Sialectasis

Sialectasis (sialoangiectasis) is the dilatation of the ducts within salivary glands. It is most commonly seen in the parotid gland and is associated with ascending infections and gland destruction.

Clinical presentation

Isolated, diffuse swelling of the affected salivary gland.

Pathology

Etiology

Any condition that causes chronic inflammation:

• idiopathic
• Sjogren syndrome
• post-infectious
• recurrent sialadenitis
• salivary duct strictures
• congenital (rare)

Radiographic features

Digital subtraction sialography

Injection of contrast medium through cannulation of the parotid/submandibular duct after stimulation by a sialogogue (e.g. citric acid). Sialectasis has different patterns of dilatation:

• punctate
• globular
• cavitary
• cylindrical
• fusiform

Stricture of the main duct can be seen as abrupt tapering of the duct. Preliminary film is acquired for any radiopaque stone.

Ultrasound

Enlarged gland with multiple hypoechoic branching ducts. Bilateral and symmetrical in systemic diseases e.g. Sjogren syndrome. A stone can be seen within the duct as small hyperechoic structure, and if large enough post acoustic shadowing can be seen.

MR sialography

Heavy T2 weighted turbo spin-echo MR sequence is required for visualization of the duct system before and after stimulation with a lemon mouth swab. Duct dilatation, abrupt transition of its caliber as well as signal voids representing stones could be identified.

Treatment and prognosis

Often fails conservative treatment and surgical management such as duct dilatation or incision is required.