Pharyngeal, Neck and Facial Infections: Sialoadenitis

History

Facial swelling and/or facial pain in the parotid or submandibular region or in the floor of the mouth. Possible sialoadenitis or other salivary gland abnormality.

Exam

Contrast-enhanced CT of the maxillofacial region and neck and related anatomy with images obtained in the balanced or venous vascular phase to ensure optimal visualization of both arterial and venous structures as well as possible reactive changes around infected collections. 0.5-3.0 mm thick sections were obtained in the axial plane and reformatted 3D and/or in the coronal and sagittal planes and viewed inter actively in 3 dimensions at the computer work station.

MR: Anatomically focused axial, sagittal and coronal images through the face and neck region to the carina including T1 and T2 weighted acquisitions done without or with and without gadolinium contrast enhancement.

Prior Study

None

Findings

General

There is excessive enhancement, edema and/or fluid collection involving the superficial fascia or subcutaneous fat and skin. [Yes/No]

There is excessive enhancement, edema and/or fluid collections within or surrounding the mandible/maxilla (dental or sinonasal related), pharynx, parapharyngeal space, buccal space, masticator space, floor of the mouth or neck that would be an alternate explanation for the patient’s symptoms. [Yes/No]

There is significant secondary airway encroachment present. [Yes/No]

Parotid Glands

The parotid glands are enlarged and/or show abnormal enhancement. [Yes/No]

There are intraglandular parotid cysts and/or sialocoeles. [Yes/No]

There is a developing abscess within the parotid gland. [Yes/No]

The parotid ducts and/or intraglandular ductal systems are dilated and/or with evidence of intraductal stones other causes of obstruction. [Yes/No]

There is edema (cellulitis) and/or abscess within the fat surrounding the parotid gland and/or of the masticator space or other adjacent spaces. [Yes/No]

The retromandibular and the facial veins are abnormal. [Yes/No]

There are abnormalities along the course of the facial nerve. [Yes/No]

The parotid, retromastoid, subocciptal and posterior neck lymph nodes are abnormal by imaging criteria. [Yes/No]

Submandibular glands

The submandibular glands are enlarged and/or show abnormal enhancement. [Yes/No]

There are intraglandular submandibular cysts and/or sialocoeles. [Yes/No]

There is a developing abscess within the submandibular gland. [Yes/No]

The submandibular ducts and/or intraglandular ductal systems are dilated and/or with evidence of intraductal stones other causes of obstruction. [Yes/No]

There is edema (cellulitis) and/or abscess within the fat surrounding the submandibular gland and/or of the submandibular, sublingual or other adjacent spaces. [Yes/No]

The submandibular (Level 1) lymph nodes are abnormal by imaging criteria. [Yes/No]

Sublingual glands

The sublingual glands are enlarged and/or show abnormal enhancement. [Yes/No]

There is edema or abscess within the sublingual space/floor of the mouth. [Yes/No]

Other Lymph Node Groups

The other cervical (Levels 2-6), supraclavicular and/or retropharyngeal lymph nodes are abnormal by imaging criteria. [Yes/No]

Other findings

The lacrimal glands are enlarged and/or enhance abnormally. [Yes/No]

There is evidence of thrombus, thrombophlebitis or other occlusive or inflammatory process of the jugular vein or smaller venous tributaries. [Yes/No]

There is evidence of thrombus, inflammation of the common, external or internal carotid artery. [Yes/No]

There is evidence of active extravasation or a contained leakage from an arterial source. [Yes/No]

Other significant abnormal findings are present. [Yes/No]

Impression