Definition & Overview
A sialography, also called radiosialography, is a medical procedure used to examine the salivary glands. It is a diagnostic scan that uses radiography to detect abnormalities in the said glands.
The salivary glands are found on both sides of the face. They are responsible for releasing saliva into the mouth and keeping the oropharynx and oesophagus moist. They also assist in breaking down carbohydrates. By doing so, they play a key role in the digestive process.
Who Should Undergo and Expected Results
Sialography is helpful in diagnosing diseases affecting the salivary glands, which include the following:
- Parotid glands – These are the largest glands. They are located inside each cheek, just above the jaw, and in front of the ears.
- Submandibular glands – These are located below the jawbone on both sides of the jaw.
- Sublingual glands – These are located at the bottom of the mouth under the tongue.
Most problems with the salivary glands and ducts are caused by:
- Blockage or obstruction
- Salivary gland tumours
- Salivary duct stones
- Salivary duct infections
- Oral cancer
- Other types of mouth cancer
- Sarcoidosis, a condition characterised by the inflammation of various parts of the body
- Sjogren’s syndrome, an autoimmune disorder characterised by dry eyes and dry mouth
These conditions may cause symptoms such as:
- Foul taste in the mouth
- Inability to fully open the mouth
- Discomfort when opening the mouth
- Pain when opening the mouth
- Dry mouth
- Facial pain
- Swelling of the face
- Swelling of the neck
- Swelling over the jaw
A sialography scan is important in diagnosing problems with the salivary glands and ducts. It is an important test because the salivary glands and ducts also play a crucial role in the body. By releasing saliva, these glands make sure the mouth, oesophagus, and stomach are moist enough to digest food and break down nutrients. Thus, the results of a sialography scan have an effect on digestion.
A moist environment in the mouth also helps wash bacteria and food particles from the teeth. Thus, the salivary glands also help maintain good oral health.
Performing a sialography can help doctors make sure the patient’s salivary glands and ducts are in good condition. Doing so can help prevent potential problems that may affect digestion, such as indigestion and malnutrition.
The results of a sialography scan are interpreted by a radiologist who also summarises the results in a report before it is sent to the patient’s attending physician.
Normal results show that there are no blockages or tumours along the ducts and in the gland.
On the other hand, abnormal results may show stones, narrowed ducts, an inflamed gland, or a tumour. If the results are abnormal, other tests may have to be performed. These include:
- Ultrasound scan
- Magnetic resonance imaging (MRI) scan
- Computer tomography (CT) scan
How is the Procedure Performed?
A sialography scan is an x-ray procedure. It is simple and usually done under 30 minutes on an outpatient basis. The test typically takes place in the radiology department or an x-ray room of a hospital or clinic.
A sialography scan is performed through the following steps:
- Prior to the scan, the patient is first given an antibacterial mouthwash followed by a sedative. The sedative helps keep the patient calm during the entire test. If the patient is having difficulty keeping still, the doctor may provide a stronger sedative.
- During the actual test, the patient is asked to lie down on an x-ray table and to open his mouth wide. The procedure may cause minimal discomfort, but anaesthetics are not usually necessary.
- The doctor will place a catheter, or a small flexible tube, in the salivary duct’s opening.
- The doctor will inject the contrast dye material into the catheter.
- The doctor will then take an x-ray scan of the patient’s mouth. The scan can be performed from different angles.
- The contrast dye material will show up brightly on the scan results, allowing doctors to easily detect whether there are abnormalities or blockages along the ducts all the way to the gland.
- If necessary, the doctor will ask the patient to drink lemon juice to increase the volume of saliva in the mouth. Doing so allows the doctor to observe how saliva drains into the patient’s mouth.
- After the test, the contrast dye will be drained into the mouth. The doctor or the patient will massage the glands to make sure all the dye drains out. The dye material may taste bitter, but it is safe to swallow.
There is no need to recover from the procedure. Patients can resume their normal diet and activities right after the test.
Possible Risks and Complications
The risks of a sialography scan are very minimal. Like other x-ray scans, the test exposes patients to radiation. But this is very minimal and is within safe levels. However, there may be restrictions on the use of the test if the patient is:
- A child
- A pregnant woman
Other potential risks include:
- Allergic reaction to the contrast dye substance - Some patients may be allergic to contrast dye or iodine. If the test is really necessary, these patients are given anti-allergy medication either during or after the test.
- Punctured salivary duct
Patients should watch out for signs of a problem, such as:
- Prolonged soreness or pain
Moreover, in some cases, the patient’s salivary duct opening may be hard to locate. If this is the case, the test will take longer than usual.
Rose SS. “Sialography in diagnosis.” Postgrad Med J. 1950 Oct; 26(300): 521-531. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2530405/
Raj PR, Rawther NN, Nausheen E, Abraham MA, George GB. “Sialography – A case report.” IOSR Journal of Dental and Medical Sciences. 2016 Feb. 15(2): 67-70. http://www.iosrjournals.org/iosr-jdms/papers/Vol15-issue2/Version-8/M015286770.pdf