0:01

This is yet another example of an inflammatory

0:04

process which may spread to the carotid space.

0:08

In this case, the patient had swelling in the submandibular

0:11

region on the right side, and was complaining

0:14

about a past history of Calculus disease

0:17

within the submandibular duct.

0:20

As we scroll down from above,

0:23

we come upon the tongue and we see that there is

0:26

some inflammation already in the palatine tonsil

0:29

on the right side, with some extension

0:32

to the retropharyngeal space.

0:35

And we also see a small calcification.

0:39

This little calcification is associated with

0:41

ductal dilation of the submandibular duct.

0:46

Here we see the dilated submandibular duct.

0:49

Here we have the retropharyngeal space,

0:53

which normally should just have fat within it.

0:56

Here we are seeing our carotid

0:58

artery and our jugular vein

1:03

and we're going to follow the carotid artery to

1:06

look for any pathology that might be occurring

1:09

in the carotid sheath. As we continue downward,

1:13

again, we have that dilated duct.

1:16

We have a submandibular gland which

1:19

is relatively large in size,

1:20

but I have to say the contralateral one is

1:23

pretty big too. It's got dilated ducts as well.

1:26

So this patient probably had Calculus

1:28

disease bilaterally.

1:30

And here's that big submandibular gland.

1:34

Once again, this is our platysma muscle,

1:36

which is thickened and irregular and has edema

1:40

associated with it compared to the normal

1:42

platysma muscle on the left side.

1:45

And we also see a little bit of a rim of low

1:49

density around the carotid artery on the

1:51

right side. Normal fat, nice and black.

1:55

Separation of carotid and jugular vein,

1:58

contralateral side this edema

2:00

which is in the carotid sheath

2:03

secondary to the submandibular process with

2:07

sialolithiasis, the stone,

2:11

sialodochitis,

2:12

which is inflammation of the ductal system,

2:16

sialadenitis,

2:18

which is inflammation of the gland associated

2:20

with carotiditis in the right carotid sheath.