Submandibular sialolithiasis with CT and scintigraphy: CT values and salivary gland excretion in the submandibular glands

Ogura, Ichiro,Hayama, Kazuhide,Sue, Mikiko,Oda, Takaaki,Sasaki, Yoshihiko Korean Academy of Oral and Maxillofacial Radiology 2017 Imaging Science in Dentistry Vol.47 No.4

Purpose: Sialolithiasis is one of the most prevalent large obstructive disorders of the submandibular glands. The aim of this study was to investigate submandibular sialolithiasis with computed tomography (CT) and scintigraphy, with a particular focus on the relationship between CT values of the submandibular glands and their excretion rate. Materials and Methods: Fifteen patients with submandibular sialolithiasis who underwent CT and salivary gland scintigraphy were included in this study. The relationship between the CT values of submandibular glands with and without sialoliths and salivary gland excretion measured using salivary gland scintigraphy was statistically analyzed. Dynamic images were recorded on the computer at 1 frame per 20 seconds. The salivary gland excretion fraction was defined as A (before stimulation test [counts/frame]) / B (after stimulation test [counts/frame]) using time-activity curves. Results: The CT values in the submandibular glands with and without sialoliths was $9.9{\pm}44.9$ Hounsfield units(HU) and $34.2{\pm}21.8HU$, respectively (P=.233). Regarding the salivary gland excretion fraction using scintigraphy, the A/B value in the submandibular glands with sialoliths ($1.09{\pm}0.23$) was significantly lower than in the submandibular glands without sialoliths($1.99{\pm}0.57$, P=.000). Conclusion: Assessments of the CT values and the salivary gland excretion fraction using scintigraphy in the submandibular glands seem to be useful tools evaluating submandibular sialolithiasis.

Submandibular sialolithiasis with CT and scintigraphy: CT values and salivary gland excretion in the submandibular glands

Ichiro Ogura,Kazuhide Hayama,Mikiko Sue,Takaaki Oda,Yoshihiko Sasaki 대한영상치의학회 2017 Imaging Science in Dentistry Vol.47 No.4

Purpose: Sialolithiasis is one of the most prevalent large obstructive disorders of the submandibular glands. The aim of this study was to investigate submandibular sialolithiasis with computed tomography (CT) and scintigraphy, with a particular focus on the relationship between CT values of the submandibular glands and their excretion rate. Materials and Methods: Fifteen patients with submandibular sialolithiasis who underwent CT and salivary gland scintigraphy were included in this study. The relationship between the CT values of submandibular glands with and without sialoliths and salivary gland excretion measured using salivary gland scintigraphy was statistically analyzed. Dynamic images were recorded on the computer at 1 frame per 20 seconds. The salivary gland excretion fraction was defined as A (before stimulation test [counts/frame]) / B (after stimulation test [counts/frame]) using time-activity curves. Results: The CT values in the submandibular glands with and without sialoliths was 9.9±44.9 Hounsfield units (HU) and 34.2±21.8 HU, respectively (P=.233). Regarding the salivary gland excretion fraction using scintigraphy, the A/B value in the submandibular glands with sialoliths (1.09±0.23) was significantly lower than in the submandibular glands without sialoliths (1.99±0.57, P=.000). Conclusion: Assessments of the CT values and the salivary gland excretion fraction using scintigraphy in the submandibular glands seem to be useful tools evaluating submandibular sialolithiasis.

악하선 종양의 임상적 고찰

김동욱(Doog Woog Kim),양석민(Suk Min Yang),오성수(Sung Soo Oh) 대한두경부종양학회 2000 대한두경부 종양학회지 Vol.16 No.2

Objectives: Submandibular gland tumors is rare. The aim of this study is to get a clinical feature of submandibular gland tumors and to apply a treatment of submandibular gland tumors of future patients. Methods: We analyzed retrospectively the 18 patients with submandibular gland tumors who were treated surgically at Presbyterian Medical Center(PMC), during the period of 8 years from 1992 to 1999. Analysis was performed regarding the incidence, classification, surgical treatment, surgical complication, recurrence and prognosis. Result : 1) Male to female sex ratio was 1:1.25, the most prevalent age group was the 5th decade. 2) Benign tumors were 12 cases(66.7%) and malignant tumors were 6 cases(33.3%). 3) Histopathologically, the most common benign submandibular gland tumor was pleomorphic adenoma, and the most malignant submandibular gland tumor was adenoid cystic carcinoma. 4) In pleomorphic adenoma, excision of submandibular gland was performed in all case(8case). In malignant tumors, excision and supraomohyoid node dissection was performed in 3cases, and modified-radical neck dissection(RND) was performed in 2cases, and than standard RND was performed in 1case. 5) In the malignant tumor, we choose a radiation therapy as adjuvant therapy. 6) In a surgical complication of submandibular gland tumor, we had a facial nerve injury(1case). 7) Recurrence rate of submandibular gland tumor was 22.2%, and than all case were malignant tumor. Overall 5-year survival rate of submandibular gland cancer was 50%. Conclusion: In above results, postoperative recurrence rate is low in benign, but high in malignant tumor of submandibular gland. Surgical procedure should not be aggressive in benign tumor, but should be aggressive in malignant tumor of submandibular gland and an adjuvant radiation therapy should be considered.

