OBSTRUCTIVE SIALOADENITIS ROLE OF INTERVENTIONAL SIALOGRAPHY

The Salivary stones and strictures are the most common cause of unilateral parotid or submandibular gland swelling. Traditionally, these patients treated by open surgery submandibular stones are still the most common cause of submandibular gland resection parotid gland resection is less frequent as it is major surgical procedure with postoperative complication like facial nerve paresis. The common cause of stone formation is obstruction, stricture formation leading to stasis of saliva, dehydration, change in salivary pH associated with oropharngeal sepsis. Over the last two decades, increasing awareness for minimally invasive treatment and with development of interventional radiological procedures for the management of obstructive sialadenitis has led to avoid surgical removal of gland and complications associated with surgery. The interventional sialographic procedures can be used to remove salivary duct stones and is treatment of first choice in salivary duct strictures. For stone removal and stricture dilatation local anesthesia, I/V cannulas of different sizes, balloon dilators and wire baskets are used under fluoroscopy. The wire guided sialographic technique (1) is used for sialography and the I/V cannula used for sialography is used as access for interventional sialography. The stones in the intraglandular ducts, large stones and distal stones near the hilum of the gland are difficult to remove and the small size mobile stones can be easily removed.