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Physics, Techniques and Procedures

Sialography

radiographic examination of the parotid or submandibular glands after injection of contrast medium into the duct system. Nonionic water-soluble contrast media (350 mg iodine/ml) are preferred. Plain films similar to the post-contrast views (see below) should be taken prior to contrast medium injection for demonstration of calculi. A dental film placed in the buccal sulcus outside the upper molar teeth at the parotid duct orifice may also be beneficial. The procedure is performed with the patient supine. The salivary duct orifice is first explored and dilated with metal probes (e.g. lacrimal probes). For contrast medium injection, several devices exist, including flexible cannulae with finely drawn-out tips, and metal-tipped catheters. Injection of contrast medium is performed slowly with a 2 ml syringe, and the injection is stopped when the patient feels discomfort, or after an injected amount of 1 ml. Post-contrast radiographs include oblique lateral (Fig.1) and true lateral views, a posteroanterior view for the parotid gland or a mandibular occlusal radiograph for the submandibular duct. Excellent views may also be obtained with dental panoramic equipment (pantomography).

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Fig.1

Oblique lateral projection of normal submandibular sialogram.
Sialography, Fig.1