Sialoendoscopy, sialography, and ultrasound: a comparison of diagnostic methods

Abstract

<jats:title>Abstract</jats:title><jats:sec id="j_med-2016-0081_s_020_w2aab3b8d359b1b7b1aab1c14b1Aa"><jats:title>Objective</jats:title><jats:p>To compare the accuracy of ultrasound, sialography, and sialendoscopy for examining benign salivary gland obstructions.</jats:p></jats:sec><jats:sec id="j_med-2016-0081_s_021_w2aab3b8d359b1b7b1aab1c14b2Aa"><jats:title>Methods</jats:title><jats:p>In this prospective study, patients with symptoms of obstruction of the major salivary gland duct system presenting at the ENT Clinic University Hospital, Ostrava, from June 2010 to December 2013 were included. All patients (n=76) underwent ultrasound, sialography, and sialoendoscopy. The signs of sialolithiasis, ductal stenosis, or normal findings were recorded after the examinations. Statistical analysis of the sensitivity and specificity of all the methods was performed, as well as a comparison of the accuracy of each method for different kinds of pathology (sialolithiasis or stenosis).</jats:p></jats:sec><jats:sec id="j_med-2016-0081_s_022_w2aab3b8d359b1b7b1aab1c14b3Aa"><jats:title>Results</jats:title><jats:p>The sensitivity of ultrasound, sialography, and sialoendoscopy for sialolithiasis findings were 71.9%, 86.7 %, and 100%, respectively. The sensitivity of sialography and sialoendoscopy for stenosis of the duct was 69.0%, and 100%, respectively. The study showed impossibility of ultrasonic diagnostics of ductal stenosis. The sensitivity of sialoendoscopy for both pathologies was significantly higher than that from ultrasound or sialography (p&lt;0.05). The specificity of sialoendoscopy was significantly higher than that from by ultrasound or sialography (p&lt;0.05).</jats:p></jats:sec><jats:sec id="j_med-2016-0081_s_023_w2aab3b8d359b1b7b1aab1c14b4Aa"><jats:title>Conclusion</jats:title><jats:p>Sialoendoscopy was the most accurate method for examination ductal pathology, with significantly higher sensitivity and specificity than by ultrasound or sialography.</jats:p></jats:sec>

3D Reconstruction and Prediction of Sialolith Surgery

“…The great majority (80–90 percent) of salivary calculus occur in the submandibular gland, whereas 5–20 percent in the parotid gland [1–7] and in the sublingual gland. As for the minor salivary glands, the occurrence of calculus is less common.…”

“…For Ligtenberg and Veerman, imaging findings of calcifications in large salivary glands and/or salivary ducts are usually related to salivary calculus or sialoliths [14]. Therefore, based on such findings, it is indispensable to perform clinical examination and anamnesis [1, 3, 5, 7, 8, 11, 14]. …”

“…There are several diagnostic imaging tools available which are aimed at improving investigation, namely, panoramic radiography, occlusal radiography, sialography, ultrasound, and computed tomography, especially cone beam computed tomography and magnetic resonance [1, 4, 7, 11, 14]. Although only 20 percent of the normal panoramic radiographs and occlusal radiographs are capable of evidencing sialoliths [14], they are valid examinations as they allow excluding mandibular bone pathologies resembling this condition.…”

“…Cone beam computed tomography allows a better evaluation of the glandular parenchyma and adjacent structures involved, thus being possible to obtain precise information for choosing the best treatment. Ultrasonographic examination, which is more used for cystic lesions (e.g., ranulas), can also be a valued tool for obtaining information on the size and shape of calcifications and their exact localisation [1, 7, 12–14]. …”

“…Several techniques are used for diagnosis of sialolithiasis, ranging from simple techniques such as palpation and inspection [2], including analysis of secreted saliva [2, 7], to complementary examinations such as radiography, sialography, computed tomography, and ultrasonography [1–7]. However, depending on the location of sialolith (e.g., mainly in the duct of the submandibular gland), occlusal radiograph can be used for its visualisation [3, 8] if it is located in the glandular parenchyma; otherwise, other imaging examinations allow a better visualisation.…”