Fluoroscopic Sialography

What is this procedure?

Fluoroscopic sialography is an imaging procedure used to examine the salivary ducts and glands. A small amount of contrast dye is gently injected into the salivary duct, and live X-ray imaging (fluoroscopy) is used to show the shape of the ducts, and whether there are any blockages, stones, or areas of narrowing.

Why is it done?

Your doctor may recommend this test to investigate:

• Recurrent or unexplained swelling of a salivary gland
• Suspected ductal blockage, narrowing, or mucus plugs
• Possible salivary stones not clearly seen on ultrasound
• Persistent pain related to salivary gland function
• Follow-up after previous salivary gland procedures

Sialography provides detailed information about the ducts that other scans may not show.

What happens during the procedure?

• You will be lying comfortably.
• The doctor will locate the small opening of the salivary duct inside your mouth.
• A very fine catheter or dilator is gently inserted into the duct.
• A small amount of contrast dye is slowly injected.
• Using live X-ray, images are taken as the contrast moves through the ducts.
• You may feel a sense of fullness or pressure, but it should not be painful.
• The whole procedure usually takes 15–30 minutes.

After the procedure

• You can go home shortly after the examination.
• Your may feel slight soreness for a short time.
• Drink plenty of water for the rest of the day.
• You may be advised to massage the gland or suck on sour sweets to help flush out the contrast dye.

Benefits

• Provides detailed imaging of the salivary ducts
• Helps diagnose blockages, stones, and areas of narrowing
• Can guide decisions about further treatment (e.g., washout, stone retrieval, surgery)
• Minimally invasive and generally well tolerated

Possible risks

These are uncommon:

• Inability to complete the procedure, in some cases, the duct is too small or chronically narrowed to insert the tube and the test cannot be completed
• Temporary discomfort or swelling of the gland
• Mild bleeding from the duct opening
• Infection (rare)
• Allergic reaction to contrast (very rare)
• Very rarely, temporary irritation or narrowing of the duct

Your doctor will discuss any risks relevant to you.

Radiation exposure

Fluoroscopy uses a low dose of X-rays. The amount of radiation is small and kept as low as reasonably possible. The benefits of the test usually outweigh the risks.

Follow-up

Your doctor will review the imaging results with you and discuss whether any further treatment or procedures are needed.