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7/25/2019 glandula salivarius dan penjelasannya
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SIALOGRAPHY &THE SALIVARY GLANDS
DISEASE
Drg. Rurie Ratna Shantiningsih,
MDSc
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Pretest
Serang !anita usia "# th $atang %e RSGM PrSe$' $engan %e(uhan )e'*eng%aan )a$a$aerah $i *a!ah (i$ah, $isertai $engan rasan+eri %eti%a 'a%an. Pe'*eng%aan terse*ut%a$ang hi(ang $engan sen$irin+a, na'un
sering ti*ati*a 'uncu( (agi. Ti$a% a$a ri!a+atgigi +ang rusa% 'au)un )en+a%it siste'i%.
-enis )e'eri%saan a)a saa +ang $a)at$i(a%u%an serang $%ter gigi untu%'enega%%an $iagnsa $ari %asus terse*ut/
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In0estigatins n Sa(i0ar+G(an$ $isease
The 'ain in0estigatins inc(u$e1 P(ain ra$igra)hic e2a'inatin
Sia(gra)h+ 3')ute$ t'gra)h+ 43T5 Ra$iist)e i'aging
6(! rate stu$ies 7(trasun$ Magnetic resnance i'aging 4MRI5.
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3 SALIVARY GLANDS :
PAROTID LARGEST LOCATED BY EAM
- MANDIBULAR RAMUS
SUBMANDIBULAR / SUBMAXILLARY
SMALLEST- 1stmolar to Gonon
SUBLINGUAL LOCATED BE!IND T!EMENTUM "n#$r t%$ s"&ln'"al (ol#
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DUCTS
Parti$ $uct (cate$ *+ 'a2i((ar+*ne8 9n$ u))er '(ar5 PAROTIDGLANDStensen:s $uct
Su*'an$i*u(ar Duct (cate$ n en$ su*(ingua( ri$ge t ;(( su*'an$i*u(ar< S7=MA>ILLARY ?hartn:s $uct
Su*(ingua( $uct 4se0era( s'a((5(cate$ a(ngsi$e su*'an$i*u(ar $uctt S7=LING7AL GLAND
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1) Parot# Glan#
*) S"&man#&"lar Glan#
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SIALOGRAPHY
A ra$igra)hic e2a'inatin the sa(i0ar+g(an$s an$ $ucts using cntrast 'e$ia
The )rce$ure is $i0i$e$ int three)hases.
@ The )re)erati0e )hase
@ The ;((ing )hase@ The e')t+ing )hase.
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s + re) ace n! +& 3T
Sae an$ si')(e *ut
$icu(t t )err' 8 har$t (cate$ an$catheteriBe $ucts
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EC7IPMENT NEEDS
RAD< 6L7ORO
ROOM
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PRO3ED7RE
Sia(gra' Tra+ 8 GauBe, Steri(e t!e(s, S)t Light,
Magni+ing g(asses, G(0es, E+e!ear,
'as% LEMONS cut int !e$ges Lacri'a( Pr*es He'stats # cc s+ringes Sia(gra' 3atheter 4Ra*in05 nee$(es r canu(as
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PATIENT PREP
4N s)eci;c )re) ra('uth!ash in nice5
Re'0e an+ 'eta( 8 *ri$ge!r%,tngue )iercing
Get Histr+ 8 )resent t
ra$i(gist =E6ORE setting u)tra+
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S"&man#&"lar
salo'ra+%,
Clnal o&s$r.aton o( #"t or($s
Dlataton o( #"t or(a$s
Cann"latonn o( t%$ #"ts
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S7=MANDI=7LAR GLAND
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PAROTID GLAND
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S7=MANDI=7LAR GLAND
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Inectin cntrast 'e$ia intsa(i0ar+ $ucts
OIL =ASED 3ONTRAST SINOGRAPHIN
?ATER =ASED 4IONI35
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INDI3ATIONS 6OR E>AM
Stnes 43a(cu(i5 sia((ithiasis
O*structin < StricturesPain & S!e((ing InectinMasses < Tu'rs
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3ONTRAINDI3ATIONS1
Histr+ cntrast 'e$ia
a((ergiesPartits 4'u')s5Se0ere inFa''atin thesa(i0ar+ $ucts
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3ntrast 'e$ia ?ater *ase$
i$inate$ 4inic rnninic5
Less $ense 8a*sr*e$ aster 8n resi$ue
3nra+, H+)aue,Is0ue,Rengra)hin4
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Contrast media used
@Ionic aqueous solutions., including:
K DiatriBate 47rgra;n5
K MetriBate 4Trisi(5
@ Non-ionic aqueous solutions, including:
K (he2( 4O'ni)aue5
@ Oil-based solutions, including:
K I$iBe$ i(, e.g. Li)i$( 4i$iBe$)))+ see$ i(5
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e(ainan g(an$u(asa(i0arius
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Tan$a $an gea(a
Pena')a%an %(inis secara u'u', *isatera$i sing(e atau 'u(ti)(e a.(1
Pe'*eng%aan uni(atera( atau)un*i(atera( )a$a area g(an$u(a )arti$atau su*'an$i*u(a +ang ter(i*at
Rasa sa%it )a$a $aerah +ang ter(i*at Peru*ahan a(iran sa(i0a
Si l li hi i ( l l d
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a. Sialolithiasis(calculus andsalivary stone)
Defnisi :
Sia((itiasis a$( )e'*entu%an su'*atanter%a(si;%asi )a$a $u%tus sa(i0ariusis
+ang 'en+e*a*%an )enurunan a(iransa(i0a 4*iasan+a han+a g(an$u(a +angter%ena5
Clinical symptoms:Pe'*eng%aan inter'iten,rasa sa%it
%eti%a 'a%an, $an sering na')a%
sete(ah a$a %eter(i*atan ine%si.
