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Advances in imaging of obstructed salivary glands can improve diagnostic outcomes

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Abstract

Introduction

Obstruction of the major salivary glands is a relatively common condition defined as the blockage of the salivary outflow in the glandular ductal system. It can however mimic more aggressive pathology.

Methods

The most common cause of salivary obstruction is sialolithiasis, followed by ductal strictures. Salivary obstruction is clinically characterized by a food-related painful swelling of the affected gland, known as ‘mealtime syndrome’.

Results

When obstruction is clinically suspected, the role of imaging consists of confirming the obstruction, identifying its cause, evaluating the position and extent of the obstruction and evaluating for associated complications. However, if imaging shows up signs of a tumour or other pathology which can mimic an obstructed gland clinically instead, the radiologist can alert the clinician accordingly to change the course and plan of treatment. Several imaging techniques are available for investigating the obstructed salivary glands.

Conclusions

This review looks at the causes of obstruction and the use, diagnostic performance and practicality of the various imaging modalities. Importantly, an imaging approach algorithm for the evaluation of the obstructed salivary gland is also proposed.

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References

  1. Escudier MP, McGurk M (1999) Symptomatic sialoadenitis and sialolithiasis in the English population, an estimate of the cost of hospital treatment. Br Dent J 186:436–466

    Google Scholar 

  2. Madani G, Beale T (2006) Inflammatory conditions of the salivary glands. Semin Ultrasound CT MRI 27:440–451

    Article  Google Scholar 

  3. Som PM, Brandwein MS (2003) Salivary glands: anatomy and pathology. In: Som PM, Curtin HD (eds) Head and neck imaging, 4th edn. Mosby, St. Louis, Missouri, pp 2005–2133

    Google Scholar 

  4. Jäger L, Menauer F, Holzknecht N, Scholz V, Grevers G, Reiser M (2000) Sialolithiasis: MR sialography of the submandibular duct—an alternative to conventional sialography and US? Radiology 216:665–671

    PubMed  Google Scholar 

  5. Williams MF (1999) Sialolithisis. Otolaryngol Clin North Am 32:819–834

    Article  PubMed  CAS  Google Scholar 

  6. Siddiqui SJ (2002) Sialolithiasis: an unusually large submandibular salivary stone. Br Dent J 193:89–91

    Article  PubMed  CAS  Google Scholar 

  7. Ngu RK, Brown JE, Whaites EJ, Drage NA, Ng SY, Makdissi J (2007) Salivary duct strictures: nature and incidence in benign salivary obstruction. Dentomaxillofacial Radiol 36:63–67

    Article  CAS  Google Scholar 

  8. Nahlieli O, Nakar LH, Nazarian Y, Turner MD (2006) Sialoendoscopy. A new approach to salivary gland obstructive pathology. JADA 137:1394–1400

    PubMed  Google Scholar 

  9. Capaccio P, Torretta S, Ottavianil F, Sambataro G, Pignataro L (2007) Modern management of obstructive salivary diseases. Acta Otorhinolaryngol Ital 27:161–172

    PubMed  CAS  Google Scholar 

  10. Yousem DM, Kraut MA, Chalian AA (2000) Major salivary gland imaging. Radiology 216:19–29

    PubMed  CAS  Google Scholar 

  11. Rauch S, Gorlin RJ (1970) Diseases of the salivary glands. In: Gorlin RJ, Goldman HM (eds). Oral pathology. Mosby, St. Louis, p 962

  12. Nahlieli O, Eliva E, Hasson O et al (2000) Pediatric sialolithiasis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 90:709–712

    Article  PubMed  CAS  Google Scholar 

  13. Rabinov JD (2000) Imaging of salivary gland pathology. Radiol Clin North Am 38:1047–1057

    Article  PubMed  CAS  Google Scholar 

  14. Bryan R, Miller R, Ferreyro R, Sessions R (1982) Computed tomography of the major salivary glands. AJR 139:547–554

    PubMed  CAS  Google Scholar 

  15. Brown JE (2006) Interventional sialography and minimally invasive techniques in benign salivary gland obstruction. Semin Ultrasound CT MRI 27:465–475

    Article  Google Scholar 

  16. Arkedian L, Shamir D, Trabelsi M, Peled M (2010) Chronic obstructive parotitis due to strictures of Stenson’s duct—our treatment experience with sialoendoscopy. J Oral Maxillofac Surg 68:83–87

    Article  Google Scholar 

  17. Becker M, Marchal F, Becker CD et al (2000) Sialolithiasis and salivary ductal stenosis, diagnostic accuracy of MR sialography with a three-dimensional extended-phase conjugate-symmetry rapid spin-echo sequence. Radiology 217:347–358

