Other imaging modalities

Question 1

why do we image the salivary glands?

Answer 1

Obstruction
– Mucous plugs
– Salivary stones (sialoliths)
– Neoplasia

Dry mouth

Swelling

Question 2

Why is ultrasound good for salivary glands?

Answer 2

Glands are superficially positioned
– Apart from the deep lobe of the parotid (hidden deep to the ramus

Can assess parenchymal pattern, vascularity, ductal dilatation or neoplastic masses

Can give a sialogogue (ie citric acid) to aid saliva flow
– Will allow better visualisation of dilated ducts

Question 3

symptoms of obstructive disease?

Answer 3

• “Meal time symptoms”
• Prandial swelling and pain
• “rush of saliva into the mouth”
• Bad taste
• Thick saliva
• Dry mouth

Question 4

what are indications for silaography?

Answer 4

Looking for obstruction or stricture (narrowing) of
salivary duct which could be leading meal time symptoms

Planning for access for interventional procedures
(basket retrieval of stones or
endoscopy)

Question 5

what are risks of sialography?

Answer 5

Discomfort

Swelling

Infection

Allergy to contrast (veryrare)
– MRI is alternative as nocontrast used

Question 6

what should parotid and submandibular glands look like?

Answer 6

Parotid gland “tree in winter”

Submandibular gland “ bush in winter”

Question 7

what are signs of benign lesion?

Answer 7

⚫ Well defined
⚫ Encapsulated
⚫ Peripheral vascularity
⚫ No lymphadenopathy

Question 8

what are signs of malignant lesion?

Answer 8

⚫ Irregular margins
⚫ Poorly defined
⚫ Increased/tortuous
internal vascularity
⚫ Lymphadenopathy

Question 9

what is this

Answer 9

osteonecrosis/MRONJ

Question 10

what is this?

Answer 10

osteomyelitis