Sonopalpation: A Novel Application of Ultrasound for Detection of Submandibular Calculi

Patel, Nandish V.; Hashemi, Sean; Joshi, Arjun S.

doi:10.1177/0194599814545736

Cited by 24 publications

(13 citation statements)

References 14 publications

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“…Furthermore, the experience of the practitioner performing the examination contributes to the range of sensitivities seen in the literature, with experienced surgeon-performed ultrasounds showing the best diagnostic characteristics. 10,11,22-25…”

Section: Discussionmentioning

confidence: 99%

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In Vivo Accuracy of Ultrasound for Sizing Salivary Ductal Calculi

Badger

Patel

Romero

et al. 2020

Otolaryngol.--head neck surg.

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Objectives The present study was developed to evaluate the accuracy of in vivo ultrasound sizing for parotid and submandibular salivary gland calculi, as compared with ex vivo pathology sizing with a standard plastic ruler after extraction. Study Design Retrospective chart review. Setting Ultrasound is frequently used to size salivary calculi and make treatment decisions, but the accuracy of measurements from this modality has not been validated. Subjects and Methods We evaluated and reviewed the charts and ultrasound examinations of 167 patients who underwent procedures for the treatment of sialolithiasis involving the parotid and submandibular glands. US examinations were performed between 2009 and 2016 in a tertiary-level hospital setting by the senior author. Measurements were collected from ultrasound evaluation before sialolithotomy, and pathology measurements were taken after removal. Ultrasound measurements in millimeters were compared with the measurements collected with a ruler. The differences were calculated and compared. Results A total of 167 calculi measurements were compared. Good concurrent validity between pathology and ultrasound measurements was suggested by a Pearson correlation of 0.92 (95% CI, 0.887-0.937). On Bland-Altman plot, correlation of the difference between US and pathology measurements showed a mean difference of 0.095 mm (95% CI, –0.19 to 0.38 mm) with a limit of agreement ranging from –3.59 mm (95% CI, –3.84 to –3.34 mm) to +3.78 mm (95% CI, +3.53 to +4.03 mm). Conclusions Ultrasound is an accurate, relatively precise, and minimally invasive imaging tool for salivary gland sialolithiasis. Preoperative size of calculi can be used to guide management and clinical decision making. Level of Evidence 2C.

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Section: Discussionmentioning

confidence: 99%

“…This improves to 96.6% sensitivity and 90% specificity with the addition of sonopalpation performed by a head and neck surgeon. 11 Salivary ultrasound performed by an experienced otolaryngologist may obviate the need for further imaging studies. It is inexpensive, increasingly available, and convenient for patient and otolaryngologist.…”

mentioning

confidence: 99%

In Vivo Accuracy of Ultrasound for Sizing Salivary Ductal Calculi

Badger

Patel

Romero

et al. 2020

Otolaryngol.--head neck surg.

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“…The C5/6 disc space was observed on the cranial‐side gap of the C6/7 disc. To identify the causative disc, the surgeon slid the probe from the C6/7 to C2/3 discs in the cranial direction under US guidance to check for tender areas (sonopalpation) 5 (Figure 2).…”

Section: Methodsmentioning

confidence: 99%

“…However, if the lesion is extensive, it can be difficult to narrow down to the disc generating pain prior to discography using MRI alone. Therefore, we introduced the sonopalpation technique, which involves palpation under ultrasound (US) guidance to identify areas of tenderness and aid in visualizing potential lesions 5 …”

