The Value of Cone Beam Computed Tomography ןn the Detection of Salivary Stones Prior to Sialendoscopy

Objectives: The present study aimed to assess the value of cone beam computed tomography (CBCT) in the detection of salivary stones in patients with signs and symptoms of salivary gland obstruction.

Methods: In a cohort of 127 patients with signs and symptoms of salivary gland obstruction a total number of 142 major salivary glands (73 parotid and 69 submandibular glands) were analysed. CBCT-scans were performed in order to assess the presence of one or more salivary stones. All glands were additionally investigated by sialendoscopy. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated for the submandibular gland, the parotid gland, and the whole group based on the observers’ abilities to diagnose the presence or absence of calculi on the CBCT-scan using the data of the sialendoscopies as golden standard.

Results: In the whole group of 142 glands analysed, 50 salivary stones (34 in the submandibular and 16 in the parotid gland) were detected on the CBCT-scans. Sensitivity (94%), specificity (90%), positive predictive value (84%), and negative predictive value (97%) for the whole group were good to excellent with an overall accuracy of 92%.

Conclusion: CBCT seems to be a promising imaging modality in the detection of salivary stones. The high accuracy combined with low costs, high availability and limited radiation exposure makes CBCT an ideal first line imaging modality in patients with signs and symptoms of obstructed major salivary glands.