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5th Oral Disease - Imaging/ Radiographs > Salivary Disease Imaging > Flashcards

Salivary Disease Imaging Flashcards

1
Q

what are common salivary gland issues?

A

Dry mouth
Painful and swollen gland
Lump in gland

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2
Q

Possible causes of dry mouth/

A 
Diabetes - raised blood sugar 
Medication - antidepressants, diuretics, cytotoxic
Radiotherapy
Autoimmune conditions
Sjogrens
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3
Q

What could cause pain and swelling of the glands?

A

Sialadenitis - salivary gland infection

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4
Q

What are the types of sialadenitis?

A

Acute or chronic

Acute - bacterial or viral
Chronic - secondary to reduced saliva flow

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5
Q

What can be the cause of lumps in saliva gland?

A

Tumours - can be benign or malignant

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6
Q

What glands contain lymph nodes?

A

Parotid contains small lymph nodes

Submandibular/ lingual don’t

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7
Q

What imaging is appropriate for dry mouth?

A

Ultrasound first line

If suspect Sjogrens - sialography

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8
Q

What imaging is appropriate for painful swollen gland?

A

Plain radiography

Sialography

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9
Q

What imaging appropriate for lump?

A

Ultrasound
Core biopsy for tissue diagnosis
If malignant - MRI

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10
Q

What is the only cause of dry mouth that can be identified on imaging?

A

Sjogrens - disease destroys gland parenchyma

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11
Q

What would you expect to see on imaging of Sjogrens?

A

Normal gland replaced by black spaces

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12
Q

How does obstructive sialadenitis present?

A

Swollen and painful gland occur at mealtimes

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13
Q

What causes obstructive sialadeniis?

A

Calculi, structures or debris in ductal system

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14
Q

Where is calculi most common?

A

Submandibular gland

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15
Q

Where are strictures most common?

A

Parotid

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16
Q

Which gland is least likely to be obstructed

A

Sublingual -lacks a single duct - multiple small duct

17
Q

How to investigate salivary obstruction?

A

Plain film radiograph

Ultrasound can identify stones - not as sensitive as sailogram

18
Q

How to investigate submandibular obstruction?

A

Lower true occlusal

Posterior oblique

19
Q

How to investigate parotid obstruction?

A

AP extra-oral film

20
Q

What is sialography

A

Injecting contrast into duct - iodine in contrast radiopque

Stones less dense than contrast so show as filling defect

21
Q

How to tx submandibular calculi?

A

If visible anterior 1/3 - surgical excision
Small and mobile- basket removal
Beyond mylohyoid bend - excision via extra-oral approach

22
Q

What is basket removal?

A

Intra-ductal technique
Basket inserted closed into duct and advanced passed calculus
Basked opened and drawn to opening

23
Q

Complications of basket removal?

A

Pain and swelling
failure to remove stone
get basket stuck in duct

24
Q

How to tx strictures in parotid gland?

A

Balloon-dilation

Or superficial parotidectomy

25
Q

How to tx stones in parotid gland?

A

If at duct opening - excision
Extra-glandular duct - basket retrieval
If in parenchyma - lithotripsy/ parotidectomy

26
Q

What is balloon dilation?

A

Intra-ductal technique
Dilation of papilla w/ lacrimal probe followed by insertion of angioplasty balloon
Uninflated balloon positioned across stricture under x-ray guidance and inflated

27
Q

Complications of balloon dilation?

A

Stricture can be too tight
Can be uncomfortable - even with LA
Some strictures won’t dilate
1/3 will re-stenose

28
Q

What is the success of baskets and balloons?

A

Basket - 68%

Balloon - 76% - reduce 50% after 2 years

29
Q

Common feature of salivary gland tumour?

A

slow-growing solid mass

30
Q

What features would be more predictive of a malignant tumour?

A

Rapid growth, fixation to skin/ underlying tissue, pain

31
Q

What would you see with malignant parotid tumour?

A

Facial nerve weakness

32
Q

Rule of thumb for gland tumour?

A

Smaller the gland the higher the chance of malignancy

33
Q

What are the two common benign salivary gland tumours?

A

Pelomorphic adenoma

Warthin’s tumour

34
Q

What is plemorphic adenoma and who does it affect?

A

Benign tumour
Affect male:female 1:1
Affect 30-60 year olds

35
Q

Where does Warthin’s tumour appear?

A

Only in parotid - in parotid tail

and only in smokers

36
Q

Imaging features of benign salivary neoplasms?

A

Well-defined solid mass w/ smooth-lobulated margin

37
Q

Imaging features of malignant salivary gland tumour?

A

Infiltrative, ill-defined margin

38
Q

Why are lymph nodes found in parotid but not submandibular/lingual?

A

Embryological development - parotid in encapsulated after devleopment of lymphatic system (sub encapsulated before)

5th Oral Disease - Imaging/ Radiographs (4 decks)

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