Simple and effective sialography with modification of contrast injection

In several cases, a person can have an abnormal mass in the outer mandible or under the tongue and is usually accompanied with the decrease of saliva. Early and accurate examination is needed to diagnose this case. In this case report, we present two cases of salivary glands defect. The aim of this article is to submit two cases to review the etiology, risk factors, clinical manifestation, and examination methods of sialadenitis using a modified contrast injector to the duct of salivary gland. CASE 1: A 17-year-old man came with a complaint of a lump under the right jaw. Sialography examination using a modified syringe with abbocath 24G showed an occlusion of the right and left Warton duct stoma. Right and left Bartholin's duct stoma occlusion post excision and marsupialization of the ranula. The complaint felt shrink after sialography. Three months follow-up, the patient said the lump was no longer felt and there were no complaints. CASE 2: A 19-year-old man came with a complaint of clear fluid coming out when eating on the surgical scar under the right side of the jaw. From the plain photo, it appears that there is a missing amputatum of the right mandibular symphysis, body, angle, ramus processus condylaris et coronoideus of the left mandible. Sialography examination using a modified syringe with abbocath 24G showed suggest a sialocutaneous fistula (cut of the right mandibular ramus region to Stensen's duct and submandibular). Then the patient underwent fistula excision. A month follow-up after the excision patient had no feeling of lump but sometimes 3-4 drops still came out.

Salivary tract injury is a quite rare case. Most frequent etiologies are iatrogenic. Sialography is a simple but effective method to identify obstruction of the salivary tract, including salivary tract injury. According to several studies, sialography identifies sialolithiasis with high sensitivity and specificity.

Sialography is a simple but effective method that is beneficial for the treatment and examination with high specificity and sensitivity to assess the possibility of obstruction of the salivary ducts.