0:00

We're going to end our mastery series course on the

0:05

salivary glands with a repeat of

0:08

the discussion about sialocele.

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Remember that sialocele is a cyst that can occur usually

0:14

within the parotid gland because that's the gland that's

0:16

most commonly traumatized by fisticuffs

0:20

or other blunt trauma.

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And it may also occur secondary to stones.

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And this is a situation where you have pools of saliva

0:30

that are in the cyst, that are communicating still

0:34

with the Stensen's duct, with the parotid duct.

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If it no longer communicates or is walled off without

0:41

a true epithelial lining, we call that a pseudocyst.

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So these are the two different types of post-traumatic

0:48

cysts that can occur within the salivary glands.

0:51

As I mentioned previously,

0:54

you can demonstrate the communication of the

1:00

cyst with the ductal system by doing sialography.

1:05

So here is a case of a cyst that was superficial

1:08

to the masseter muscle on a T2-weighted scan.

1:11

It did not show contrast enhancement.

1:14

Is this a pseudocyst?

1:15

Is this a first branchial cleft cyst?

1:18

A little bit unlikely.

1:18

They're usually back more posterior.

1:21

What is the nature of this cyst?

1:23

Well, for this we did do that sialography.

1:26

You can see a faint amount of contrast coming across the

1:29

sialogram into this area where there is a pool of contrast,

1:33

much better seen on the CT scan.

1:36

Whereas I demonstrated previously, we had contrast that

1:39

was inserted into and injected into the parotid duct.

1:43

And this is the iodinated contrast communicating with

1:48

the ductal system, identifying this as a sialocele.

1:51

Well this not to communicate with the ductal system

1:55

and be walled off as a cyst post-trauma,

1:58

we would term it the pseudocyst.

2:03

So, I'd like to thank you for your attention during this

2:07

quite comprehensive course on the salivary glands,

2:10

both the major as well as the minor salivary glands.

2:14

Congratulations.

2:15

We went through a pretty detailed anatomic review.

2:19

We talked about the various scan sequences

2:21

that we use both in CT as well as MRI,

2:24

with emphasis high-resolution imaging

2:26

with vibe and cyst imaging.

2:29

We discussed the benign neoplasms dominated by

2:32

pleomorphic adenoma, the malignant neoplasms,

2:36

which include predominantly mucoepidermoid carcinomas in

2:40

the parotid gland and adenoid cystic carcinoma

2:43

in the submandibular gland,

2:45

the sublingual gland, and the minor salivary glands.

2:48

Finally, we talked about the benign inflammatory

2:51

conditions of the salivary glands,

2:54

spending a lot of time on sialolithiasis, stones both

2:57

in the ductal system as well as in the gland itself,

3:00

which dominate in the submandibular glands,

3:03

and then a variety of causes of sialadenitis, that is,

3:07

inflammatory disease of the salivary glands.

3:10

We finished up with a look at the various cysts

3:14

that can occur within the parotid gland.

3:16

In particular, those include congenital branchial cleft cyst, type I,

3:21

first branchial cleft cyst,

3:23

and type II first branchial cleft cyst,

3:25

as well as many of the inflammatory cysts,

3:28

including lymphoepithelial cysts and nodules

3:31

and the ranula in the floor of the mouth.

3:35

Thank you very much,

3:36

and I hope you enjoyed the content.