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Sialography Procedure And Technique | Radiology |

Sialography is the procedure which is used to imaging, Monitoring and detection of any disease in salivary gland mainly parotid gland. 

Sialography Procedure And Technique  Radiology
Image Credit: urmc.rochester.edu

Sialography

Uses Of Sialography

  • Sialography is used to examine ductal acinar.

  • System Of major salivary gland by injecting radiopaque contrast medium into the gland to make them visible on radiographs.

Indication

  • Inflammatory Infection
  • Calculi
  • Ductal and Glandular Destruction
  • Pain & Swelling
  • Tumors 
  • Changes secondary to trauma.

Contraindication

  • Allergy to compound containing Iodine
  • Acute Inflammation / Infection
  • If patient undergoing thyroid functioning test 

Advantage

  • High Resolution Image 
  • High Resolution image of duct system
  • Controlled Localized Radiation Dose.

Disadvantage

  • Painful on injection
  • Difficult on perform
  • Irritation Necrosis
  • Allergy

Sialography Technique

  • The most sophisticated procedure is performed with the fluoroscopy guided position & injection of water soluble contrast medium by means of catheter permutation technique
  • Catheter & Guide were used 
  • Stenson's Duct open on the surface of buccal mucosa near 2nd molar
  • Duct runs posterior to parotid gland along the surface of mastoid muscle
  • Orifice of Wharton's duct is located at anterior position of floor of the mouth and it runs on surface of melanoid muscles.
  • Duct orifice is sprayed with local anesthesia 
  • First Guide wire is inserted into the salivary duct through the orifice thereafter the catheter is instead along with the wire and wire is removed.
  • After catheter is filled with saliva, it is connected to injection syringe with a connected tube filled with contrast media.
  • Under fluoroscopic imaging appropriate position is determined & then contrast medium is injected.
  • Usually in case of submandibular gland the agent is used 0.50 to 0.75 ml & for parotid gland 0.70 to 1.00ml
  • After injection of contrast agent radiographs taken
  • Parotid: AP/Oblique
  • Submandibular: lateral oblique 
  • Sialolith located in anterior posterior - Occlusal view
  • After this catheter is removed
  • Patient instructed to suck lemon ( 1% solution of citric acid & then asked to rinse for excretion of dye ).
  • Take a post procedure delayed radiographs after 5min (AP/Oblique/Lateral) to conform evacuation of contrast from the salivary gland normal excrete 100% of dye with in 5min after removal of catheter. 
Sialography Procedure And Technique | Radiology |
Image Credit: urmc.rochester.edu


Appearances of Sialography 

Parotid:                         Tree in winter/ Leafless tree
Submandibular:            Brush in winter
Sialodochitis:                Sausage like appearance
Sjogren's Syndrome:    Cheery blossom appearance
Intrinsic Benign Tumor: Ball in hand appearance

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