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. 2004 Sep;21(3):143-8.
doi: 10.1055/s-2004-860872.

Salivary duct intervention

Tim Buckenham  1
Affiliations

Salivary duct intervention

Tim Buckenham. Semin Intervent Radiol. 2004 Sep.

Abstract

Interventional sialography can be used to remove stones or delayed strictures from the submandibular or parotid glands. For stone removal, short-tipped, wire retrievable baskets are predominately used. Stones in the intraglandular ducts are almost impossible to remove, while stones proximal to the anatomic genu of either the parotid or submandibular ducts are also difficult to remove. More distal stones are amenable to percutaneous extraction. Stones 20% greater than the diameter of the duct should probably not be removed percutaneously. An access sheath, in the parotid or submandibular duct, greatly aids retrieval. Additionally, strictures in the parotid or submandibular ducts can be dilated with small guidewire and balloon systems. Reasonably high technical success of between 80% and 92% is reported with balloon siloplasty.

Keywords: Salivary duct; percutaneous extraction; stones.

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Figures

Figure 1
Figure 1
Sialogram showing a normal submandibular duct (Wharton's duct). Note the relatively straight course after the duct curves around the mylohyoid muscle.
Figure 2
Figure 2
Normal sialogram of the parotid duct (Stenson's duct). No accessory duct is present.
Figure 3
Figure 3
Standard equipment required for the extraction of sialolith. Note the 4-French vascular access sheath and the 5-wire helical calculus extraction basket.
Figure 4
Figure 4
(A) Digital subtraction sialogram of a submandibular duct. There is a large proximal parenchymal filling defect representing a calculus. This calculus was difficult to retrieve due to its position at the glandular hilum. (B) The calculus extracted from submandibular gland. Note size, which often determines the feasibility of extraction.
Figure 5
Figure 5
Postdilatation sialogram of an extraparenchymal parotid duct stricture proximal to the origin of an accessory duct. This was a difficult dilatation due to displacement of the balloon catheter into the accessory duct. Note residual stenosis after dilatation, a common sialographic appearance.
See this image and copyright information in PMC

References

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