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An experimental model is presented for in vitro comparative evaluation of radiopaque media. Experimental results parallel the clinical picture of fractionated filling films and comparative radiodensity of oil- and water-soluble media.
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In five patients with branchial arch syndromes the presence of the salivary glands was demonstrated. Clinical, sialographic, and scintigraphic examinations revealed morphologic defects and diminished function of the parotid glands. Hyperfunction of the submandibular glands was assumed in the three patients in whom scintigraphic studies were performed. The findings may be of diagnostic value in patients in whom the clinical signs of the syndrome have remained occult.
The damage caused to rat submandibular glands by intraductal injection was examined. When a small volume of isotonic saline was injected, even if salivation was not influenced, salivary composition was greatly affected because the intercellular junctions of the duct cells were damaged. Intraductal injections of hyperosmotic solutions or highly viscous liquids were more effective in damaging intercellular junctions. When interpreting the significance of a salivary composition in clinical diagnosis, it is necessary to consider the sialographic damage which might influence the salivary composition.
Sialograms of an 18-year-old female patient known to suffer from juvenile recurrent parotitis (JRP) disclosed the destructive glandular changes typical of the disease. During the 10 years subsequent to the sialographic examination, the patient did not experience any further attacks of JRP. Sialograms carried out when the patient was 28 years of age demonstrated a normal gland. This case illustrates that a damaged parotid gland is capable of regeneration following JRP.
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Gingival health and salivary gland function were evaluated for a period of 5 years in 14 patients who received head and neck irradiation for nasopharyngeal carcinoma (seven patients; total dose greater than 60 Gy, nasopharyngeal field) and Hodgkin's lymphoma (seven patients; total dose less than 50 Gy, "mantle" field). Plaque index (PII), bleeding index (BI), gingival recession (GR), whole saliva flow rate (WSFR), left parotid sialographic morphology, and salivary gland radioisotopic activity were assessed immediately before radiotherapy and annually thereafter. The nasopharyngeal group had perfect correlation between postradiation depression of WSFR and the sialographic and scintigraphic scores (R = -1.00 and -0.96, respectively). The degree of gland dysfunction correlated negatively with BI and the BI/PII ratio (r = -0.497) and with GR (r = 0.681). The same correlations were noted in the group with Hodgkin's lymphoma during the first 3 years of follow-up. However, recovery of parotid gland function (WSFR and scintigraphic scores) and morphology (sialographic scores) and return to the preradiation relation between WSFR and both BI/PII ratio (r = 0.75) and GR (r = -0.71) were noted in the fourth year. The differences between the nasopharyngeal and Hodgkin's lymphoma groups are attributable to the delineation of the radiation field employed in each group.
Actinomycosis is an uncommon chronic disease usually caused by Actinomyces israelii. It affects the soft tissue mainly but sometimes spreads to involve salivary glands, bone, or even the skin of the face and neck. Five cases have been seen in our department. Several imaging modalities were used to assist in making the diagnosis. The cases are presented and the literature reviewed. Ultrasonography was found to be a useful diagnostic tool especially in developing the differential diagnosis.
The carcinogenic risks associated with the cephalometric x-ray techniques customarily used in orthodontics and oral surgery have been estimated. Lateral, posteroanterior, 45 degrees oblique, lateral temporomandibular joint tomography, basilar techniques, and commonly-used combinations were examined. Data reported in a previous article on doses absorbed by pituitary (brain), salivary, and thyroid glands were used to calculate increased risk over normal incidence using the BEIR V model. The findings are expressed in a number of graphs. Tables list the estimated percentage increase in carcinomas for several of the most often used cephalometric procedures, and compare these with the more common complete mouth (periapical) and panoramic surveys. The overall conclusion is that responsible use of cephalometric radiology adds very little to the person's carcinogenic burden.
Fifteen cases (16 concavities) of the so-called "Stafne's bone cavity" were investigated with the use of computed tomography. The sizes, bony outlines, and contents were analyzed on axial images. In all cases, computed tomography clearly demonstrated the concavities on the lingual surface of the mandible. There were no empty concavities. The bony outlines and contents were divided into three types. The concavities with a portion of submandibular gland as a content were larger than those with other contents. Four of six concavities not extending to the buccal cortical plate were filled solely with fat tissue, whereas all concavities with expansion of the buccal cortical plate contained submandibular gland.
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Twelve pediatric patients with parotid or submandibular salivary gland calculi were successfully diagnosed following appropriately aimed imaging methods. The treatment modalities were: secretory stimulation of the gland to induce spontaneous passage, sialolithotomy or sialadenectomy. The treatment of choice was dependent on the size and location of the calculi, as well as on the affected gland and its functional secretory state.
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An unusual case of bilateral papillary cystadenoma lymphomatosum of the parotid with multiple lesions showing no active uptake of 99mTc pertechnetate is presented. Similar cases showing no accumulation of radionuclide are reviewed.
PURPOSE: To describe the use of endoscopy as a technique for diagnosing and treating sialolithiasis. Sialolithiasis is a common pathology of the major salivary glands, yet its accurate detection and treatment is still intriguing. PATIENTS AND METHODS: Eight cases of sialolithiasis were treated with our new technique which combines endoscopy and treatment. Two illustrative patients treated by this technique are described in detail. CONCLUSION: Endoscopy, has gained popularity in most surgical fields. We found that the available standard equipment used for TMJ arthroscopy can be used for exploration and extraction of calculi from the salivary ductal system.
Because salivary gland function and morphology can be changed by a variety of diseases and drugs, the process of clinically assessing and diagnosing salivary gland changes in patients suspected of having Sjögren's syndrome (SS) must include not just clinical recognition of the problem and assessment of its nature and severity, but identification of the cause. Determining the presence of the salivary component of SS in a patient suspected of having the disease involves three types of observations: (1) eliciting symptoms and observing signs suggesting decreased salivary function (xerostomia) during the examination, (2) objectively assessing functional or anatomical salivary changes with different types of clinical procedures that are not necessarily disease-specific, and (3) applying the most disease-specific procedures as diagnostic criteria to determine the cause of the problem. Currently used diagnostic criteria for the salivary component of SS are reviewed and compared. Alternative diagnostic criteria should be avoided if they substitute non-specific tests for more disease-specific tests. There is as yet no perfect diagnostic criterion for the salivary component of SS, but significant focal sialadenitis in a labial salivary gland biopsy is the best in terms of its disease specificity, convenience, availability and low risk.
We describe the successful use of ultrasound-guided retrieval of a submandibular stone with a basket in two patients.
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