두개저까지 확장된 악하선 점액류

김일규,양정은,장재원,주상현,편영훈,김루시아,Kim, Il-Kyu,Yang, Jung-Eun,Chang, Jae-Won,Ju, Sang-Hyun,Pyun, Young-Hun,Kim, Lucia 대한악안면성형재건외과학회 2011 Maxillofacial Plastic Reconstructive Surgery Vol.33 No.2

The mucocele is a mucus extravasation cyst arising from the salivary gland. Although it is a common?lesion of the minor salivary gland, it is uncommon when it originated from the submandibular gland. The ranula is a form of mucocele which specifically occurs in the floor of the mouth and the sublingual gland is generally accepted as the origin of ranula. They can be classified into two types based on extent: simple ranula are confined to the sublingual space and plunging ranula extend into the adjacent space. It is difficult to differentiate the submandibular gland mucocele from the plunging ranula because both of them can occupy the submandibular space. A 37-year old male visited our clinic with the chief complaint of left facial swelling. The patient's history revealed that he had suffered from a cystic lesion on the left side of the floor of the mouth 10 months previously. He supposed the cystic lesion had come from trauma at other dental clinics. Using CT and MRI, we diagnosed a simple ranula on the sublingual space and a submandibular gland mucocele. We then excised the mucocele with the submandibular gland by an extraoral approach and the sublingual gland by an intraoral approach under general anesthesia. We report a rare case of an enormous submandibular gland mucocele which extended into the pterygoid plate and parapharyngeal space with good surgical results.

A rare cause of painful neck mass: submandibular gland flstula

( Hak-jun Kim ),( Woo-il Kim ),( Min-young Yang ),( Won-ku Lee ),( Tae-wook Kim ),( Hyun-joo Lee ),( Gun-wook Kim ),( Hoon-soo Kim ),( Hyun-chang Ko ),( Byung-soo Kim ),( Moon-bum Kim ),( Sung-min Par 대한피부과학회 2018 대한피부과학회 학술발표대회집 Vol.70 No.1

Salivary gland fistula is a fistula involving a salivary gland or duct. Most salivary gland fistulae are related to the parotid gland. Submandibular fistulas on the other hand are very rare entities with only few cases reported till date. Most of submandibular gland fistulas are known to be congenital in origin, but acquired cases can rarely occur. Herein, we report a rare case regarding submandibular gland fistula in dermatologic literatures. A 53-year-old woman presented with erythematous patch with painful subcutaneous mass on lt. side of neck, which had developed over the course of 3 weeks. Symptom persisted despite treatment with empirical oral antibiotics. The computed tomography neck scan revealed enhancing tubular structure from submandibular gland to anterior aspect of platysma muscle and abscess, which was consistent with submandibular gland fistula. The patient was managed conservatively with antibiotic therapy for 3 months and the symptoms improved markedly. Submandibular gland fistula is rare condition and might be easily misdiagnosed, because it usually presents nonspecific symptoms like painful neck swelling. Accurate diagnosis may be achieved by means of through clinical manifestation, radiographic findings, and sometimes surgical exploration. Dermatologist should be kept in mind the possibility of a submandibular gland fistula when a painful mass arising in the neck does not respond to initial treatment.

Distribution of Mast cells and nerves in the Developing Postnatal Submandibular and Sublingual Glands of Rats

Kim,Jae-Gon,Lee,Young-Soo,Baik,Byeong-Ju,Cho,Eui-Sic,An,Soo-Hyeon 大韓小兒齒科學會 1999 大韓小兒齒科學會誌 Vol.26 No.2

