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A 7-year-old girl had dry mouth and recurrent infections of the lacrimal fistulae with decreased lacrimal secretion. All four puncta were absent, and a Schirmer test showed decreased lacrimal secretion. Salivary gland imaging with sodium pertechnetate 99mTcO4 showed absence of all major salivary glands. Lower lip biopsy disclosed normal structure of the salivary gland. No evidence of abnormal inheritance patterns could be demonstrated.

lno C, Matsuyama K, Ino M , Yamashita T, Kumazawa T. Approach to the diagnosis ofsiuladenosis using sialography. Acta Otolaryngol (Stockh) 1993; Suppl 500: 121 -125.Since parotid swelling is the most informative symptom of sialadenosis, we examined parotid swelling with sialography as a means of diagnosing sialadenosis. An X-ray was taken from a fixed position relative to the body, using a focus film distance (FFD) of 70 cm. To determine an "index" of parotid swelling, the distance between the submandibular bone ridge and the end of the main duct was measured on X-ray. After examination of 30 normal parotids, abnormal swelling was defined as an "index" exceeding I .9 cm. Sixteen of 24 patients suspected of having sialadenosis showed swelling exceeding I .9 cm. Six of 7 patients who were histologically diagnosed with sialadenosis showed swelling in excess of 1.9 cm. Our method is reproducible and recurrence of parotid swelling correlating with sialadenosis can be objectively demonstrated. Furthermore. serum amylase levels in patients who were diagnosed with sialadenosis were measured before and after sialography. After sialography serum amylase levels increased remarkably higher than those of normal subjects. Thus if a patient with underlying diseases has an "index" over 1.9 cm and his serum amylase level after sialography increases reniarkably, a diagnosis of sialadenosis is likely. Key nvrds: amylase, parotid.Acta Otolaryngol Downloaded from informahealthcare.com by Nyu Medical Center on 05/14/15For personal use only.

Objective/Hypothesis This study was undertaken to detect the faculty of secretion of saliva from minor salivary glands by analyzing a color reaction on a test tape containing iodine and starch that was applied on the lower lip. Study Design A study involving 63 patients with oral dryness, 7 patients with Sjögren syndrome, and 70 healthy individuals was performed. Methods A test tape (1 × 1 cm) containing iodine and starch was set on the mucosal area anterior to the labia frenulum for 30 seconds. Because the number of blue spots was considered to correspond to the number of ostia of the salivary gland on the lower lip that was examined, the number of blue spots occurring as a reaction of iodine and starch on the test tape was counted and was compared among three groups. In addition, the relationship between the histopathological findings and the number of spots was analyzed. Results The average number of spots in the patients with oral dryness (4.52 ± 3.18 [mean ± SD]) was lower than that in healthy individuals (9.49 ± 2.52, P <.01), and that in the patients with Sjögren syndrome (2.14 ± 1.35) was the lowest among all groups in the study. Moreover, this reduction in the number of spots in those patients was accompanied by histopathological changes of the minor salivary glands. Conclusion These findings suggest that this simple, noninvasive method can be successfully used for the estimation of the faculty of secretion of saliva from the minor salivary glands.

\s=b\In 56 patients with Bell's palsy, a submandibular gland function test employing a dynamic technetium Tc 99m scan was performed, to study the relationship between the test results and the prognosis of paralysis. Patients who had no difference in function on the affected facial side compared with the healthy side during the test (performed within ten days after symptomatic onset) had a high rate of early improvement. Patients who showed no response to the salivary secretory stimulant administered had an incomplete recovery and were all considered for surgery. Prognosis within ten days after onset was possible in as many as 37 of the 56 cases. (Arch Otolaryngol 1985;111:244-248) It is important to ascertain the prog¬ nosis of facial paralysis in the early symptomatic period in order to plan treatment. A number of tests (nerve excitability test [NET], evoked electromyography [EMG], stapedial reflex [SR] test, electrogustometry [EGM], lacrimation test, salivary flow test, and others) have been used to this end, and the salivary flow test is (Dr Yamashita).regarded as affording the earliest prognosis.13 This test, however, has certain disadvantages: (1) difficulty in using with children; (2) inconsistency of data due to the testing expertise required; and (3) difficulty in perform¬ ing frequently. On the other hand, sali¬ vary flow has been measured by a radioisotope test using technetium Tc 99m (95mTc) with good results. This test has already been used by Bernard and Duraffour4 and Rosen et al5 to measure the rate of radioisotope accumulation in the salivary glands of patients with facial paralysis, but the number of cases is limited and results are still preliminary.We employed a flow dynamic meth¬ od using a radioisotope, to measure salivary flow rate more objectively and precisely and to determine the submandibular salivary flow rate in patients with facial paralysis. This method permitted an early prognosis of the facial paralysis. SUBJECTS AND METHODSWe examined 56 patients with clinically diagnosed unilateral Bell's palsy, within ten days after symptomatic onset. A sec¬ ond test was performed three weeks later. Ten normal subjects were used as controls. Sodium pertechnetate Tc 99m (4 mCi) was injected into the cubital vein, and, immedi¬ ately thereafter, a colimeter with an energy level of 140 keV was used to obtain roentgenograms of the subject at the axial position. Roentgenograms were taken at 30-s intervals for 30 minutes. To promote salivary secretion, ascorbic acid was administered 15 to 20 minutes after the intravenous (IV) administration of sodium pertechnetate Tc 99m, when accumulation was at a maximum level. By measuring the value before and after injection, we obtained the stimulatory secretion ratio (SSR). The SSR ratio (SSR affected side-SSR healthy side) of patients with Bell's palsy was obtained and expressed as a percentage. RESULTS Control GroupA time-activity curve of the radio¬ isotope in the salivary gland of a control is shown in Fig 1. Immediately after injection of sodium pertechne...