ROLE OF CT SIALOGRAM IN THE DIAGNOSIS OF PAROTID REGION SWELLINGS

Rafik Khalil, Mohamed; Moussa, Mohamed; Sakr, Mahmoud; Hamza, Yasser; A. El-Hammady, Habashi; A. Farahat, Ali

doi:10.21608/ejsur.2002.375151

ROLE OF CT SIALOGRAM IN THE DIAGNOSIS OF PAROTID REGION SWELLINGS

Document Type : Original Article

Authors

¹ Departments of Surgery, Faculty of Medicine,University of Alexandria, Egypt

² Departments of Surgery, Faculty of Medicine, University of Alexandria, Egypt

³ Radiology, Faculty of Medicine, University of Alexandria, Egypt

10.21608/ejsur.2002.375151

Abstract

Background: Parotid diseases are treated either by surgery or by conservative measures. Parotid surgery however
carries the risk of facial nerve injury, which results in permanent functional and esthetic deficit. Therefore, every effort should be made to avoid unnecessary parotid operations.
Objectives: The present study was conducted to evaluate the use of CT and CT sialography for patients with lesions in the parotid region.
Patients and Methods: Patients (N=30) were subjected to thorough clinical assessment, ultrasonographic examination,
computerized tomography (CT) of the parotid region, parotid CT sialography, and fine needle aspiration cytology (FNAC).
Excised specimens were then sent for histopathological examination.
Results: There were 17 males and 13 females. Their ages ranged from 3 to 60 years (mean 35.95± 14.13). Ten patients had regional lymphadenopathy, with associated facial nerve affection in two. CT diagnosed the nine lesions of extra-parotid origin and the nine patients with chronic sialectasis. It could identify the mass lesion in the remaining patients. It also suspected the malignant nature of the lesion in two patients (sensitivity 100%). CT sialogram was tried in all patients, but was successfully performed in only 20. It demonstrated normal, yet compressed duct system in the nine patients with benign tumours. It also showed displacement and distortion of the duct system in the one case of adenocarcinoma (sensitivity 57.14%, specificity 100%).
Conclusions: Computerized tomography is a valuable and effective technique in confirming or excluding parotid gland mass lesions, as well as extra-parotid masses. It can suspect the malignant nature of the mass. CT sialography was found to be difficult technique to apply. In this study, it did not offer additional benefit over CT in the diagnosis of parotid masses.

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