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Salivary gland imaging; with serial images

CPT4 code

Name of the Procedure

Salivary Gland Imaging; Serial Imaging
Common names: Sialography, Salivary Duct Imaging

Summary

Salivary gland imaging is a diagnostic procedure that involves taking a series of images to evaluate the salivary glands and ducts. This helps identify blockages, infections, tumors, or other issues affecting saliva production.

Purpose

Salivary gland imaging is used to diagnose problems related to the salivary glands such as blockages, infections, or growths. The main goal is to provide a clear view of the salivary ducts and glands to facilitate accurate diagnosis and appropriate treatment.

Indications

  • Persistent dry mouth or xerostomia
  • Swelling or pain in the salivary glands
  • Recurrent infections of the salivary glands
  • Suspected salivary gland stones (sialolithiasis)
  • Tumors or growths in the salivary glands
  • Abnormalities detected in other imaging studies

Preparation

  • Fasting is typically not required.
  • Patient may be advised to avoid eating or drinking a few hours before the procedure.
  • The patient should inform their healthcare provider of any allergies, especially to contrast dye, as it is often used in the procedure.
  • Prior blood tests may be required to check kidney function.

Procedure Description

  1. The patient is positioned comfortably, usually lying down.
  2. A local anesthetic may be applied to the inside of the mouth or salivary duct opening to minimize discomfort.
  3. A thin catheter is inserted into the salivary duct.
  4. A contrast dye is injected through the catheter to highlight the salivary ducts on the images.
  5. A series of X-rays or other imaging scans (like MRI or CT) are taken at various intervals to capture detailed images.
  6. The catheter is removed and the area is cleaned.

Equipment used: X-ray machine, catheter, contrast dye, possibly MRI or CT scanner.
Anesthesia: Local anesthetic may be used.

Duration

The procedure typically takes about 30 minutes to an hour.

Setting

Performed in a hospital radiology department, outpatient imaging center, or specialized clinic.

Personnel

  • Radiologist
  • Radiologic technologist
  • Nurse (for assistance and patient care)

Risks and Complications

  • Mild discomfort or pain during the procedure
  • Allergic reaction to contrast dye
  • Infection at the catheter insertion site
  • Rarely, damage to the salivary ducts

Benefits

  • Accurate diagnosis of salivary gland disorders
  • Guidance for appropriate treatment plans
  • Potential for early detection of serious conditions

Recovery

  • The patient can usually go home shortly after the procedure.
  • Mild soreness or swelling at the insertion site may occur.
  • Patients are advised to drink plenty of fluids to help flush out the contrast dye.
  • No major activity restrictions typically required.
  • Follow-up with the healthcare provider may be needed to discuss results.

Alternatives

  • Ultrasound imaging, which does not involve radiation or contrast dye.
  • MRI or CT scan without contrast, though these may provide less detailed images.
  • Fine needle aspiration biopsy for suspected tumors.
  • Sialendoscopy, a minimally invasive procedure to directly visualize the salivary ducts.

Patient Experience

Patients might feel mild discomfort or a sense of pressure during the catheter insertion and dye injection. Post-procedure, some might experience slight soreness in the mouth. Pain management typically involves over-the-counter pain relievers if needed, and most patients can resume normal activities within a few hours.

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