Acute Sialadenitis in Childhood: CT Findings and Clinical Manifestation according to the Gland Involvements

Transcription

1 Acute Sialadenitis in Childhood: CT Findings and Clinical Manifestation according to the Gland Involvements Poster No.: C-0669 Congress: ECR 2012 Type: Scientific Exhibit Authors: A. Lee; Bucheon/KR Keywords: Head and neck, Salivary glands, Pediatric, CT, Ultrasound, Sialography, Inflammation, Infection DOI: /ecr2012/C-0669 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. Page 1 of 12

2 Purpose To compare CT findings and clinical features in children and adolescents with acute sialadenitis according to the involved salivary glands <Introduction> Three major salivary glands Parotid gland : The largest salivary gland with triangular shape, Posterior to mandibular angle Submandibular gland : Round in shape at the level of hyoid bone Sublingual gland: oval shape, small size Sialadenitis: acute infection in salivary gland - Parotitis The most common sialadenitis Mainly affects children Usually not related to sialolithiasis - Submandibular sialadenitis Less common in children Abundant salivary flow with rich mucous component Rapid excretion - Sublingual sialadenitis: rare Methods and Materials Subjects From to children-adolescents with acute sialadenitis Age: 2 ~ 18 years old (mean: 12) M: F = 34 : 16 Page 2 of 12

3 CT Obtained both pre- and post-contrast enhanced scans Equipments GE prospeed single, GE light speed ultra 8, GE light speed VCT 64 (GE Medical System) Standard algorithm Acquisition with thickness of 3.75 or 5 mm CT criteria for sialadenitis Unilateral or bilateral enlargement of the gland Homogeneous or heterogeneous enhancement Intraglandular abscess : Exclude extraglandular abscess in submandibular space Peri-glandular inflitration Additional points for submandibular gland : Irregular in shape at the level of hyoid bone Lobulating margin Divided into three groups according to the involved glands I Parotid gland, n=16 II Submandibular gland, n=20 III Both glands involvements, n=14 Images for this section: Page 3 of 12

4 Table 1: Methods and Materials Page 4 of 12

5 Results Statistical significance between involved glands On CT findings Abscess : I Sialolith : II Cellulitis : III On Clinical features Swelling : II & III Palpable mass : I Younger age : I Longer treatment period : I I Parotid gland, II Submandibular gland, III Both glands involvement Limitations Retrospective study Small number of subjects Selection bias - Not all patients of acute sialadenitis were included Included only patients who were performed CT scan - Not randomized controlled study No consideration of microbiology - Not confirmed bacterial or viral infection Images for this section: Page 5 of 12

6 Table 2: Result: CT findings according to glandular involvements Page 6 of 12

7 Table 3: Result: Clinical features according to glandular involvements Table 4: Result: Statistically significant differences between glandular involvements Page 7 of 12

8 Fig. 1: Case 1: Right parotid abscess in a 3 year-old girl Page 8 of 12

9 Fig. 2: Case 2: Bilateral parotid sialadenitis in a 3 year-old boy Page 9 of 12

10 Fig. 3: Case 3: Sialadenitis in right parotid & bilateral SMG in a 9 year-old boy Page 10 of 12

11 Conclusion In acute sialadenitis, age, abscess, sialolith, cellulitis, swelling, palpable mass, and treatment period were different according to involved salivary glands. Therefore, these difference of disease manifestations could be help making proper management and reducing complication. References 1. Even-Tov E, Niv A, Kraus M, Nash M. Candida parotitis with abscess formation. Acta Otolaryngol 2006;126: Ueta E, Tanida T, Doi S, Osaki T. Regulation of Candida albicans growth and adhesion by saliva. J Lab Clin Med 2000;136: Krippaehne WW, Hunt TK, Dunphy JE. Acute suppurative parotitis: a study of 161 cases. Ann Surg 1962;156: Brook I. Aerobic and anaerobic microbiology of suppurative sialadenitis. J Med Microbiol 2002; 51: Bova R, Walker P. Neonatal submandibular sialadenitis progressing to submandibular gland abscess. Int J Pediatr Otorhinolaryngol 2000;53: Som PM, Curtin HD. Head and Neck Imaging. 4th Ed. St Louis: Mosby, 2003; Bryan RN, Miller RH, Ferreyro RI, Sessions RB. Computed Tomography of the Major Salivary Glands. AJR 1982;139: Mandel L, Bijoor R. Imaging (Computed Tomography, Magnetic Resonance Imaging, Ultrasound, Sialography) in a Case of Recurrent Parotitis in Children. J Oral Maxillofac Surg 2006;64: Williams MF, Sialolithiasis, Otolaryngol. Clin. North Am. 1999;32: Huisman TAGM, Holzmann D, Nadal D: MRI of chronic recurrent parotitis in childhood. J Comput Assist Tomogr 2001;25:269 Page 11 of 12

12 Personal Information Aleum Lee MD. Department of Radiology, Soonchunhyang Bucheon University Hospital, Korea Page 12 of 12