Sjögren's syndrome and thyroid disease.
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Trauma involving the parotid gland is rare and is usually caused by penetrating injuries or fractures of the facial skeleton. A unique case is presented of rupture of the parotid gland after a minor external force in a 14 year old boy. The radiological findings are presented, which pointed to diffuse rupture of the gland parenchyma with an intact duct system. A conservative management policy using antibiotics and anticholinergics was effective, with complete resolution of symptoms. A literature review of more serious parotid injuries supported the conservative management policy.
A labial biopsy technique is described and was used to study 40 patients with connective tissue disease and 60 postmortem subjects. More than one focus of lymphocytes per 4 sq mm of minor salivary tissue was found to be a consistent finding in patients with Sjögren's disease. The labial biopsy is shown to be a further valuable investigative procedure in such patients.
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A case is reported of chronic calculous parotitis beginning in a 12-month-old child. Further questioning revealed a history of parotid calculi in her mother and submandibular calculi in her maternal grandmother. The features which indicate the diagnosis of parotid calculous disease are discussed and, from a review of the literature, some observations are made on management.
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A newly devised curved side-hole cannula for use in sialographic procedures is presented. A tapered metallic cuff serves as a retention plug to prevent backflow and escape of the contrast medium.
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Computed tomography (CT) and magnetic resonance (MR) imaging studies were done prospectively in 21 unselected patients in whom 28 major salivary glands had pathologic changes. Blinded and final readings were used to establish the relationship of the lesion to the plane of the facial nerve (parotid masses), whether the lesion was intrinsic to the gland, and whether the lesion was aggressive. In the blinded reading, CT was superior to MR imaging in eight instances; in the final reading, however, with clinical information available, CT was superior in four cases of inflammatory salivary gland "masses." CT and MR imaging provided the same diagnostic information in all cases of salivary gland neoplasms. T1- and T2-weighted images proved of equal value in detection of salivary gland lesions, and use of both provided no additional specificity. In most cases, T1-weighted images alone provided the information necessary for surgical management. MR imaging is a reasonable first choice if a neoplasm is likely; the potential for improved tissue contrast at the margins of a tumor may be particularly useful. If a mass may be of inflammatory origin, contrast material-enhanced CT is a more reasonable first choice.
PURPOSE: To prospectively investigate the efficacy of a wire basket extractor in the retrieval of salivary calculi and establish selection criteria for suitable cases. MATERIALS AND METHODS: Twenty-five consecutive patients (14 male, 11 female; age range, 13-69 years) with salivary calculi (20 submandibular, five parotid) were treated by using a commercially available wire basket extractor with intermittent fluoroscopic guidance. RESULTS: Elimination of calculi was accomplished in 10 (40%) cases. In an additional seven (28%) cases, either part of the calculus was removed or whole calculi were removed with others remaining. Failure to retrieve any stone occurred in eight (32%) cases. The most common cause of failure was attachment of the calculus to the duct wall. CONCLUSION: Interventional radiology provides a useful adjuvant method of calculus removal and complements extracorporeal lithotripsy. Basket retrieval of calculi has low morbidity and is rapid and less invasive than traditional surgery. It is most effective in retrieving mobile stones in the extraglandular parotid and submandibular ducts.
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