Sialectasis

Dr Henry Knipe et al.

Sialectasis (siadochiectasis) is the cystic 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. 

Isolated, diffuse swelling of the affected salivary gland. 

Aetiology

Any condition that causes chronic inflammation:

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 pattern 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 lemon mouth swab. Duct dilatation, abrupt transition of its caliber as well as signal voids representing stones could be identified.

Often fails conservative treatment and surgical management such as duct dilatation or incision is required. 

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Article Information

rID: 32253
System: Head & Neck
Section: Pathology
Synonyms or Alternate Spellings:
  • Sialiectasis
  • Siadochiectasis
  • Dilated salivary gland ducts

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Cases and Figures

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    Case 1: calculus with proximal duct dilatation
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    Case 2: partotid duct stone
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