Sialectasis (sialoangiectasis) is the dilatation of the ducts within salivary glands. It is most commonly seen in the parotid gland and is associated with ascending infections and gland destruction.
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Clinical presentation
Isolated, diffuse swelling of the affected salivary gland.
Pathology
Etiology
Any condition that causes chronic inflammation:
- idiopathic
- Sjogren syndrome
- post-infectious
- recurrent sialadenitis
- salivary duct strictures
- congenital (rare)
Radiographic features
Digital subtraction sialography
Injection of contrast medium through cannulation of the parotid/submandibular duct after stimulation by a sialogogue (e.g. citric acid). Sialectasis has different patterns of dilatation:
- punctate
- globular
- cavitary
- cylindrical
- fusiform
Stricture of the main duct can be seen as abrupt tapering of the duct. Preliminary film is acquired for any radiopaque stone.
Ultrasound
Enlarged gland with multiple hypoechoic branching ducts. Bilateral and symmetrical in systemic diseases e.g. Sjogren syndrome. A stone can be seen within the duct as small hyperechoic structure, and if large enough post acoustic shadowing can be seen.
MR sialography
Heavy T2 weighted turbo spin-echo MR sequence is required for visualization of the duct system before and after stimulation with a lemon mouth swab. Duct dilatation, abrupt transition of its caliber as well as signal voids representing stones could be identified.
Treatment and prognosis
Often fails conservative treatment and surgical management such as duct dilatation or incision is required.