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At least 19 recordsLinked to original sources
PubMed1983

An enzyme histochemical study of human salivary duct calculi.

An investigation was undertaken to study the distribution of enzymes associated with submandibular gland salivary calculi. Ten calculi were freeze-sectioned and incubated for acid and alkaline phosphatases and for lactate, succinate and maleate dehydrogenases. All calculi were partly covered by a 50-210 micrometers wide zone of organic material consisting of connective tissue and metaplastic squamous epithelium facing the mineralized calculus, or of a structureless substance attached to the mineralized calculus. The epithelium showed an intense staining reaction for acid phosphatase and lactate dehydrogenase and a moderate reaction for succinate dehydrogenase throughout all levels of the epithelium. The structureless peripheral zone exhibited a moderate activity of acid phosphatase and succinate dehydrogenase located to an area close to the mineralized matrix. Also alkaline phosphatase and lactate dehydrogenase were found in a special pattern in the structureless zone. Sodium fluoride and sodium vanadate added to the incubation medium inhibited acid phosphatase activity whereas cupric chloride only lowered the staining reaction. Enzyme activity was found only within the peripheral zone of organic material with one exception. The results suggest that the calcification process of salivary calculi is not a passive calcification of necrotic material or mucin but rather an active process promoted by enzymes in the surrounding organic substances.

Acid Phosphatase↗
PubMed2002

Virtual endoscopic view of salivary gland ducts using MR sialography data from three dimension fast asymmetric spin-echo (3D-FASE) sequences: a preliminary study.

OBJECTIVES: We performed magnetic resonance (MR) sialography of parotid gland and/or submandibular gland ducts using three-dimensional fast asymmetric spin-echo (3D-FASE) sequencing. The objective was to make three-dimensional (3D) reconstruction images and virtual endoscopic views of the parotid gland ducts using MR sialography data sets of 3D-FASE sequences. METHODS: We reviewed the MR sialography data sets with 3D-FASE sequencing of 10 control volunteers and six patients. Three-dimensional reconstruction images and virtual endoscopic views of the parotid gland and/or submandibular gland ducts were generated with maximum intensity projection (MIP), shaded surface display (SSD), and volume rendering techniques (VRT). RESULTS: The main parotid gland and/or submandibular gland ducts, large branches within the glands, and small branches were fairly well defined in a very short acquisition time on MR sialographic images with 3D-FASE sequencing in nine of the 10 healthy volunteers. The 3D-reconstruction images of the parotid gland ducts and/or submandibular gland ducts showed the entire length of the branch paths and complete images from all angles, and the virtual endoscopic views showed the endoluminal tracts of the main ducts and the large branches in nine. In the patient with Sjogren's syndrome, chronic sialoadenitis, and salivary calculi in the Wharton ducts, the MR sialographic images showed diffuse areas of punctate high signal intensity, dilatation of Stensen's duct, or stones of Wharton's duct, respectively. Furthermore, the 3D-reconstruction images of the salivary gland ducts showed the stenoses and stones in the branch paths and complete images from all angles, and the virtual endoscopic views showed the stenoses and stones in the endoluminal tracts of the main and large branches. CONCLUSIONS: Our initial experience showed that virtual MR endoscopy could be performed to observe the endoluminal tracts of parotid and submandibular glands. The clinical use of the virtual MR endoscopy for salivary gland ducts has not been established yet. Future applications of the 3D-reconstruction images and virtual endoscopic views using MR sialography data sets of 3D-FASE sequences are very attractive and further expansion of this field is expected.

Adolescent↗
PubMed2004

Endoscopy: a minimally invasive procedure for diagnosis and treatment of diseases of the salivary glands. Six years of practical experience.

During a 6-year period we did a total of 72 videoendoscopies of the salivary glands and their associated ductal systems. This minimally invasive procedure is associated with little morbidity and discomfort. The main indication was sialolithiasis of the submandibular and parotid glands. Sialoendoscopy was used not only for diagnosis of radiolucent calculi but also for simultaneous removal of calculi. Sialoendoscopy was also of benefit in the diagnosis and treatment of other diseases of the salivary glands. Even patients with chronic sialadenitis could be helped with endoscopic dilatation of the causative sialostenosis, thereby enabling us to conserve the gland.

Adolescent↗
PubMed2001

Endoscopic excision of the submandibular gland by an intraoral approach.

The recent advent of endoscopic procedures has compelled both plastic and neck and head surgeons to reconsider the conventional methods by which the excision of submandibular gland is classically achieved. An endoscopic intraoral approach for excision of the submandibular gland is described. This procedure is anatomically safe and can be made with minimal morbidity; a transcervical incision is avoided. Both specific instruments and solid anatomical knowledge are necessary to perform a safe and efficient glandular endoscopic excision. The essential surgical steps are as follows: 1) Careful identification of the Wharton duct and lingual nerve; 2) Retraction of the mylohyoid muscle; 3) Protection of the sublingual gland and lingual nerve; 4) Extraoral manipulation of the submandibular gland obtaining intraoral protrusion; and 5) Careful dissection of the posterior third of gland, avoiding injury on the facial artery and vein. Two patients were operated on with this technique and were very pleased with their results. No complications were registered. With advanced endoscopic instruments, new surgical technique, and surgeon experience, endoscopic intraoral excision of the submandibular gland can be the method of choice in benign neoplasia, sialolith, sialoadenitis and plunging ranula.

