Diagnosis and Management of Salivary Lesions of the Neck

Carlson, Eric R.

doi:10.1016/j.cxom.2014.10.005

Cited by 10 publications

(5 citation statements)

References 21 publications

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“…This survey supports previous suggestions that, in North America, CT is commonly used as a first line imaging modality for the evaluation of sialolithiasis (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11) and reveals significant variations in the technique used for evaluating suspected salivary stones. Among the respondents, the most commonly used protocol for evaluating sialolithiasis was an UE acquisition followed by a single CE acquisition (35.3%).…”

Section: Discussionsupporting

confidence: 88%

“…The imaging approach for the work-up of salivary gland disorders can vary substantially (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11). In North America, computed tomography (CT) is typically considered the first line imaging modality of choice for evaluation of sialolithiasis whereas in Europe, ultrasound is more widely used (1)(2)(3)(4)(5)(6)10,11). Factors accounting for the popularity of CT include its widespread availability, fast scan acquisition times, high resolution, ability to evaluate the deep anatomic spaces in the neck, and excellent evaluation of bone detail.…”

Section: Introductionmentioning

confidence: 99%

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Practice variations in salivary gland imaging and utility of virtual unenhanced dual energy CT images for the detection of major salivary gland stones

et al. 2018

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Background There are variations in computed tomography (CT) protocols used for evaluating sialolithiasis, with some protocols including acquisitions before and after IV contrast administration. Dual-energy CT (DECT) can be used to generate virtual unenhanced (VUE) images, potentially precluding the need for an uninfused scan. Purpose In this study, we performed a survey in order to assess variations in the imaging approach for sialolithiasis and evaluated the accuracy of DECT VUE images for the detection of salivary stones. Material and Methods Practice variations were evaluated by an online survey of the membership of the American Society of Neuroradiology. We then identified 28 patients with salivary gland calcifications matched with 28 negative controls that had both an unenhanced and a contrast-enhanced acquisition performed as DECT. A total of 123 major salivary gland calcifications and 85 tonsilloliths were evaluated and the true unenhanced series was used as gold standard. Results The survey revealed substantial variations in CT protocols used for sialolithiasis. On a per-patient basis, DECT VUE had 96.4% sensitivity and 100% specificity. On a per-calcification basis, sensitivity and specificity was 100% for stones > 2 mm but dropped for smaller calcifications. The false-negative cases corresponded to clinically insignificant, intra-glandular parotid calcifications. Inter-reader agreement was excellent (0.9256). Conclusion This study confirms that there are significant variations in CT protocols used for evaluation of sialolithiasis. A single contrast-enhanced DECT acquisition with reconstruction of VUE may represent an attractive, streamlined alternative and enable the elimination of the true unenhanced phase and associated radiation exposure.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Practice variations in salivary gland imaging and utility of virtual unenhanced dual energy CT images for the detection of major salivary gland stones

et al. 2018

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“…Sialadenectomy is the surgery of choice for recurrent obstructive sialadenitis also if a sialolith with a substantial mass is located within the gland and intraoral surgical access is not possible. [6] In the present paper we have a new case of coexisting WT with sialolithiasis. We recommend that longstanding sialolithiasis cases should be carefully examined to exclude suspicions of WT before surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Magnetic resonance imaging is recommended if the degree of suspicion is high based on sonographic findings in patients with sialolithiasis. [6] The treatment of submandibular gland WT is sialadenectomy due to multi centric features. Sialadenectomy is the surgery of choice for recurrent obstructive sialadenitis also if a sialolith with a substantial mass is located within the gland and intraoral surgical access is not possible.…”

Section: Discussionmentioning

confidence: 99%

Coexistence of a sialolith, a Warthin tumor in the submandibular gland, and sialocutaneous fistula in the neck

