Sialography

Oral Vestibule

Space between the lips/cheeks and teeth/gums

Oral Cavity Proper

Space inside the dental arches, occupied largely by the tounge when at rest

Lips

Covered externally by skin, internally by mucous membrane

• contain the orbicularis oris muscle

Cheeks ( buccae )

Formed by buccinator muscles

• lined by mucosa; outer surface is skin

32

How many teeth does the adult have?

20 decidous

How many teeth does the children have

Incisors, Canines, Premolars, Molars

Teeth types :

Cutting, tearing, grinding food

Functions of teeth

Gingiva ( Gums )

Fibrous tissue covering alveolar bone and surrounding teeth

Hard palate

Formed by the maxilla and palatine bones

Hard palate

Seperates oral and nasal cavities

Soft palate

Muscular, mobile part posterior to hard palate, ends in UVULA

Soft palate

Closes off nasopharynx during swallowing

Tongue

Muscular organ ( instrinsic and extrinsic muscles )

Tongue

Covered with papillae ( some with taste buds )

Taste, speech, swallowing, food manipulation

Functions of tongue?

Body anterior 2/3 ( oral part ) , root/base posterior 1/3 ( pharyngeal part )

Apex tip of the tongue

Parotid, submandibular, sublingual

Salivary glands major glands?

Parotid

What major salivary glands in Stensen’s duct to upper 2nd molar?

Submandibular

What major salivary gland is in Wharton’s duct to floor of mouth?

Sublingual

What major salivary gland is in ducts of Rivinus to floor of mouth?

Secretion of saliva ( lubrication, digestion, antimicobial action)

What is the function of Salivary glands?

Frenula

Labial frenelum : midline fold attaching lip to gum

Lingual frenulum : under tonge, limits movement

Term applied for the radiologic examination of the salivary gland and ducts with the use of contrast medium

What is Sialography?

Radiopaque medium

It is injected into the main duct and flows into the intra-glandular ductules

Inflammatory lesions, tumor to determine the extent of salivary fistulae, to localize diverticulae, strictures and calculi, Examination done one at a time ( per gland )

Sialography used to demonstrate?

2-3 minutes

How many minutes before the procedure; patient is given a secretory stimulant to open the duct for ready identification of its orifice and for easier passage of a cannula or catheter

10 minutes

How mang minutes the Radiograph may be taken? Later to verify clearance of the medium

Fresh lemon slice/juice

What secretory stimulants?

Before exam to open the duct, to localized the orifice of selected duct, for easier passage of a cannula or catheter

What is the purpose of secretory stimulants before exam?

To stimulate rapid evacuatioan of the CM, take radiograph 10 mins after the procedure and to VERIFY the clearance of CM

What is the purpose of after exam of secretory stimulants?

In Contrast media

In this procedure the manual pressure syringe attached to cannula or catheter

Hydrostatic pressure

Use of syringe barrel with plunger removed attached to drip stand

28 cm

In CM, the hydrostatic pressure how many cm the distance above level of patients mouth?

Severe inflammation, Severe infection of salivary glands, History allergy to CM

What is the contraindications?

Removed dentures, removed radiopaque

patient preparation?

It’s on supine position, What is the CR of the Tangential projection?

Tangential Projection ( prone )

rotate the head away from the side being examined, when the parotid stensens duct, rest patients on head forehead and nose

Fill the mouth with air and then puff the cheeks out as much as possible, if not let the patient suspend respiration during exposure

How to study parotid gland? Better detail can be obtained particularly for demonstration of calculi by having patient?

Parotid gland and duct well demonstrated lateral to and clear of mandibular ramus

What is the SS of the tangential projection?

lateral projection of Parotid

extend the patient so that space between cervical and rami is cleared

15 degrees

Rotate the head to adjust, MSP is how many degrees?

Submandibular

Head in true lateral. CR perpendicular to inferior margin of the angle mandible

Iglauer method

In this method simple manuever to increase visibility of salivary calculus by having the index finger place on the back of the tounge

Oblique projection

Deeper portions of the parotid and submandibular glands

Submandibular and sublingual glands

Axial projection ( intraoral method )

axial projection ( intra oral method )

The only projection that gibes an unobstructed view of the sublingual gland

Uniform filling of the duct and gland, Tree like branching pattern, Complete evacuation on post evacuation images

What are the normal findings?

Calculus

Abnormal concretion of minerals salts, often called a stone

Epiglottis

Inflammation of the epiglottis

Fistula

Abnormal connection between two internal organs or between an organ and the body surface

Foreign Body

Foreign material in the airway

Salivary duct obstruction

Condition preventing the passage of saliva through the duct

Stenosis

Narrowing or contraction of a passage

Tumor

New tissue growth where cell proliferation is uncontrolled

Sjorens

Detect ductal, dilatation, sialectasis ( string of pearls sign )

Calculi

Sialoliths

Salivary ducts ( most common in submandibular gland ) Salivary gland stones