Jessica Giordano’s research while affiliated with University of Palermo and other places

Aims: To analyse retrospectively all cases of spontaneous salivary fistulae studied by radiological imaging from January 1999 to December 2011. Salivary fistulae are uncommon; they could be congenital or acquired caused by injury, neoplasm, surgery or may represent a rare long-term complication of sialolithiasis and/or recurrent sialoadenitis. Materials and methods: We retrospectively report our 12 years experience in patients with proved unusual intraoral spontaneous salivary fistula. All ours patients were referred for classical symptoms as recurrent salivary infection and purulent oral discharge. Results: 6 cases of intraoral inflammatory salivary fistulae were studied (5 submandibular, 1 parotid), 3 cases were related to sialoliths and other 3 to sialoadenitis; among them 2 have both sialoliths and active adenitis. All patients underwent to sialography and fistulography and all fistulous tracts were detected. Different diagnostic options were applied according to the localization of fistulae. Conclusion: Looking to our experience we suggest studying patients with sialography and/or fistulography and Magnetic Resonance (MR) especially for patients with a high probability of being subjected to major surgery. MR allows to see fistulae, relation between fistulae and near tissue, and to distinguish inflammation from other pathology. Computed Tomography (CT) is ideal to study shape and dimension of sialolith and to evaluate eventual bone involvement.

Aim of the present paper was to investigate the imaging and related clinical characteristics of sialolithiasis in Italian pediatric population trying to determine the difference between pediatric and adult. Twenty-nine pediatric patients (age range 1-17 years) with pain and postprandial swelling and/or purulent discharge in the salivary gland areas were referred to radiology department after pediatric ear, nose and throat (ENT) evaluation. They all were submitted to ultrasound examination of the main salivary glands. Multidetector computed tomography (MDCT) only was performed in 2/6 patients, in 2/6 patients both sialography and MDCT were performed due to inconclusive MDCT features, 2/6 only sialography was performed. Sialoliths were classified on their location and size. In 6 out of 29 patients (4 males, 2 females, age range 1-17 years) salivary stones were detected. Sialoliths were detected in 5/6 patients in the submandibular gland and 1/6 in the parotid gland. All sialoliths, excepted for a case of multiple sialoliths, were located in the distal part of the main salivary ducts. Imaging characteristics of sialolith in pediatric group are similar than in adult population in few aspects. In fact sialoliths are smaller in size and located more frequently in the distal part of the main salivary duct, than in adult, making sialography cannulation more complex and requiring short thickness in MDCT.