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Endoscopic Procedures I: Esophagogastroduodenoscopy01:29

Endoscopic Procedures I: Esophagogastroduodenoscopy

An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
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Retroductal Nanoparticle Injection to the Murine Submandibular Gland
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Stensen's Duct Dynamic Anatomy Assessed with Sialography.

Piper A Wenzel1, Ryan K Thorpe1, Joan E Maley2

  • 1Department of Otolaryngology - Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.

Ear, Nose, & Throat Journal
|August 28, 2024
PubMed
Summary

Dynamic infusion digital sialography reveals the full extent of Stensen's duct, overcoming limitations of static imaging. This novel technique assesses dynamic changes in duct length and angulation during catheter removal.

Keywords:
Stensen’s ductparotidsalivary glandssialendoscopysialography

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Area of Science:

  • Radiology
  • Medical Imaging
  • Anatomy

Background:

  • Static imaging methods for sialography obscure distal ductal anatomy.
  • Dynamic changes in the flexible salivary ductal system are not well-assessed by current techniques like cone beam computed tomography and magnetic resonance sialography.

Purpose of the Study:

  • To introduce and evaluate a novel approach using dynamic infusion digital sialography to analyze the complete Stensen's duct.
  • To identify dynamic changes in the parotid gland's Stensen's duct anatomy.

Main Methods:

  • Retrospective review of 409 parotid sialograms, selecting 14 cases (7 normal, 7 with strictures).
  • Dynamic (fluoroscopic) infusion sialography with contrast (iopamidol/gadolinium) was performed.
  • Measurements of duct length and masseteric bend angle were taken in repose, during catheter withdrawal (stretch), and after withdrawal (recoil).

Main Results:

  • Stensen's duct length increased by a median of 6.3% during catheter withdrawal (P < .001).
  • The angle of the masseteric bend significantly increased from 117.7° in repose to 155.4° during catheter withdrawal (P < .001).
  • This dynamic technique allowed unobstructed visualization of the distal duct.

Conclusions:

  • Dynamic infusion digital sialography with fluoroscopic recording during catheter removal enables unobstructed assessment of the distal duct.
  • The technique effectively captures the dynamic nature, varying length, and angulation of Stensen's duct.
  • This method offers a comprehensive analysis of parotid gland ductal anatomy.