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Ra$igra)hic eature
G& A) M$n"n"00an a#an,a salolt% +# #"0t"s %arton
m$lal" t$%n0 o0l"sal
G& B) Nam+a0 'am&aran salolt% m$lal" t$%n0 +$ra+0al
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Ra$igra)hic eature
Tergantung $ari ting%atan %a(si;%asin+a,sia((ith $a)at na')a% ra$i)a% 'au)unra$i(usen 4se%itar 9 t %asus
na')a% ra$i(usen5.
Sia(gra)h+ $a)at 'e'*antu 'enentu%an
(%asi *stru%si +ang ti$a% ter$ete%si$engan )e'eri%saan ra$igra;,
teruta'a )a$a sia((ith +ang ra$i(usen.
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Radiografis Sialogram.
Lateral view of s!ma"di!lar gla"ds demo"strati"g a radiol#e"t
sialolit$ i" t$e mai" d#t
Bacterial Sialadenitis
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. BacterialSialadenitis(Parotitis and
submandibulitis)Defnisi1
A$( ine%si *a%teria( a%ut atau %rnis +ang tera$i)a$a terminalaciniatauparenchyma$ari g(an$u(asa(i0arius.
Clinical eatures1
Le*ih sering 'engenai g(an$u(a )artis na'ung(an$u(a su*'an$i*u(a uga %a$ang ter%ena.e*an+a%an %asus uni(atera( $an $a)at 'engenai
se'ua usia. Pena')a%an %(inis1 )e'*eng%aan,%e'erahan, tendernes, malaise, enlarged regionallymph nodes$an %a$ang9 na')a% a$an+a )ustu(a
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Ra$igra)hic eature
Sia(gra)h+ 'eru)a%an %ntrain$i%asiuntu% %ea$aan ine%si a%ut %arenae)ite( $u%tus 'ena$i ra)uh +ang
$a)at 'en+e*a*%an e%stra0asasi$ari contrastagent, sehingga tera$irea%si )en(a%an *en$a asing $an
'en+e*a*%an rasa sa%it +ang (e*ih)arah.
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Contrast-enhanced CT image. The left sumandiular
'lan# 2arro3s4 s lar'$r t%an t%$ r'%t 3t% no s"''$ston o( a&s$ss
(ormaton) T%s a++$aran$ s om+at&l$ 3t% #(("s$ +arotts an#
$ll"lts)
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c. Sialodochitis(Ductalsialadenitis)Defnition1
Meru)a%an inFa'asi +ang 'engenai ductalsystem$ari g(an$u(a sa(i0arius.
Clinical eatures1Di(atasi $ari ductalsystem'eru)a%an
ga'*aran +ang 'enn( )$ )e'eri%saan'engguna%an sia(gra)h+.
Mes%i)un u'u'n+a han+a 'engenaig(an$u(a su*'an$i*u(ar , na'un $a)at ugana')a% )a$a g(an$u(a )arti$.
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Ra$igra)hic eature
3T, MRI, $an scintigra)h+ *u%an'eru)a%an in$i%asi +ang te)at untu%)e'eri%saan %e(ainan g(an$u(a sa(i0arius
a%i*at %ea$aan inFa'asi $u%tus. Ha( itu $i%arena%an )e'eri%saan
terse*ut se(ain 'aha(, nns)esi;% $anti$a% *egitu *an+a% 'e'*eri%aninr'asi untu% )enega%an $iagnsis$i*an$ing%an $engan sia(gra;.
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Salo'ram)
Lat$ral .$3 o( t%$ s"&man#&"lar 'lan# s%o3s nt$rmtt$nt
strt"r$ an# #laton o( t%$ man #"ts5 3%% s t,+al o(
# # l # %t