    PubMed  CAS  Google Scholar 

  18. Jadu F, Yaffe MJ, Lam EWN (2010) A comparative study of the effective radiation doses from cone beam computed tomography and plain radiography for sialography. Dentomaxillofacial Radiol 395:257–263

    Article  Google Scholar 

  19. Kalinowski M, Heverhagen JT, Rehberg E, Klose KJ, Wagner H-J (2002) Comparative study of MR sialography and digital subtraction sialography for benign salivary gland disorders. Am J Neuroradiol 23:1485–1492

    PubMed  Google Scholar 

  20. Varghese JC, Thornton F, Lucey BC, Walsh M, Farrell MA, Lee MJ (1999) A prospective comparative study of MR sialography and conventional sialography of salivary duct disease. AJR 173:1497–1503

    PubMed  CAS  Google Scholar 

  21. Sartoretti-Schefer S, Kollias S, Wichmann W, Valavanis A (1999) 3D T2-weighted fast spin-echo MRI sialography of the parotid gland. Neuroradiology 41:46–51

    Article  PubMed  CAS  Google Scholar 

  22. Gadodia A, Seith A, Sharma R, Thakar A, Parshad R (2010) Magnetic resonance sialography using CISS and HASTE sequences in inflammatory salivary gland diseases: comparison with digital sialography. Acta Radiol 51:156–163

    Article  PubMed  Google Scholar 

  23. Drage NA, Brown JE (2009) Cone beam computed sialography of sialoliths. Dentomaxillofacial Radiol 38:301–305

    Article  CAS  Google Scholar 

  24. Szolar DH, Groell R, Braun H et al (1996) Ultrafast computed tomography and three-dimensional image processing of CT sialography in patients with parotid masses poorly defined by magnetic resonance imaging. Acta Otolaryngol 116:112–118

    Article  PubMed  CAS  Google Scholar 

  25. Gritzmann N, Rettenbacher T, Hollerweger A, Macheiner P, Hübner E (2003) Sonography of the salivary glands. Eur Radiol 13:964–975

    PubMed  CAS  Google Scholar 

  26. Alyas F, Lewis K, Williams M et al (2005) Diseases of the submandibular gland as demonstrated using high resolution ultrasound. Br J Radiol 78:362–369

    Article  PubMed  CAS  Google Scholar 

  27. Bialek EJ, Jakubowski W, Zajkowski P, Szopinski KT, Osmolski A (2006) US of the mayor salivary glands: anatomy and spatial relationships, pathologic conditions, and pitfalls. Radiographics 26:745–763

    Article  PubMed  Google Scholar 

  28. Ching ASC, Ahuja AT (2002) High-resolution sonography of the submandibular space: anatomy and abnormalities. AJR 179:703–708

    PubMed  CAS  Google Scholar 

  29. Pamela Zengel A, Berghaus C, Weiler M, Reiser DAClevert (2011) Intraductally applied contrast-enhanced ultrasound (IA-CEUS) for evaluating obstructive disease and secretory dysfunction of the salivary glands. Eur Radiol 21:1339–1348

    Article  PubMed  Google Scholar 

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Acknowledgments

The stay of B.S.G. in the Department of Radiology of Northwest London Hospitals NHS Trust was supported by the European Society of Radiology/European School of Radiology (ESR/ESOR) Exchange Programme for Head and Neck Imaging Fellowships.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Radiology, Hospital Universitario Fundación Jiménez Díaz, Fundación Jiménez Díaz, Avda. Reyes Católicos, 2-28040, Madrid, Spain

    B. Sobrino-Guijarro

  2. Department of Oral and Maxillofacial Surgery, Northwest London Hospitals NHS Trust, Northwick Park Hospital, Watford Road, London, HA1 3UJ, England, UK

    L. Cascarini

  3. Department of Radiology, Northwest London Hospitals NHS Trust, Northwick Park Hospital, Watford Road, London, HA1 3UJ, England, UK

    R. K. Lingam

Authors
  1. B. Sobrino-Guijarro
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  2. L. Cascarini
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  3. R. K. Lingam
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Correspondence to R. K. Lingam.

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Sobrino-Guijarro, B., Cascarini, L. & Lingam, R.K. Advances in imaging of obstructed salivary glands can improve diagnostic outcomes. Oral Maxillofac Surg 17, 11–19 (2013). https://doi.org/10.1007/s10006-012-0327-8

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  • DOI: https://doi.org/10.1007/s10006-012-0327-8

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