Adult↗
PubMedDate not supplied

MR sialography: initial experience using a T2-weighted fast SE sequence.

PURPOSE: The aim of this study was to evaluate an MR technique optimized for imaging of the parotid gland ductal system. METHOD: The pulse sequence was optimized in 10 volunteers to depict static or nearly static fluid in the parotid ductal system. A heavily T2-weighted fast SE sequence (TR 3,600 ms/TE 800 ms) with a slice thickness of 30-40 mm using an 8 cm surface coil allowed depiction of the fluid-filled parotid duct. Thirteen patients with benign as well as malignant parotid gland pathologies were examined: sialadenitis (n = 2), sialadenosis (n = 3), Heerfordt syndrome (n = 1), pleomorphic adenoma (n = 2), parotid carcinoma (n = 1), lymphoepithelial carcinoma (n = 1), cystadenolymphoma (n = 2), and non-Hodgkin lymphoma (n = 1). RESULTS: The heavily T2-weighted projection image yielded good quality sialographic images. The main duct and primary branching ducts were clearly depicted in all normal cases. The main duct was visualized in all patients. Intra- and extraglandular duct widening and ductal strictures were well depicted. Sialolithiasis with a calculus in the main duct was correctly demonstrated in one case. CONCLUSION: MR sialography is noninvasive and does not depend on duct cannulation or contrast agent injection. Initial experience with a thick slice projection technique indicates that MR sialography can be successfully applied to image the parotid gland ductal system.

Adenolymphoma↗
PubMed1998

[The diameter of the Stenon and Wharton ducts. Significance for diagnosis and therapy].

In assessing new minimally invasive diagnostic techniques (duct endoscopy) and therapy (lithotripsy) of salivary gland disease, it is of importance to know the true dimensions of the secretory ducts. Twenty-five ducts of the parotid gland and 20 ducts of the sub-mandibular gland were examined histologically at different points of their anatomic course and their in vivo diameters were evaluated using a previously determined formalin-induced shrinking factor. The mean diameter of Stensen's duct at four different points along its length ranged between 0.5 mm and 1.4 mm, depending on the site. A narrowing at the middle of the duct was striking. In all preparations examined, the minimum width of the secretory duct was located at the ostium. In Wharton's duct the narrowest duct diameter was also identified at the ostium. The mean values for the duct diameters ranged between 0.5 mm and 1.5 mm. For diagnostic and therapeutic purposes, endoscopes, balloon catheters and stone-extraction baskets should conform as much as possible to physiological duct widths. A diameter of 1.2 mm should be considered the upper limit for duct instruments. Our findings also suggest that in the case of salivary stone lithotripsy the best results will be achieved when the maximum size of a stone fragment does not exceed 1.2 mm.

Aged↗
PubMedDate not supplied

Interventional sialography: a single-center experience.

PURPOSE: To evaluate interventional sialography for the treatment of chronic recurrent sialadenitis due to calculus and/or stricture. METHODS: We performed a retrospective review and follow-up of 12 patients treated over a 3-year period. The techniques for calculus extraction by papillotomy and basket extraction, and stricture dilatation by a combination of predilation with lacrimal dilators and then angioplasty balloons are described and the literature is reviewed. RESULTS: Follow-up of 1-40 months (mean 14.6 months) showed that 7 of 12 patients remained symptom free and 2 others became asymptomatic after an interval. There were no major complications from the procedure. CONCLUSION: Interventional sialography is a safe and acceptable alternative to surgery and can be considered as first-line therapy for symptomatic salivary duct calculus and stricture.

Catheterization↗
PubMed2006

Hydatid cyst in the duct of the submandibular gland.

The case of a hydatid cyst located in the duct of Wharton of a 56-year-old farmer is reported not only because of the unusual location of the disease, but also because the clinical manifestations and surgical findings of the hydatid cyst strongly resembled those of a salivary calculus in the duct of Wharton. The patient presented with a non-painful swelling of the right submandibular region. The mass, which appeared 5 years before seeking medical advice, augmented progressively during the first year after its onset and remained stable during the next 4 years. The subsequent surgical excision of the mass was uneventful and a round mass, which was palpated intraoperatively in the duct of Wharton was assumed to be a sialolith. The diagnosis for a hydatid cyst of the duct of Wharton was made by histological examination. Although salivary calculus is the most common finding in cases of obliteration of the duct of Wharton, histological examination of the surgically excised submandibular gland may reveal benign tumours. In extremely rare cases where hydatid cysts are located in the cervicofacial area, a detailed further diagnostic procedure is required in order to diagnose possible involvement of other organs.

Diagnosis, Differential↗