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Sialography by Prof j venkat
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