SIALOGRAPHY

1
SIALOGRAPHY THE SALIVARY GLANDS

• A radiographic examination of the salivary glands
  and ducts using contrast media

2
Injection of contrast media into salivary ducts

• OIL BASED CONTRAST
• SINOGRAPHIN
• WATER BASED (IONIC)

3
INDICATIONS FOR EXAM

• Stones (Calculi) sialolithiasis
• Obstruction / Strictures
• Pain Swelling
• Infection
• Masses / Tumors

4
CONTRAINDICATIONS

• History of contrast media allergies
• Parotits (mumps)
• Severe inflammation of the salivary ducts

5
(No Transcript)
6
SIALOGRAPHY
SNOPEK CH 21 BALLINGER VOL. 2 CH.
14  
3 SALIVARY GLANDS PAROTID LARGEST LOCATED
BY EAM - MANDIBULAR RAMUS   SUBMANDIBULAR /
SUBMAXILLARY SMALLEST- 1st molar to
Gonion   SUBLINGUAL LOCATED BEHIND THE MENTUM
under the sublingual fold  
7
(No Transcript)
8
(No Transcript)
9
DUCTS

•  Parotid duct
• located by maxillary bone 2nd upper molar)
• Stensens duct
  PAROTID GLAND
• Submandibular Duct located on end of
• sublingual ridge to fill
  submandibular
• Whartons duct
  SUBMAXILLARY
• Sublingual duct (several small) located alongside
  submandibular duct to SUBLINGUAL GLAND

10
1. Parotid Gland2. Submandibular Gland
11
(No Transcript)
12
(No Transcript)
13
Mostly replaced now by MRI CT
 

• Safe and simple but difficult to perform hard
  to located and catheterize ducts

14
EQUIPMENT NEEDS

• RAD/
• FLUORO ROOM

15
PROCEDURE

• Sialogram Tray
• Gauze, Sterile towels, Spot Light, Magnifying
  glasses, Gloves, Eyewear, mask
• LEMONS - cut into wedges
• Lacrimal Probes
• Hemostats
• 5 cc syringes
• Sialogram Catheter (Rabinov)
• needles or canulas

16
PATIENT PREP 

• (No specific prep oral mouthwash in nice)
• Remove any metal bridgework, tongue piercing
• Get History present to radiologist BEFORE
  setting up tray

17
(No Transcript)
18
RADIOGRAPHS

• 1. SCOUT FILMS important to r/o stone for SOFT
  TISSUE (LIGHT EXPOSURE)
• Like mandible series AP (OML) (Grid )
• Both Obliques (Ext. cassette)
• True Lateral (x-table) (Grid or extremity
  cassette)
• Tangential films may be required
• Mentum or Parotid
• 2. Give lemon - contast injected
• 3. SPOT FILMS taken by DR during fluoro
• 4. Post films taken 10 min after injections
  check drainage

19
SUBMANDIBULAR GLAND
20
PAROTID GLAND
21
SUBMANDIBULAR GLAND
22
(No Transcript)
23
(No Transcript)
24
(No Transcript)
25
(No Transcript)
26
(No Transcript)
27
(No Transcript)
28
(No Transcript)
29
Contrast media

• Water based iodinated (ionic or nonionic)
• Less dense absorbed faster no residue
  
• Conray, Hypaque, Isovue, Renographin (60/76)

• Oil-based
• More dense, absorb slower
• can cause granuloma (stones)
• hard to completely excrete
• Ethiodol, Sinographin

30
(No Transcript)
31
DUCTS

• Parotid duct located by maxillary bone 2nd
  upper molar) - PAROTID GLAND Stensens duct
• Submandibular Duct located on end of
  sublingual ridge to fill submandibular /
  SUBMAXILLARY Whartons duct
• Sublingual duct (several small) located alongside
  submandibular duct to SUBLINGUAL GLAND

32
(No Transcript)
33
(No Transcript)
34
(No Transcript)
35
(No Transcript)
36
(No Transcript)
37
(No Transcript)
38
(No Transcript)
39
(No Transcript)
40
(No Transcript)
41
(No Transcript)
42
THE END
43
(No Transcript)
44
Tangential parotid gland, supine position.
45
(No Transcript)
46
(No Transcript)
47
End of Salivary Lecture Presentation Questions?