Salivary Gland Flashcards
Sialography POI
Salivary glands
Sialography CM
Water-soluble iodinated media
For definitive dx of a problem related to one of the salivary ducts
Sialography
Sialography indications
Stenosis
Obstruction
FB
Tumor
Calculus
Fistula
Epoglottis
SOFT CalFE
With the advent of CT and MRI, if indication is (1) or (2), sialography is seldom used
- lesion
- calculi
Sialography procedure
- Scout film
- 2-3 mins before examination secretary stimulant (lemon wedge)
- Inject CM
- Rad’phic exam
- Lemon wedge
- 10mins after exam - take a radiograph
Sialography manner of injection
- Mostly manual pressure
- Others: hydrostatic
- Some CM filling are under fluoroguidance and spot films are obtained
Sialography projections and their specific POIs
- Tangential
- Parotid - Lateral
- Parotid
- Submandibular - Axial (intraoral)
- Antero-medial part of SM
- Entire sublingual gland
Pt position/s in tangential parotid
- recumbent/ sitting
- supine
- prone
Supine position for tangential parotid
head rest- occiput; adjusted so that mandibular ramus-//-LA of IR, rotated slightly TOWARD side being examined to place POI-perp-IR
Main basis for parotid gland
Mandibular ramus
Prone position for tangential parotid
head rest- chin; ritated AWAY from side being examined; flexion of head adjusted so that mandibular ramus-//-LA of IR
Tangential parotid cxt and crd
8x10” (18x24cm)- LW- tabletop
// to the lat surface of mandibular ramus at a point bn EAM and mandibular angle (perp to surface of IR)
Tangential prone if stensen’s duct need not to be demonstrated
head rest- forehead and nose
Tangential parotid for calculi
pt- fill mouth w air and puff cheeks out as much as possible
Pt position/s in lateral parotid
Semi-prone/ Sitted/ Upright;
affected side closest to the IR w neck extended to free mandibular ramis of c-vertebrae;
MSP-head- 15deg towards IR from true lat position
Lateral parotid cxt and crd
8x10” (18x24cm)- LW- tabletop;
perp at a point bn 1” (2.5cm) above mandibular angle
Lat Submandibular pt position/s
Affected side closest to IR w/ neck extended to free mandibular rami of c vertebrae;
MSP of head in true lat posn
Lat Submandibular cxt and crd
8x10” (18x24cm)- LW- tabletop;
perp at the mandibular angle
Lat Submandibular special consideration
Iglauer: displace submandibular gland
pt- index finger back of tongue
Axial SM pt position/s
Supine: pt- close mouth hold packet in posn;
shoulders-same transverse lane;
elevate thorax;
flex knee
Axial SL position/s
same with Axial SM
Axial SM and SL cxt&crd
Occlusal film (57x76mm/ 2 1/4x3”)- LA directed transverse w/in mouth;
in contact w/ anterior borders of mandibular rami;
perp to plane of film;
MSP- level 2nd molars
This i the only projection that gives an
unobstructed i mage of the sublingual gland regions.
AXIAL PROJECTION
INTRAORAL METHOD
