Cbct sialography
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Transcript of Cbct sialography
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PA119
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IMPORTANCE OF CBCT SIALOGRAMS : CASE REPORT ON CONE BEAM COMPUTED SIALOGRAPHY OF RADIOLUCENT SIALOLITHS
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Case report: relevant findings• 60 yr old female c/o chronic pain in left parotid region
since 2 years.
• No relevant medical history
• Dental history reveals multiple extractions a year back in 2nd quadrant in the pursuit of pain relief.
• Previously diagnosed with chronic bacterial sialadenitis
and was being treated for the same , the past one year.
• Scout film OPG as well ultrasound imaging was non contributory
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INVESTIGATIONS
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CBCT scan of early emptying
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Sialolith seen in the deep lobe
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Sialolith identified in the superior lobe distal to isthmus
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TREATMENT• by sialoendoscopy two sialoliths were
retrieved.
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Discussion•newer novel technique for imaging major
salivary glands
•overcomes shortcomings of other imaging modalities scout films, Ultrasound, CT , MRI
• when compared to 2D plain film sialography result was overwhelming.
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Sialoliths•most common obstructive condition
•male predilection, 3rd – 6 th decade of life
•submandibular gland>parotid gland>sublingual
•radiopaque and radiolucent calculi
•pain and swelling / asymptomatic
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Sialography• Radiographic examination of the salivary glands and ducts
after the introduction of a radiopaque dye into the ducts.
• PROCEDURE: Cannulation of Duct– Localize– Dilate– Cannulate– Secure– Injection – Imaging
• Phases : ductal phase , acinar phase, post evacuation phase
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CBCT•latest imaging modality
•high resolution , low radiation dose , fast scanning time , geometrically accurate image
•3D reconstruction , visualization in any direction, in any slice thickness and from which cross sectional slices can be obtained in any direction.
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REVIEW OF LITERATURE• Rarely been reported
• Drage and Brown were pioneers in reporting cases of CBCT sialography to identify sialolith (2009)
• in 2010 and 2013 Jadu et al studied effective radiation doses between cbct and plain radiography for sialography and also diagnostic capabilities between the two sialographic imaging modalities
• Nagla’a Abdel-Wahed in 2013 has also done an assessment of the role of cone beam computed sialography in diagnosing salivary gland lesions
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Significance• Importance in diagnosis & identification of the
problem
• Rare approach to a regular case
• Modification in treatment planning.
• Assists in sialoendoscopic removal of etiology
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CONCLUSION In obstructive salivary gland diseases, CBCT
sialograms can guide precision sialoendoscopic
retrieval thereby providing amazing results
leading to saving patients from more morbid
treatment plans.
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REFERENCES1. Drage NA, Brown JE. Cone beam computed sialography of sialoliths. Dentomaxillofac Radiol 2009; 38 : 301-5.
2. Jadu FM, Yaffe MJ, Lam EW. A comparative study of the effective radiation doses from cone beam computed tomography and plain radiography for sialography. Dentomaxillofac Radiol 2010;39:257-263.
3. B Li, X Long,Y Cheng , S Wang. Cone Beam CT sialography of Stafne Bone Cavity. Dentomaxillofacial Radiology 2011: 40: 519-523,2011
4. Jadu FM, Lamm EWN. A comparative study of the diagnostic capabilities of 2D plain radiograph and 3D cone beam CT sialography . Dentomaxillofacial Radiol 2013:42:20110319
5. Nagla’a Abdel-Wahed, Maha E. Amer, Noha Saleh Mahmoud Abo-Taleb. Assessment of the role of cone beam computed sialography in diagnosing salivary gland lesions.Imaging Science in Dentistry 2013; 43 : 17-23•