Ultrasound in Salivary Gland Disease
Centre Antoine-Lacassagne Service de Radiologie, Nice, France. ORL
(Impact Factor: 0.88).
01/1993; 55(5):284-9. DOI: 10.1159/000276440
This text reviews the normal ultrasound (US) anatomy of the salivary glands along with tumoral, lithiasic, and inflammatory pathologies. For salivary gland tumors, US does have limitations (failure to visualize the entire parotid gland, relations with the nerve plexus, in-depth spread of large tumors, false-negative errors of malignancy for small encapsulated tumors). However, US is a simple technique allowing correct identification of the benign nature of a lesion in over 80% of the cases. For lesions under 3 cm in diameter, US is generally the only imaging technique used; for larger lesions, CT or MR is required. Sialolithiasis and inflammatory diseases are being documented by US more and more and the indications for sialography have strongly decreased.
Available from: Yuan-Ji Day
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ABSTRACT: Acute parotid gland enlargement in association with general anesthesia is rare and has also been called anesthesia mumps. We present two patients who were scheduled for lumbar spine surgery under general anesthesia. Each developed acute unilateral parotid gland enlargement over one side of the face proven by sonography. Case 1: A 52-year-old man was scheduled for his third lumbar spine to first sacral spine surgery for scoliosis and spondylolisthesis. The patient was provided general anesthesia with oral endotracheal intubation and placed in the prone position with the neck flexed at approximately 10 degrees. The head was turned to the left side and the right side of the face was placed on a soft gel rolling pad. After 6 hours of surgery, swelling of the right parotid gland was noted upon endotracheal extubation. Twenty four hours later, the patient received sonographic examination of the salivary gland which showed dilatation of the right parotid duct with obstructive inflammation. After receiving non-steroidal anti-inflammatory drug (NSAID) treatment, his symptoms and signs subsided 2 weeks after the surgery. Case 2: A 53-year-old woman was scheduled for her third lumbar spine to fifth lumbar spine instrumentation and internal fixations for spondylolisthesis. A similar anesthetic regimen and surgical position was provided as with Case 1. The duration of the surgery was about 5 hours and swelling of the right parotid gland was also noted postoperatively. Sonographic examination of the salivary gland showed only an inflammatory process without dilatation of the parotid duct. She had complete recovery of the condition 10 days after surgery. There were no complications nor residual enlargement of the parotid gland in either of our two patients after conservative treatment.
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ABSTRACT: We emphasise the importance of high-resolution CT with reconstruction in the demonstration of submandibular gland (SMG) sialolithiasis and its role in monitoring treatment. We studied 76 patients with swollen and tender SMG, some with fever. They underwent conventional radiography, sonography (US) and high-resolution CT with reconstructions. Conventional radiographs demonstrated single stones in 29 patients. Axial CT, before reconstructions, demonstrated single stones in 63 patients and multiple stones in another 5. Following CT reconstructions, multiple stones were demonstrated in 37 patients. On US stones were diagnosed in only 33 patients, and multiple stones in only 1. All 68 patients with stones shown on imaging and 2 without stones underwent surgery, with good clinical results. Total removal of the SMG and its duct was performed in patients with multiple stones, chronic inflammatory changes in the SMG, or a solitary stone in the SMG or deep in the duct. A small incision for removal of a solitary stone in the distal aspect of Wharton's duct was performed in 15 patients, with excellent clinical results. Another 14 patients with multiple salivary gland stones, diagnosed on CT reconstructions, did not improve following this procedure and needed further surgery; clinical improvement occurred following excision of the SMG and Wharton's duct. Histological examination in all of these confirmed the presence of additional stones. Conservative anti-inflammatory treatment was recommended for 6 patients in whom CT reconstructions did not demonstrate stones.
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ABSTRACT: Specifications about the size of healthy salivary glands are not available to date. Therefore, we determined the size of the submandibular and the parotid glands by ultrasonography in 50 subjects (25 men, 25 women, mean age 45 y, range 20-68) with no history of disease affecting the salivary glands. The subjects were equally distributed concerning gender and age. Body weight did not differ more than 20% from the ideal weight following Broca's formula (mean body weight 71 kg, range 46-95 kg). In the submandibular glands we found an anterior-posterior length of 35 mm +/- 5.7 mm, a paramandibular dimension to the depth of 14.3 mm +/- 2.9 mm and a dimension in frontal scanning of 33.7 mm +/- 5.4 mm. The parotid glands were measured 46.3 mm +/- 7.7 mm in the axis parallel to the mandibular ramus and 37.4 mm +/- 5.6 mm in the transversel axis. The dimension of the parotid parenchyma was measured with 7.4 mm +/- 1.7 mm lateral to the mandible and 22.8 mm +/- 3.6 mm dorsal to the mandible. No statistically significant difference to the 5%-level was found concerning gender. The dimension of the parotid glands correlated statistically significantly with body weight (p = 0.03). This correlation was not found in the dimension of the submandibular glands. Age did not correlate with the dimension of salivary glands. Results of the submandibular glands were compared with volume measurements of submandibular glands from cadavers.
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