Tatar¹

2017

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ÖZSialolithiazis submandibüler bezde en sık görülen patoloji olmakla birlikte, submandibüler bezden kaynaklanan Warthin tümörü nadirdir. Bu yazıda, sağ submandibüler bölgede şişlik, kızarıklık ve boyunda submandibüler bölgede seropürülan drenajın olduğu kütanöz fistülü olan 63 yaşında bir erkek hasta sunuldu. Ultrasonda taş tespit edildiği için, sialoadenektomi ve fistül trakt eksizyonu yapıldı. Patolojik incelemede, sialolithiazisin yanı sıra, Warthin tümörü tespit edildi.Anahtar sözcükler: Kütanöz fistül; kistadenoma lenfomatozum; papiller; tükürük bezi kakülleri; Warthin tümörü. ABSTR ACTAlthough sialolithiasis is the most common submandibular gland pathology, a Warthin tumor arising from the submandibular gland is rare. In this article, we report a 63-year-old male patient with a swollen right submandibular region, erythematous, and a fistulous area from which a cutaneous fistula with seropurulent exudates located at the submandibular region. Ultrasound revealed a stone and, therefore, sialoadenectomy and excision of the fistulous tract were performed. Besides the sialolith, the pathological examination revealed a Warthin tumor.

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“…their clinical behavior is typical: they are characterized by a chronic and recurrent proceeding. 2,3 Sialolithiasis, one of the most common obstructive lesions, is generally due to calculi, which are attributed to retention of saliva and settling of calcium salts among a thickened core of ductal cells. Calculi grow bigger until the obstruction of the excretory duct is obtained.…”

Section: Introductionmentioning

confidence: 99%

The use of laser CO₂in salivary gland diseases

et al. 2016

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Salivary gland diseases can include reactive lesions, obstructive lesions, and benign tumors. All these clinical entities are slow growing. Salivary glands reactive lesions, such as mucoceles, can result from extravasation of saliva into the surrounding soft tissue or from retention of saliva within the duct. Sialolithiasis, one of the most common obstructive lesions, is generally due to calculi, which are attributed to retention of saliva. Monomorphic adenoma is a salivary gland benign tumor, which is exclusively resulted from proliferation of epithelial cells, with no alterations interesting the connective tissue. The elective therapy of these lesions is surgical excision because sometimes they can be accompained by difficulties during chewing and phonation and can interfere with prosthesis's stability. The aim of the study is to evaluate the efficacy of CO 2 laser in the treatment of patients with salivary gland diseases. Three different cases -a mucocele, a scialolithiasis and a monomorphic adenoma -were treated with CO 2 laser excision (CW and 4W), under local anesthesia. Two different techniques were used: circumferential incision for the adenoma, and mucosa preservation technique for mucocele and sialolithiasis. In each case final haemostasis was obtained by thermocoagulation, but suture was applied to guarantee good healing by sewing up the flaps. The patients were checked after twenty days and the healing was good. The carbon dioxide laser (CO 2 laser) was one of the earliest gas laser to be developed, and is still the highest-power continuous wave laser that is currently available. In dentistry the CO 2 laser produces a beam of infrared light with the principal wavelength bands centering around 9.4 and 10.6 micrometers. Laser excision can be very useful in oral surgery. In the cases presented CO 2 laser offered, differently from traditional surgery, simplified surgical technique, shorter duration of operation, minimal postoperative pain, minimal scarring, bloodless field and the possibility to realize minimally invasive surgery. These advantages made the operation tolerable for the patients, that became more compliant. Optimum functional results can be expected.

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Diagnosis and Management of Salivary Lesions of the Neck

Cited by 10 publications

References 21 publications

Practice variations in salivary gland imaging and utility of virtual unenhanced dual energy CT images for the detection of major salivary gland stones

Practice variations in salivary gland imaging and utility of virtual unenhanced dual energy CT images for the detection of major salivary gland stones

Coexistence of a sialolith, a Warthin tumor in the submandibular gland, and sialocutaneous fistula in the neck

The use of laser CO₂in salivary gland diseases

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Diagnosis and Management of Salivary Lesions of the Neck

Cited by 10 publications

References 21 publications

Practice variations in salivary gland imaging and utility of virtual unenhanced dual energy CT images for the detection of major salivary gland stones

Practice variations in salivary gland imaging and utility of virtual unenhanced dual energy CT images for the detection of major salivary gland stones

Coexistence of a sialolith, a Warthin tumor in the submandibular gland, and sialocutaneous fistula in the neck

The use of laser CO2in salivary gland diseases

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The use of laser CO₂in salivary gland diseases