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Diagnostic ultrasound ( PDFDrive )

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CHAPTER 48 The Pediatric Head and Neck 1631

m

gg

gh

dg

2

4

3

mh

FIG. 48.6 Normal Submandibular Space. Sagittal diagram shows

submandibular gland (1), sublingual gland (2), submandibular (Wharton)

duct (3), sublingual duct (4), mylohyoid muscle (mh), genioglossus muscle

(gg), geniohyoid muscle (gh), anterior belly of digastric muscle (dg), and

mandible (m).

1

two perpendicular planes, usually long and transverse, with a

high-frequency linear transducer. he glands are triangular,

homogeneous, and more echogenic than muscle but less echogenic

than the parotids 15 (Fig. 48.7). On high-resolution sonography,

ine linear streaks can be observed, representing intraglandular

ductules. he Wharton duct may be visualized as a thin echogenic

wall medial to the sublingual gland. Movement of the patient’s

tongue may aid in visualization of the duct. 16

he sublingual gland lies on the mylohyoid muscle between

the mandible and genioglossus muscle. In addition to the gland,

the sublingual area includes the submandibular duct and sublingual

vessels, which lie medial to the gland. Scanning of the

gland should be performed with a high-frequency linear transducer

submental in two perpendicular planes with the patient

supine and the head retrolexed. 17 A standof pad can be helpful

in accessing the anatomy. On transverse imaging the gland is

oval, whereas on long sections the gland has a lentiform shape

(Fig. 48.8). he echogenicity of the sublingual gland is similar

to the parotid and submandibular glands. 17

MH

FA

M

A

B

FIG. 48.7 Normal Submandibular Gland. (A) Transverse color Doppler scan shows homogeneous triangular gland with mandible (M) laterally

and mylohyoid muscle (MH) medially. Facial artery (FA) is also present laterally along the gland. (B) Longitudinal color Doppler imaging shows

central linear structure without color (arrow), representing nondilated Wharton duct.

GH

DG

MH

SM

DG

MH

GG

SL

M

SL

A

B

FIG. 48.8 Normal Sublingual Gland. (A) Transverse image shows triangular homogeneous sublingual glands laterally adjacent to mandible.

Arrow, Wharton duct; DG, anterior belly of digastric muscle; GG, genioglossus; M, mandible; MH, mylohyoid; GH, geniohyoid; SL, sublingual gland.

(B) Longitudinal ultrasound shows the submandibular gland (SM) posteriorly and the lenticular homogeneous sublingual gland (SL).

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