Sialography by Prof j venkat
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Sialography is a radiographic examination of the salivary glands that involves injecting contrast medium into the salivary duct followed by x-ray imaging. It is used to identify calculi, masses, inflammation or other abnormalities of the parotid or submandibular glands. The procedure involves dilating the duct opening, inserting a catheter, and taking x-ray images as contrast is injected to outline the ductal system. Findings are evaluated for any obstructions, strictures, or other pathology. Potential complications include sialadenitis or duct damage.
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- 1. SIALOGRAPHY By Prof J Venkat Professor in Radiography Chennai India +919444923675 WhatsApp venkatdgr8@gmail.com SPECIAL PROCEDURE SERIES IN RADIOGRAPHY
- 2. By Prof J Venkat Professor in Radiography Chennai India OBJECTIVE • Definition • Anatomy • Indications • Contraindications • Equipment needed • Materials needed • Contrast media • Preparation • Procedure • Filming • Positive findings • Complications • Post procedural care/Instructions
- 3. By Prof J Venkat Professor in Radiography Chennai India • Sialography is the radiographic examination of the salivary glands. It usually involves the injection of a small amount of contrast medium into the salivary duct of a single gland, followed by routine X-ray projections. • This is the study to demonstrate the parotid or submandibular glands by injection of contrast medium into the duct system. • First Sialogram Arcelin (1912) DEFINITION - SIALOGRAPHY
- 4. By Prof J Venkat Professor in Radiography Chennai India ANATOMY • Salivary glands three types • Parotid Gland - They are located just in front of the ears. • Submandibular Glands – They are located below the Mandible • Sublingual Glands – They are located below the tongue
- 5. By Prof J Venkat Professor in Radiography Chennai India INDICATIONS • Calculi – stones • Swelling • Xerostomia – Dryness of mouth • Chronic inflammatory disease. • Mass lesion. • Obstructive lesion. • Penetrating trauma. • Strictures. • Fistula.
- 6. By Prof J Venkat Professor in Radiography Chennai India CONTRAINDICATIONS • Allergy to Contrast media • Acute Sialadenitis. • Inflammation of Salivary glands
- 7. By Prof J Venkat Professor in Radiography Chennai India EQUIPMENT NEEDED • Fluoroscopy machine • OPG- Optional • Bucky system • Cassette • 10x8 • 12x10
- 8. By Prof J Venkat Professor in Radiography Chennai India MATERIALS NEEDED • Lemon / Vitamin C tablet • Gloves • Dilators • Rabinov sialography catheter or Venflon • Connecting tube • Plaster • 10 CC syringe • Dressing tray • Gauze • Cotton • Cups • Forceps • Blade handle • Kidney tray Picture from Techniques in Diagnostic Imaging Edited by Graham H. White House and Brian s. Worthington
- 9. By Prof J Venkat Professor in Radiography Chennai India CONTRAST MEDIA • Water soluble Iodinated contrast • Non-Ionic or Ionic Contrast media • Iohexol 250mg I/mL • Omnipaque • Contrapaque • Dosage 2-3 ml , until patient feel discomfort
- 10. By Prof J Venkat Professor in Radiography Chennai India PREPARATION • Patient asked to remove all metal ornaments around head and neck • Denture should be removed • Nil oral for 4 hours • Patient asked to remove the cloths and wear hospital gown • IV line should be ready • Blood tests report should be available
- 11. By Prof J Venkat Professor in Radiography Chennai India PROCEDURE • Patient lie down on the table in supine • The origin of salivary gland is identified and wiped with gauze • Lemon juice sprayed over orifice and waited for few minutes • The orifice slightly massaged and look for a bead of saliva • Dilatator introduced sequentially • Catheter filled with contrast inserted into orifice • Catheter taped at the cheek with plaster • Various view taken during injection of the contrast
- 12. By Prof J Venkat Professor in Radiography Chennai India PAROTID GLAND • Parotid duct opens into the mouth on the inner surface of the cheek, usually opposite the maxillary second molar through Stensen’s duct. • Dilator used to dilate the duct after spraying lemon over it • Catheter filled with contrast and stabilized at cheek • PA and lateral oblique view taken during the injection
- 13. By Prof J Venkat Professor in Radiography Chennai India SUBMANDIBULAR GLAND • Submandibular duct opens at the base of the frenulum of the tongue through Wharton’s duct. • Dilator used to dilate the duct after spraying lemon over it • Catheter filled with contrast and stabilized at cheek • PA and lateral oblique view taken during the injection
- 14. By Prof J Venkat Professor in Radiography Chennai India FILMING • Scout film taken to rule out any pathology including stones and mass • Ap, lateral, oblique and tangential view • Films are taken during injection. The catheter is left in place till the adequacy of films is ensured. • Positioning for parotids: • Frontal view is taken with face rotated 5-10 degrees towards the side of study. • Lateral view is taken with 15-20 degrees cranial tube tilt. • Positioning for submandibular gland • Lateral view is taken with 15-20 degrees cranial tube tilt. • OPG taken if available • Cone beam CT also give better views • If Necessary, CT scan also can be used.
- 15. By Prof J Venkat Professor in Radiography Chennai India POSITIVE FINDINGS INFLAMED PAROTID GLAND STRICTURE SUBMANDIBULAR DUCT
- 16. By Prof J Venkat Professor in Radiography Chennai India COMPLICATIONS •Sialadenitis and abscess •Stricture of the ducts. •Pain or rupture of ducts •Damage to duct orifice
- 17. By Prof J Venkat Professor in Radiography Chennai India POST PROCEDURAL CARE • Remove the cannula catheter • Ask patient to rinse the mouth, give some lemon juice and educate the patient to self massage the salivary gland to help express the retained contrast • Pain killers can be given
- 18. THANK YOU •References • Radiological Procedures - A Guideline Edited by Dr Bhushan N. Lakhakar • A Guide to Radiological Procedures Edited by Stephen Chapman • Fundamentals of Special Radiographic Procedures Edited by ALBERT M. SNOPEK • Clark’s Positioning in Radiography By Kathleen C Clark (1896-1968) • Techniques in Diagnostic Imaging Edited by Graham H. White House and Brian s. Worthington • Wikipedia, The Free Encyclopedia By Prof J Venkat Professor in Radiography Chennai India +919444923675 WhatsApp venkatdgr8@gmail.com