mentioning

confidence: 99%

Ultrasound‐Guided Cervical Intervertebral Disc Injection Without Fluoroscopy

Maeda

Masuda³

et al. 2022

J of Ultrasound Medicine

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Cervical disc degeneration commonly results in referred neck pain, which is traditionally diagnosed via fluoroscopy-guided provocative discography. Herein, we discuss three cases of neck and shoulder pain treated with cervical intradiscal injections administered under ultrasound (US) guidance. The most painful intervertebral disc was identified using the sonopalpation technique, which involved palpation while visualizing anatomical structures using US. Injectant spread within the intervertebral disc was validated using superb microvascular imaging rather than fluoroscopy. Symptoms significantly improved following blocks at the identified sites, suggesting that US can be used to guide cervical intradiscal injections even in the examination room.Key Words-cervical intervertebral disc; cervical intradiscal injection; disc degeneration; discogenic neck pain; neck pain N eck pain is a significant public health problem worldwide. 1,2 Cervical discogenic pain is among the most common causes of neck pain, 3 the diagnosis of which is usually confirmed by reproducing the concordant pain via provocative discography with contrast under fluoroscopic guidance. Advancements in magnetic resonance imaging (MRI) have enabled us to identify the causative degenerated disc segment quite precisely. 4 However, if the lesion is extensive, it can be difficult to narrow down to the disc generating pain prior to discography using MRI alone. Therefore, we introduced the sonopalpation technique, which involves palpation under ultrasound (US) guidance to identify areas of tenderness and aid in visualizing potential lesions. 5 US is increasingly being utilized during pain interventions owing to several advantages, such as portability, real-time guidance, and lack of radiation exposure. Moreover, US can provide a detailed depiction of soft tissue structures, making it especially beneficial for cervical spine injections given that multiple vulnerable nerves and vessels are compacted within this small region. Additionally, advancements in probe technology have made it possible to visualize the inside of the intervertebral disc, 6 allowing safe guidance of the needle into the nucleus pulposus with a clear view of the spinal cord. Superb microvascular imaging (SMI) 7,8 can also be used to confirm the spread of the injectant, which is traditionally confirmed with contrast under fluoroscopy, enabling clinicians to perform provocative discography in the examination room.

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“…If transcervical US is used for submandibular stones with distal location, the transducer should be positioned longitudinally and be rotated medially around the lateral body of the mandible to enable a straight and not a tangential view of the region of interest to avoid acoustic shadowing of the mandible. Besides this simple clinical inspection and simultaneous palpation, examination by transcervical US, referred to as "sono-palpation" [133] (Figure 4A), or application of transoral ultrasound [84][85][86] (Figure 4B) were described. If the diagnosis or differential diagnosis continues to be unclear, consecutive [132] or even simultaneous [103] application of sialendoscopy was valuable for establishing the correct diagnosis in difficult cases.…”

Section: Obstructive Sialadenitis Caused By Sialolithiasismentioning

confidence: 99%

Ultrasound in Inflammatory and Obstructive Salivary Gland Diseases: Own Experiences and a Review of the Literature

Koch

Sievert

Iro

et al. 2021

JCM

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Background: Ultrasound is established as a diagnostic tool in salivary glands for obstructive diseases such as sialolithiasis and tumors. Concerning inflammatory diseases and in non-sialolithiasis-caused obstruction, much fewer data are available. In recent years, technical development has allowed a better assessment of the gland parenchyma, and knowledge about intraductal pathologies has increased considerably, which has provided new insights and a new interpretation of ultrasound findings. Objectives: To provide a comprehensive review of the literature that includes our own experiences and to point out the state of the art in ultrasound in the diagnostics of inflammatory and obstructive salivary gland diseases, taking adequate techniques and recent technical developments into consideration. Data sources and study eligibility criteria: A systematic literature search was performed in Pubmed using various specific key words. Results: According to the literature results, including our own experiences, ultrasound is of value in up to >90% of cases presenting with inflammatory and/or obstructive diseases. Technical developments (e.g., elastography) and the application of modified ultrasound techniques (e.g., transoral ultrasound) have contributed to these results. Today, ultrasound is considered a first-line diagnostic tool in these diseases. However, in some inflammatory diseases, the final diagnosis can be made only after inclusion of the anamnesis, clinical symptoms, serologic blood tests, or histopathologic investigation. Conclusions: Ultrasound can be considered as a first-line diagnostic tool in obstructive and inflammatory salivary gland diseases. In obstructive diseases, it may be sufficient for diagnostics in >90% of cases. In inflammatory diseases, ultrasound is at least an excellent screening method and can be used to establish the diagnosis in cases of an early suspicion. In all diseases ultrasound can contribute to better management and can be used for monitoring during follow-up.

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Sonopalpation: A Novel Application of Ultrasound for Detection of Submandibular Calculi

Cited by 24 publications

References 14 publications

In Vivo Accuracy of Ultrasound for Sizing Salivary Ductal Calculi

In Vivo Accuracy of Ultrasound for Sizing Salivary Ductal Calculi

Ultrasound‐Guided Cervical Intervertebral Disc Injection Without Fluoroscopy

Ultrasound in Inflammatory and Obstructive Salivary Gland Diseases: Own Experiences and a Review of the Literature

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