본 연구는 출생 후 성장과정에 있는 흰쥐의 턱밑샘과 혀밑샘에서 비만세포와 신경의 분포양상을 알아보고 이들이 침샘의 성장 및 분화에 관여하는지를 규명하고자 수행되었다. 비만세포는 출생 후 턱밑샘과 혀밑샘에서 모두 관찰되었으며 성장에 따라서 증가되는 양상을 보였으나 8주 이후에는 세포밀도가 변화하지 않았다. 출생시 턱밑샘보다는 혀밑샘에서 더 많은 수의 비만세포가 존재하였고, 2주와 4주에서는 대부분의 비만세포가 신경혈관요소의 주변 결합조직에서 분포하였으나 일부는 선포와 근접하여 분포하고 있었다. Protein gene product 9.5(PGP 9.5)에 면역반응을 보이는 신경섬유들은 출생 후 모든 시기의 선조직에서 관찰되었으며, 꾸불꾸불한 형태로써 주도 도관과 혈관 주변에 분포하고 있었다. 면역 반응을 나타내는 신경섬유는 출생 후부터 8주까지는 급격히 증가하였으나 그 이후에는 거의 변화가 없었다. 2주에 신경섬유는 선포주변에서 급격히 증가하였으나 4주와 8주에는 분화하는 도관주변에서 특히 증가하였다. 이후부터 24주까지는 도관주변에 신경섬유가 감소하는 것 이외에는 변화가 거의 없었다. 본 연구결과 출생 후 성장기의 흰쥐의 턱밑샘과 혀밑샘에서 비만세포의 분포변화와 PGP 9.5에 면역반응을 나타내는 신경섬유가 처음으로 확인되었으며, 비만세포와 신경섬유는 선포의 분화 및 성숙, 그리고 도관구조의 분화와 밀접한 관계가 있음을 알 수 있었다. 따라서 비만세포와 신경은 출생 후 성장기의 턱밑샘과 혀밑샘에서 상호작용을 통하여 서로의 분화를 유도하고 촉진시킴으로서 선포와 도관의 성장과 분화에 영향을 줄 것으로 사료된다. The distribution of mast cells and nerves were investigated in the submandibular and sublingual glands of postnatal rats, using morphometric, histochemical and immunohistochemical techniques. Mast cells were observed in the submandibular and sublingual glands of postnatal development. Number of mast cells gradually increased in both glands following development. At birth, mast cells were relatively fewer in submandibular gland than those in sublingual gland than those in sublingual gland, and they were mainly distributed in parenchymal tissues. At 2∼4 weeks, most of the mast cells were observed in the connective tissues, surrounding neurovascular elements, but some mast cells were closely related with the acini of submandibular gland. PGP 9.5 immunoreactive nerve fibers were found in the submandibular and sublingual glands of all developmental age. The nerve fibers were showed in varicose shape, and mainly located in adjacent area of ducts and vascular components of both glands. The number of nerve fibers were increased rapidly until 8 weeks, but they were not increased any more until 24 weeks. Therefore, it is suggested that mast cells and nerve fibers related with each other, and that their interactions may play roles not only in maturation of secretory units but also growth and differentiation of the tubular structures of the rat submandibular and sublingual glands during postnatal development.

악하선 분비관의 결찰 후 타액선 조직의 변화

차승만(Seung-Man Cha),정인교(In-Kyo Chung) 대한구강악안면외과학회 2005 대한구강악안면외과학회지 Vol.31 No.5

Obstructive adenitis of the salivary gland following salivary stone or infectious disease of the gland and surrounding tissues is a common disease. It is often difficult to decide whether to perform total excision of the gland or to consider conservative treatment. The present study was designed to investigate histological, histochemical changes of submandibular gland after ligating the excretory duct for identifying the results of gland duct obstruction. A group of 40 rat of Sprague-Dawley weighing about 200~220gm were used in the present study. 30 rats had ligation of the main excretory ducts of submandibular glands just at the exit from the glands. For controls, 10 rats had a sham operation without duct ligation. They were inducted into euthanagia state by intracardial Ketamine injection in 1, 2, 3, 5, 7, 14, 21, 28, 35 and 42 days after the ligation. In each ligation period, 3 animals were used for ligation and one animal was for control. The submandibular glands were dissected out at sacrifice and stained with H&E, PAS, mucicarmine stain and histological examination were carried out under the light microscope. After examination and comparison of all specimens, the results were as follows: 1. In the features of H&E stain, acini disappeared by degrees after the ligation of the excretary duct and interstitial cells were displaced into fibrous connective tissue. Salivary gland had been atrophied with enlarging ducts and proliferating ductal cells. 2. Through total experimental period, a lot of vessels were observed and the atrophy of serous gland was severer than that of mucous gland. 3. The deep portion of submandibular glands showed severe degeneration rather than superficial portion of them after the ligation. 4. The changes which had enlarged ducts and proliferating ductal cells were observed in entire gland and more prominent in serous gland than mucous gland after the ligation. 5. Although PAS and mucicarmine reactions were decreased gradually after the ligation with the lapse of time, since 2 to 3 weeks they were strong positive reactions on entire gland, especially on duct-like structure. So, we can suggest that salivary gland will be atrophied but, survived acini will be redistributed around the ducts.

