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5 results on '"Wenzel, Piper"'

1. Proposal for standardized ultrasound analysis of the salivary glands: Part 1 submandibular gland.

Author

Hoffman, Henry, Koch, Michael, Witt, Robert, Ryan, William, Zenk, Johannes, Katz, Philippe, Rahmati, Rahmatullah, Rassekh, Christopher, Donato, Francisco, McCulloch, Timothy, Joshi, Arjun, Chang, Jolie, Gillespie, M, Pichardo, Priscilla, Orloff, Lisa, Marcelino, Antoino, Wenzel, Piper, Cohen, David, Fundakowski, Christopher, Cognetti, David, Walvekar, Rohan, Bertelli, Antonio, Quon, Harry, Anderson, Carryn, Policeni, Bruno, and Siegel, Gordy

Subjects
anatomic subsites, color doppler, salivary glands, shear wave elastography, submandibular, ultrasound
Abstract

OBJECTIVES: The Salivary Gland Committee of the American Academy of Otolaryngology-Head and Neck Surgery seeks to standardize terminology and technique for ultrasonograpy used in the evaluation and treatment of salivary gland disorders. METHODS: Development of expert opinion obtained through interaction with international practitioners representing multiple specialties. This committee work includes a comprehensive literature review with presentation of case examples to propose a standardized protocol for the language used in ultrasound salivary gland assessment. RESULTS: A multiple segment proposal is initiated with this focus on the submandibular gland. We provide a concise rationale for recommended descriptive language highlighted by a more extensive supplement that includes an extensive literature review with additional case examples. CONCLUSION: Recommendations are provided to improve consistency both in performing and reporting submandibular gland ultrasound.

Published
2024

4. Stensen’s Duct Dynamic Anatomy Assessed with Sialography

Author

Wenzel, Piper A., Thorpe, Ryan K., Maley, Joan E., Policeni, Bruno A., Beichel, Reinhard R., Henkle, Kailey D., and Hoffman, Henry T.

Abstract

Objectives:The presence of a catheter required for contrast infusion during sialography obscures imaging of the distal duct. Static imaging via cone beam computed tomography and magnetic resonance sialography fails to address changes that occur dynamically to the anatomy of the flexible salivary ductal system. We aim to identify dynamic changes to the parotid gland by introducing a novel approach to analyze the full extent of Stensen’s duct based on dynamic infusion digital sialography. Methods:Retrospective chart review of a single-center consecutive series of 409 parotid sialograms performed between April 2008 and June 2023 permitted selection of a contemporary series including seven normal sialograms and seven sialograms with stricture(s). Dynamic (fluoroscopic) infusion (iopamidol/gadolinium) sialograms were assessed through blinded review by two radiologists employing the institution’s picture archiving and communication (PACS) system (©2023 Koninklijke Philips N.V., Amsterdam, Netherlands). Measurements determined changes, in two dimensions, to the angle of the masseteric bend and duct length while the catheter was in place (repose), during catheter withdrawal (stretch), and during recoil after withdrawal. Differences in median lengths and angles of Stensen’s duct between the three time points were compared using Wilcoxon matched-pairs signed rank and Mann–Whitney tests. Results:Fourteen patients [median age (IQR), 55 years (24.7); 10 women] were evaluated. The median angle of the masseteric bend was 117.7° in repose versus 155.4° during catheter withdrawal (P< .001, n = 14). The median distance measured from the Stensen’s duct orifice to the first major ductal bifurcation was 81.5 mm (IQR = 12.3) in repose. The median percent increase in length from repose to stretch was 6.3% (P< .001, n = 14). Conclusions:Dynamic infusion digital sialography with fluoroscopic recording during catheter removal permits assessment of the distal duct unobstructed by the presence of a catheter. The technique also identifies the dynamic nature and varying length and angulation of Stensen’s duct.

Published
2024
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5. Clinical and radiographic follow-up after the Wilkie procedure at 28 years: A case report.

Author

Wenzel P, Maley J, Marcelino AZ, and Hoffman H

Abstract

Rerouting of the parotid ducts posteriorly to drain into the tonsillar fossae (Wilkie procedure) was initially designed to address drooling in patients with cerebral palsy. This procedure was subsequently modified to include bilateral submandibular gland excision and extended to apply to other etiologies of sialorrhea. Our literature review failed to identify report of long-term follow-up beyond 2 decades following this procedure. We describe a 33-year-old female with spastic cerebral palsy who underwent the Wilkie procedure to treat sialorrhea and, 25 years later, developed right-sided facial swelling and dental infections in association with xerostomia. CT imaging showed symmetric atrophy of the parotid glands with fat replacement interspersed with fibrosis. Ultrasound analysis with shear wave elastography offered the additional interpretation of a greater degree of gland stiffness involving the tail of the recently inflamed right parotid gland compared to the left. This case report identifies long-term complications associated with xerostomia following initial success employing the Wilkie procedure to address sialorrhea. The radiographic evaluation supports the contention that rerouting of Stensen's duct may be associated with chronic obstructive changes to the parotid gland. Ultrasound shear wave elastography supplemented CT imaging by identifying asymmetric stiffness of the parotid glands as was consistent with the more recent right parotid inflammation., (© 2023 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Published
2023
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