Week 6 Thomson: Salivary Gland investigations Flashcards
What are salivary gland investigations
Clinical Examination & Palpation
Salivary Flow Rate
Plain Radiography
Ultrasound
Sialography
CT / MR scan
Scintiscanning
Sialadenoscopy
What is this?
Submandibular sialolith
What is happening in this?
Stricture with ballooning of proximal portion of duct
What are MRI’s useful for?
Visualisation of soft tissues
What is salivary gland scintiscanning?
- Assesses salivary gland function
- Demonstrates uptake and distribution of isotope
- Can also demonstrate tumour formation
What are options for salivary gland surgery?
- Removal of calculi
- Ductal dilation/repositioning
- Excision of sublingual and submandibular gland
- Parotidectomy (superficial or total)
- Excision of minor salivary gland lesions/tumours
How to remove calculi surgically?
- Small incision over duct to encourage stone to be removed. Sometimes can trace stone in anterior FOM but sometimes need to explore further back than FOM.
- Can use sialendoscopy
How are different sizes of salivary stones removed?
- 3-4mm: endoscopy
- 5-7mm: laser
- >8mm: combined technique
What are considerations for sublingual gland surgery?
- Limited by delicate tissues in FOM
- Often need to remove sublingual gland as well as cyst or swelling
- If you just drain cyst, it can reform
What nerves run close to the submandibular gland?
- Lingual
- Hypoglossal (supplies muscle of tongue)
What is this?
Sebaceous cyst/epidermoid cyst
- Connected to skin
- Not in submandibular triangle
What can happen when incision is made for submandibular gland?
Marginal mandibular branch of facial nerve weakness
What structures run through parotid gland?
What happened in this pic?
RHS facial nerve palsy
What is freys syndrome?
- When auriculotemporal nerve is injured due to trauma from surgery near parotid
- When pt salivates, sweat is also produced on the surface
What is this?
Adenoid cystic carcinoma (Original dentist exo’d molar as they thought there was abscess but palatal swelling became ulcerate
