotid and 11 with submandibular sialolithiasis) were treated with a stone retrieval catheter (Dormia basket) under fluoroscopy. Digital subtraction sialography (DSS) and direct digital dental imaging (RVG) were performed in addition for 11 of the cases (DSS for 7 and RVG for 4 cases). RESULTS: The sialolith was successfully removed in 10 cases. DSS and RVG were useful. Four cases failed because the stone was adherent to the ductal wall and two because the catheter could not reach the stone because of the ductal anatomy. CONCLUSION: Interventional radiology is less invasive than surgical treatment and is the recommended first choice for treatment in the majority of cases of sialolithiasis.

Adult↗
PubMed1975

Acalculous parotid sialadenopathy.

Acalculous inflammation of the parotid gland has been regarded by some as a specific disorder that can be staged as to the severity of the disease process. A review of the literature, however, indicates a divergence of opinion. It is the purpose of this study to test this hypothesis by a retrospective double-blind analysis of clinical, sialographic and histopathologic findings. Forty-two patients who were seen by the Department of Otolaryngology, Washington University School of Medicine from 1961 to 1970 were evaluated by two separate teams. There were 20 sialograms and 30 pathologic specimens, and all were re-examined. Eleven patients had both sialographic studies and histopathologic examination. The clinical presentations and sialographic findings were reviewed. These findings were then compared to each other. Our results indicate that we could not evaluate the severity of the clinical disease by sialography or histopathology. There was no consistent method of staging the sialographic and pathologic findings. In addition, there was no correlation between these two parameters. They reflect neither the patient's clinical syndrome pattern nor the extent of disease. It appears that the parotid gland responds variable to inflammation. These observations are exemplified by case histories.

Adolescent↗
PubMed2001

Chronic parotitis: diagnosis and treatment.

BACKGROUND: Chronic parotitis, or CP, is a nonspecific sialadenitis that often is seen first in the dental office. The cause, although not definitively determined, is most likely multifactorial and includes decreased salivation, stasis and an ascending retrograde duct infection. The authors present a case report to illustrate the symptomatology of CP to facilitate its differentiation from other entities that mimic CP. CASE DESCRIPTION: A 60-year-old woman with a 30-year history of recurrent swellings of her left parotid gland was diagnosed with CP. The diagnosis was based on history, clinical examination, salivary volume and chemistry, computerized tomographic scan and sialography. Treatment was palliative in nature. CLINICAL IMPLICATION: As a member of the health care team, the dentist must be familiar with the various causes of recurrent parotid infections. Early clinical recognition of CP leads to appropriate and successful care.

Chronic Disease↗
PubMed2000

Sjögren's syndrome complicated with autoimmune hepatitis and antiphospholipid antibody syndrome.

A 56-year-old Japanese female simultaneously developed thrombocytopenia, sicca symptoms, and an elevation of transaminase. Antiphospholipid antibodies were detected in her serum. The presence of anti-SS-A antibodies in the serum and sialectasis, disclosed by sialography, suggested the presence of primary Sjogren's syndrome (SjS). The laboratory data and the biopsy of the liver showed compatible findings with autoimmune hepatitis (AIH). Thrombocytopenia and liver dysfunction satisfactorily responded to corticosteroid. To our knowledge, this is the first reported case of SjS with AIH and antiphospholipid antibody syndrome (APAS). Analysis of serum cytokine levels showed a predominance of Th0-Th1 response, which is not compatible with AIH, in this complicated autoimmune state.

Antibodies, Antiphospholipid↗
PubMed1982

Computed tomography of the major salivary glands.

Forty-eight patients with proven disease of the salivary glands were evaluated by computed tomography (CT). Twenty-seven patients had salivary gland neoplasm and all were identified by CT. Fifteen benign tumors appeared as discrete, sharply marginated, high-density masses embedded in an otherwise normal gland. All 15 were correctly identified as benign by CT. There were 12 malignant tumors; 10 were invasive and presented as poorly defined, relatively dense lesions which obliterated and/or transgressed adjacent fat and fascial planes. Two malignant tumors presented as discrete masses and were incorrectly considered to be benign by CT. Twenty-one patients with inflammatory disease of the salivary glands were studied. A variety of patterns were noted, the most common a relatively diffuse, irregular area of increased density in an enlarged gland. Salivary duct calculi, diffuse sialectasis, and enlarged lymph nodes were well demonstrated. Differentiation between focal and inflammatory disease and malignant neoplasm was difficult. Computed tomography may be augmented by coincident sialography, although it is seldom necessary.

Adolescent↗
PubMed1996

MR imaging of the parotid gland in Sjögren's syndrome: a proposal for new diagnostic criteria.

OBJECTIVE: Because classic diagnostic techniques for sjögren's syndrome (SS) are invasive and require radiation exposure, a noninvasive diagnostic method might benefit patients with SS. The purpose of this study was to determine whether quantitative analysis of MR images of the parotid gland can differentiate patients with SS from normal subjects. SUBJECTS AND METHODS: We performed quantitative analysis of MR images of the parotid gland for 40 patients with definite and probable SS, for 30 normal subjects matched by age and sex to the SS patients, and for 10 patients with parotid inflammation. MR images of teh parotid gland were assessed by calculating standard deviations (SD) of signal intensity. RESULTS: SD of signal intensity exclusively (p < .0001) separated MR images of the parotid glands of patients with definite SS from those of normal subjects. SD of signal intensity for the parotid glands of patients with probable SS also were significantly higher (p < .001) than those of normal subjects. Changes in signal intensity were specific for SS and did not occur with parotid inflammation. Tentative categorization on the basis of signal intensity patterns on MR images of the parotid glands of SS patients showed a high correlation with the results of labial gland biopsy (r = .834) and sialography (r = .936). CONCLUSION: Taken together, these results conclusively indicate that quantitative analysis of MR images for SD of signal intensity is useful method for diagnosing SS and can replace classic methods, which are invasive.

Adolescent↗
PubMed1993

Facial nerve palsy as a complication of parotid gland surgery and its prevention.

The incidence of postoperative facial palsy in 73 patients who had under-gone surgery for parotid gland tumor is reported. Slight facial palsy occurred in 9 (14%) of 66 benign tumors but recovered completely within 3 months following surgery. However, in 7 patients with malignant tumors, 3 (43%) developed permanent palsy and 1 (14%) temporary palsy. The incidence of benign tumors depends on the tumor size and localization. However, the incidence decreased considerably in the last 6 years compared to the first 6 years. This is considered to be due to routine use of computed tomography with sialography and microsurgery during parotidectomy.

Adenocarcinoma↗
PubMed1984

Salivary gland involvement in systemic lupus erythematosus. A sialographic study.

Hydrostatic parotid sialography was performed in 46 rheumatological patients, 17 of whom were SLE patients. Signs of atrophy of the parotid gland were noted more often in the SLE group (53%) than in the series as a whole (29%). Strictures in the duct and ductuli were also more common in the SLE group (67%) than in the whole series (50%). Sialectasis was only slightly more common (40%) in the SLE group than in the series as a whole (38%). Two contrast media, Amipaque (metrizamide, 170 mgI/ml) and Urographin 60% (sodium amidotrizoate + meglumin amidotrizoate 10:66, 290 mgI/ml) were used, of which Amipaque proved to be clearly better tolerated. This difference is probably due to the low osmolarity of Amipaque.

Adult↗