Sialografiaan

Sialografiaan, in Dutch, refers to sialography, a radiologic examination of the salivary ductal system. The procedure visualizes the ducts of the major salivary glands, mainly the parotid and submandibular glands, by injecting a radiopaque contrast medium through the duct orifice and taking X‑ray images. It is used to assess ductal anatomy and identify abnormalities such as obstructions, sialolithiasis (salivary stones), ductal strictures, leaks, inflammatory changes, and certain tumors affecting the ductal system.

Technique and procedure: After sterile preparation, a small cannula is inserted into the appropriate duct (Stensen’s duct for the parotid, Wharton’s duct for the submandibular gland). A water‑soluble iodinated contrast is slowly injected under fluoroscopic guidance to fill the ducts and, if possible, the glandular tissue. Multiple views are obtained to evaluate the ductal tree and parenchyma. The examination can be uncomfortable and carries a small risk of infection, swelling, or an allergic reaction to contrast.

Indications and contraindications: Indicated when salivary duct obstruction is suspected, for stone detection, evaluation of chronic sialadenitis, autoimmune salivary gland disease, or prior to duct‑related surgery. Contraindications include acute infection of the gland, known allergy to iodinated contrast, inability to cannulate the duct, and, depending on clinical context, certain pregnancy considerations.

Interpretation and context: Findings may reveal ductal narrowing, sialectasis, ductal irregularities, calculi within the duct, or parenchymal changes. Limitations include invasive aspects, imperfect visualization of all ducts, and potential complications. Modern imaging increasingly uses MR sialography or ultrasound, but conventional sialography remains a diagnostic option in selected cases.