Draft Parotid Gland-Pathology

General Comments for this page:

This page is a 4th menu tier: Small Parts--->Salivary Glands---->Parotid Gland---->Normal

IMPORTANTLY: Please see http://www.ultrasoundpaedia.com/USP%20salivary glands%20winner.html for approximate layout of the content.

Please put images in order from the ADD IMAGES FOLDER

MOUSEOVERS:

[parotitis]-------------> [parotitis hl]

U/S OF THE PAROTID GLAND PROTOCOL


ROLE OF ULTRASOUND

Intraglandular and extraglandular lesions to be localised and differentiated.
To identify the cause of:

  • A lump in the gland/neck. The patient can sometimes palpate a stone under the mandible.The stone can block the duct causing infection and swelling.
  • Pain
  • Mumps
  • Illness, including mouth or dental infections
  • Mouth dryness
  • Abnormality on previous xrays,CT or sialogram
  • Guidance of injection, aspiration or biopsy



PATIENT PREPARATION

  • Low collared shirt
  • May have to remove jewellery
  • Towel across the chest/shoulders
  • Lie the patient so their head is at the top of pillow and tipped right back.
  • A pillow or towel can be placed under the shoulders.



EQUIPMENT SELECTION AND TECHNIQUE

Use of a high resolution 7-14mHz linear transducer. You may need to use a lower frequency or curved linear probe (5-7MHz)to visualise the deep portion of the submandibular or parotid glands.
Good colour / power / Doppler capabilities when assessing vessels or vascularity of a structure.
Be prepared to change frequency output of probe (or probes) to adequately assess both superficial and deeper structures.

SCANNING TECHNIQUE

  • Tip the patient's head back for better access.
  • Assess the gland's echogenicity. It should be hypoechoic with a homogeneous echotexture compared to the surrounding tissue, similar to a muscle's echogenicity.
  • Due to it's fat content, the parotid will be more attenuative than the submandibular gland.
  • Compare both sides
    • Scan the entirety of the gland from midline to lateral several times to assess :
    • The size
    • For increased vascularity
    • Any abnormality in the surrounding anatomy including the lymph nodes.
    • Duct dilatation (use Colour Doppler so you do not mistake a vessel to be a dilated duct)
  • The duct runs from the deep gland into the lingual frenulum.
  • The Duct starts from the level of the ear-lobe and courses across the cheek via the accessory parotid gland (the duct generally will not be visible unless dilated).
  • The Kuttner lymph node is between the parotid and submandibular gland.

 BASIC HARD COPY IMAGING


A salivary gland series should include the following minimum images:

  • Submandibular gland, Long & trans
  • Submandibular duct
  • Parotid gland, long & trans
  • Accessory parotid gland
  • Right side of the neck and lymph nodes
  • Left side of the neck and lymph nodes
  • Document the normal anatomy. Any pathology found in 2 planes, including measurements and any vascularity
 
 

Download USP on the app store

Login|View Cart|Email|Print
 
 HOME       ABOUT US       JOIN NOW       MEMBERS      WORKSHEETS      CALENDAR      FAQS      TESTIMONIALS      LINKS      CONTACT US

Download USP on the app store

Search
 
       
     

© Copyright 2014 Ultrasoundpaedia

Preloaded imagePreloaded imagePreloaded imagePreloaded imagePreloaded imagePreloaded imagePreloaded imagePreloaded imagePreloaded image