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Dentomaxillofacial Radiology (2009) 38, 550-553
© 2009 British Institute of Radiology
doi: 10.1259/dmfr/63463343

SHORT COMMUNICATION

Sialographic findings in Wharton duct evagination

S Salerno*,1, F Cannizzaro1, A Comparetto1, R Speciale2 and A Lo Casto1

1Sezione di Radiologia, Dipartimento Biotecnologie, Mediche e Medicina Legale Policlinico Università di Palermo, Palermo; 2Clinica Otorinolaringoiatrica, Policlinico Università di Palermo, Palermo, Italy

*Correspondence to: Sergio Salerno, Sezione di Radiologia DIBIMEL Università di Palermo, Via Cardinale Rampolla 1, 90145 Palermo, Italy; E-mail: sergio.salerno{at}unipa.it

Received 10 April 2008; revised 1 September 2008; accepted 1 November 2008

Abstract


Ductal evagination is a rare condition affecting the Wharton duct. The aim of this study was to establish the incidence, imaging features and clinical significance of ductal evagination in patients undergoing submandibular gland sialography. The sialographic findings and reports of 322 patients undergoing submandibular gland sialography during the period 1998–2007 were retrospectively reviewed. Ductal evagination was identified on sialograms as a unique diverticulum, filled with contrast medium, of the Wharton duct, with a narrow neck and a blind end. A ductal evagination was found in 5/322 patients with swelling and pain in the submandibular gland. It was always located in the middle tract of the Wharton duct. Other findings were: in 5/5 patients, an enlargement of the primary and secondary ducts due to sialodochitis; in 3/5 patients, salivary stones; in 1/5 patients, a sinuous distal tract of the Wharton duct; in 2/5 patients, a stenosis of the proximal tract of the Wharton duct. In our series, the incidence of wharton duct evagination was 1.6% incidence. It may represent a form of duct wall weakness although its cause is uncertain. It is, however, a condition that needs to be highlighted on sialograms for eventual inflammatory consequences or in guiding sialoendoscopy to avoid eventual ductal perforation.

Keywords: sialography; salivary duct; submandibular gland; evagination






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