Clinical Utility of Contemporary Digital Infusion Submandibular Sialography

Contemporary sialography couples mechanical ductal dilation with hydrodilation and utilizes iodinated contrast with antimicrobial properties to generate diagnostic data. This procedure has been reported to have therapeutic value that has not been investigated in a large contemporary series. This study examines the therapeutic value of diagnostic digital infusion submandibular sialography.

Retrospective chart review of a consecutive series of submandibular sialograms from April 2008 to November 2024, focusing on symptomatic response to sialography.

Review identified 135 submandibular sialograms with follow-up addressing post-study symptom assessment available in 67. Indications for sialography in this group included pain (6/67), swelling (23/67), or both (38/67). Symptomatic improvement following sialography was reported in 67% of cases (45/67). Those reporting initial complete relief of symptoms rarely (15%) required additional treatment during the follow-up period (p = 0.019). The radiographic diagnosis of a distal stricture was associated with a higher rate of symptom improvement (78%) when compared to those without a distal stricture (57%) (p = 0.049). Among patients in this cohort, the median effective radiation dose (1.94 mSv) for the CT imaging preceding sialography (N = 39) was significantly greater than that calculated radiation dose (0.14 mSv) for one-gland sialography (N = 42) (p < 0.001).

Diagnostic submandibular sialography is often therapeutic and is performed with limited radiation exposure. Prospective study is ongoing to provide more detailed evaluation of the therapeutic impact of this procedure.

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