Sialectasis

Abstract: Forty-eight patients with proven disease of the salivary glands were evaluated by computed tomography (CT). Twenty-seven patients had salivary gland neoplasm and all were identified by CT. Fifteen benign tumors appeared as discrete, sharply marginated, high-density masses embedded in an otherwise normal gland. All 15 were correctly identified as benign by CT. There were 12 malignant tumors; 10 were invasive and presented as poorly defined, relatively dense lesions which obliterated and/or transgressed adjacent fat and fascial planes. Two malignant tumors presented as discrete masses and were incorrectly considered to be benign by CT. Twenty-one patients with inflammatory disease of the salivary glands were studied. A variety of patterns were noted, the most common a relatively diffuse, irregular area of increased density in an enlarged gland. Salivary duct calculi, diffuse sialectasis, and enlarged lymph nodes were well demonstrated. Differentiation between focal and inflammatory disease and malignant neoplasm was difficult. Computed tomography may be augmented by coincident sialography, although it is seldom necessary.

Abstract: Background: Recurrent parotitis (RP) of childhood is a rare condition of unknown aetiology, probably immunologically mediated. Objective: To review the clinical presentation, diagnosis and management of RP of childhood. Methods: Retrospective study from 1983 to 2004 of children diagnosed with RP of childhood at a tertiary children's hospital. Results: We identified 53 children, 37 (70%) male and 16 (30%) female. The age of onset was biphasic, with peaks at 2–5 years of age and at 10 years. The commonest symptoms were swelling (100%), pain (92.5%) and fever (41.5%). Symptoms usually lasted 2–7 days with a median of 3 days. The mean frequency was 8 episodes per year. The diagnosis was often delayed, >1 year in 70% of patients, maximum 8 years. The most common diagnoses, before the definitive diagnosis of RP, were mumps (21%), ‘infection’ (15%) and stones (11%). Sialogram (57%) and/or ultrasound (41%) showed sialectasis in 81% of patients. Over half the patients (54%) were given antibiotics at least once to treat the parotitis. Two children had hypogammablobulinaemia, one child had human immunodeficiency virus infection, and one child had Sjogren's syndrome. Two children had high titre antinuclear antibodies. Conclusions: Recurrent parotitis had a biphasic age distribution. The major clinical features that distinguish it from other causes of parotid swelling are the lack of pus and recurrent episodes. A clinical diagnosis can often be confirmed by ultrasound. Antibiotics do not have a role in treatment. Affected children should be screened for Sjogren's syndrome and immune deficiency.

Abstract: Technetium 99m pertechnetate (TPT) head and neck scans have been used to evaluate patients with a variety of extracranial tumors and non-neoplastic conditions. Decreased saliva flow, a clinically dry mouth and sialectasis of the smaller salivary ducts are associated with a decrease in TPT uptake by the salivary glands. TPT scans are useful for discriminating among different salivary gland tumors (such as "hot" Warthin's tumors and "cold" mixed tumors). The position of the salivary glands can be determined by TPT scanning and the size and extent of adjacent mass lesions can be evaluated.

Abstract: The purpose of this study was to determine the diagnostic accuracy of MR sialography in the examination of patients with salivary duct disease.Forty-nine patients (23 males and 26 females; 16-78 years old; mean age, 47 years) with symptoms related to the salivary glands underwent both conventional sialography and MR sialography. The latter was performed using a heavily T2-weighted, two dimensional, fast spin-echo technique and a 12-cm circular surface coil. Contiguous 3-mm axial images with frequency-selective fat suppression were acquired through the symptomatic gland. The MR sialography findings were compared with the final diagnoses determined by conventional sialography.Conventional sialography showed calculus disease (n = 13), stricture (n = 12), sialectasis (n = 4), cast (n = 3), neoplasm (n = 2), and normal duct (n = 16). MR sialography alone had a sensitivity of 69% in revealing calculus disease. However, the sensitivity increased to 100% when MR sialograms were combined with control radiographs. ...