주 타액선 종양에 대한 10년 간의 경험

공일규(Il gyu Kong),장동엽(Dong Yeop Chang),정은정(Eun-Jung Jung),정영호(Young Ho Jung),하정훈(J. Hun Hah),성명훈(Myung-Whun Sung),김광현(Kwang Hyun Kim) 대한두경부종양학회 2006 대한두경부 종양학회지 Vol.22 No.2

Background and Objectives :This study reports our clinicopathological experiences of major salivary gland tumors. Materials and Methods :This study included 302 patients with major salivary gland tumors who had got the diagnosis from January 1995 through December 2004. Medical records were reviewed retrospectively. Results :We found 244 benign and 58 malignant major salivary gland tumors. Among 267 parotid tumors, the most common benign parotid tumor was pleomorphic adenoma. Mucoepidermoid carcinoma, adenoid cystic carcinoma, and acinic cell carcinoma were three most common parotid malignancies. Among 33 submandibular gland tumors, 20 cases were benign and 13 were malignant. There were one benign and one malignant su-blingual gland tumors. The duration of symptom of submandibular gland tumors was longer than that of parotid tumors. Most patients presented with asymptomatic mass. Seventy-one percent of salivary gland malignancies underwent postoperative radiation therapy. Five-year disease free survival rate of parotid malignant tumors seemed to be higher than that of submandibular one, although there was no statistical significance. Conclusion :Malignancy rate of each salivary gland followed old axiom that it is inversely related with the size of gland. Submandibular gland tumor tends to be delayed to reach diagnosis. Clinicians must be alert about this finding because submandibular gland tumors are known to have poorer prognosis than parotid tumors.

Innervation of submandibular and sublingual glands in elderly donated cadavers: a preliminary histological study of differences in nerve morphology between mucous and serous acini

Sachiko Asakawa,Masahito Yamamoto,Yukio Katori,Gen Murakami,Masaaki Kasahara,Satoru Matsunaga,Shin-ichi Abe 대한해부학회 2015 Anatomy & Cell Biology Vol.48 No.1

We examined morphological differences between the sublingual and submandibular glands with special reference to their innervation. The sublingual gland contained abundant periodic acid Schiff-positive mucous acini: some lobules were composed of purely mucous acini, while others were purely serous or mixed. However, in the submandibular gland, the area of mucous acini was very limited. Notably, in the sublingual gland, immunohistochemistry for neuron-specific enolase demonstrated that the serous acini carried a higher density of nerve elements than the mucous acini. However, no such difference was evident in the submandibular gland, possibly due to the small areas of the mucous acini. In both types of gland, neuronal nitric oxide synthase-positive parasympathetic nerves as well as tyrosine hydroxylase-positive sympathetic nerves were observed in the interlobular tissue, but we were unable to trace these thin fibers to the acini. Myoepithelial cells expressed smooth muscle actin, but were negative for S100B protein, glial fibrillary acidic protein and neuron-specific enolase. However, antibody against S100A stained some of the myoepithelial cells and ductal cells in the sublingual gland. Cells positive for peripheral myelin protein 22 were seen in some of the ductal cells in the submandibular gland, but not in the sublingual gland. Therefore, with regard to the neurogenic features of the gland cells, S100B reactivity might disappear first in postnatal life, whereas S100A reactivity is likely to remain as aging progresses. The sublingual gland in elderly individuals seems to provide a good model for comparison of the nerve supply between mucous and serous acini.

Distribution of Taste Receptors in Submandibular and von Ebner Salivary Glands

Yong-Ku Jun,Se-Nyun Kim,Cil-Han Lee,Young-Kyung Cho,Ki-Myung Chung,Stephen D. Roper,Kyung-Nyun Kim The Korean Academy of Oral Biology 2008 International Journal of Oral Biology Vol.33 No.1

Taste is a critically important sense for the survival of an organism. However, structure and distribution of taste receptors were only recently investigated. Although expression of the ion channels responsible for the sense of salty taste and acidity was observed in the non-taste cells, receptors for sweet and bitter taste were only identified in taste cells. Salivary glands are involved in the sensing of taste and plays important roles in the transduction of taste. The purpose of this study is to examine whether taste receptors are present in the salivary glands and to provide clues for the investigation of the taste-salivary glands interaction. Using microarray and RT-PCR analyses, the presence of taste receptor mRNAs in the rat von Ebner gland and submandibular gland was confirmed. Type I taste receptors were preferentially expressed in von Ebner gland, whereas type II taste receptors were expressed in both von Ebner gland and submandibular gland. The tastespecific signal tranducing proteins, Gαgustducin and phospholipase C β2, were also detected in both salivary glands by immunohistochemistry. Finally, the activation of the calcium signal in response to bitter taste in the acinar cells was also observed. Taken together, these results suggest that taste receptors are present in the von Ebner gland and submandibular gland and that type II taste receptors are functionally active in both salivary glands.