See also:
- Sialograms and Sialography
- Ultrasound Sialography (Ultrasound With Salivary Duct Infusion)
- Botulinum neurotoxin infusion to the parotid via Stensen's duct - Research protocol (IRB approved)
Background
Salivary Duct Infusion for therapeutic purposes has been increasingly common to deliver steroids (Diggelmann 2015), Botulinum toxin (Schwalje 2019) and other therapy including ongoing research addressing gene therapy to the gland (Baum 2012, Lai 2016, Alevizos 2017).
Leakage around the angiocatheter depicted delivering radiocontrast (Isovue 370®) in the example may be considered a 'pop-off valve' to prevent excessive pressure and rarely compromises performance of the study. However, delivery of medication under pressure may be desirable without leakage and may warrant adaptations to the size and shape of the angiocatheter employed. Additional sophistication is possible by coupling a pressure transducer to the infusion apparatus to measure the pressure duing insufflation as shown in the thumbnails above (see Schwalje et al 2019)
Video
References
Diggelmann HR, Hoffman HT. Intraductal infusion of steroids in patients with Sjögren syndrome to treat painful salivary swelling: Report of 2 cases., Ear, nose, & throat journal. 2015 June 1;94(6):238-9. PMID:26053983. doi: 10.1177/014556131509400611
Schwalje AT, Hoffman HT. Intraductal Salivary Gland Infusion With Botulinum Toxin., Laryngoscope investigative otolaryngology. 2019 September 3;4(5):520-525. PMID:31637296. PMCID: PMC6793609. doi: 10.1002/lio2.306
Lai Z, Yin H, Cabrera-Pérez J, Guimaro MC, Afione S, Michael DG, Glenton P, Patel A, Swaim WD, Zheng C, Nguyen CQ, Nyberg F, Chiorini JA. Aquaporin gene therapy corrects Sjögren's syndrome phenotype in mice. Proc Natl Acad Sci U S A. 2016 May 17;113(20):5694-9. doi: 10.1073/pnas.1601992113. Epub 2016 May 2. PMID: 27140635; PMCID: PMC4878512.
Baum BJ, et al. (2012) Early responses to adenoviral-mediated transfer of the aquaporin-1 cDNA for radiation-induced salivary hypofunction. Proc Natl Acad Sci USA 109(47):19403–19407.
Alevizos I, Zheng C, Cotrim AP, Liu S, McCullagh L, Billings ME, Goldsmith CM, Tandon M, Helmerhorst EJ, Catalán MA, Danielides SJ, Perez P, Nikolov NP, Chiorini JA, Melvin JE, Oppenheim FG, Illei GG, Baum BJ. Late responses to adenoviral-mediated transfer of the aquaporin-1 gene for radiation-induced salivary hypofunction. Gene Ther. 2017 Mar;24(3):176-186. doi: 10.1038/gt.2016.87. Epub 2016 Dec 20. PMID: 27996967; PMCID: PMC5373995.
