What is a sialogram and when is it needed?

A sialogram is a simple test that does not cause major discomfort. Anyway, it is contraindicated for pregnant or nursing women and for young children.

Last update: 02 August, 2021

A sialogram is a diagnostic test that is ordered to determine the state of the salivary glands and ducts. This test is also known as "glandular radiography," "sialography," or "ptylography."

The salivary glands are of three types and are arranged in pairs. The parotids are the largest and are on each cheek. The submandibulars are on both sides, below the jaw. The sublinguals, under the tongue.

Such glands work like sponges that secrete saliva when they receive a certain stimulus. They pour the saliva into the mouth through ducts, which are like small pipes. If there is any abnormality in this process, the usual thing is to go to a sialogram.

When should a sialogram be performed?

If there are abnormalities in the saliva, it is advisable to perform a sialogram.

The doctor orders a sialogram when he suspects there are abnormalities in a salivary gland or one of its ducts. This test allows detecting possible anatomical alterations in these areas. In this way, a more accurate diagnosis can be established.

In the first instance, what the doctor does is evaluate the symptoms. When there is a blockage in the ducts or salivary glands, manifestations such as the following usually appear:

  • Unpleasant or abnormal taste in the mouth constantly.
  • Inability to open your mouth fully.
  • Pain or discomfort when opening the mouth.
  • Pain in the mouth
  • Swelling in the upper part of the jaw, in front of the ears.
  • Swelling of the face or neck.
  • Pain in the face

These symptoms raise the suspicion of a possible abnormality, but this is only corroborated by a sialogram. This helps detect problems such as the following:

  • Blockage in the salivary glands or ducts.
  • Inflammation of the salivary glands.
  • Disorders in saliva production.
  • Duct shape abnormalities.

How is a sialogram performed?

A sialogram should be performed in a radiology center or in the radiology room of a hospital. The person in charge of doing this is an X-ray technician. The test is not painful, but it can be uncomfortable, since the mouth must be open for several minutes.

Previous preparation

A sialogram does not require prior preparation other than proper oral hygiene. It is advisable to brush your teeth well and use an antiseptic mouthwash. In most cases it does not demand the use of anesthetic, unless the patient requests it.



Anyway, It is important that before undergoing a sialogram the doctor is informed about the medications that are being ingested. Those who are allergic to iodine or some medications, should also report it.

If a woman is pregnant, or thinks she is, she should say so before the test is done. It is common for the patient to sign an authorization for a sialogram to be performed.

Process

This study is performed on an outpatient basis, usually without anesthesia.

As usual, a sialogram is an outpatient procedure that takes about 30 minutes. Sometimes it takes longer if there is difficulty locating the opening of the duct. If the patient is very nervous, a sedative may be given.

Once this is done, the following steps are completed:

  • The patient should lie on his back on an x-ray table and then open his mouth.
  • An X-ray will be taken. This allows you to check if there is anything that could interfere with the contrast substance.
  • A catheter is placed in the opening of the salivary duct. This is a small, flexible tube. The patient may be asked to hold it by hand.
  • Contrast material is injected through the duct. You may feel some discomfort and some pressure.
  • X-ray plates are taken. There may be a need to turn your head to take pictures from different angles. Sometimes it is necessary to hold your breath to keep your head still.

In some cases lemon juice is given to the patient to stimulate saliva production. After the test, there may be an unpleasant taste in your mouth from the contrast substance.

Risks and considerations

A sialogram exposes the patient to a minimal amount of radiation. This risk is considered reasonable, since the benefit is much higher. Pregnant or breastfeeding women are more vulnerable to such radiation.

Some people may have an allergic reaction to the contrast substance.. In rare cases, the test causes damage to the salivary duct. This causes pain and inflammation. There is a risk of infection, although it is very rare.

It is necessary to contact the doctor if symptoms such as the following appear after a sialogram:

  • Pain that persists for more than 24 hours.
  • Swelling or bleeding in the salivary duct.
  • Fever and chills

Meaning of the results

Interpretation of a sialogram is the responsibility of the radiologist, who will send a report to the treating physician. If the results are abnormal, one of the following abnormalities may be present:

  • Inflammation or infection of the salivary gland.
  • Narrowing of the salivary ducts.
  • Presence of stones in the salivary ducts.
  • Tumor in the salivary gland.

When there is a blockage or tumor, additional studies may be required. In general, tests such as MRI, ultrasound, tomography, sialoendoscopy, or biopsy are attended.

The sialogram, an effective diagnostic test

Pain in the mouth or discomfort with saliva may seem like minor problems, but the truth is that they should never be overlooked. Sometimes simple inflammation in the salivary ducts can be a sign of cancer.

In most cases, problems with the salivary glands or ducts can be resolved with simple treatments. If the doctor orders a sialogram, it is important to do it, since it is a tool that provides very valuable data for the diagnosis.

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