Purpose: Sialography is a salivary gland imaging in which Iodinated Contrast Media (ICM) is injected through the orifice of the salivary duct in order to demonstrate the glandular ductal architecture. Recently, 2D radiographs have been replaced with Cone-Beam CT (CBCT) creating sialo-CBCT with increased spatial resolution and relatively reduced radiation dose. Sialography has traditionally been contraindicated in patients with known ICM hypersensitivity. ICM hypersensitivity often exhibits symptoms similar to anaphylaxis. However, unlike IgE mediated allergic reaction, ICM ordinarily induce a non-specific mast cell degranulation. Pivotal to the anaphylactic reaction is the entrance of an allergen into the blood stream. Knowing that ICM in sialography is injected to the salivary duct and that the volume utilized is small, we allowed its use for patients with known past ICM hypersensitivity. The aim of this study was to retrospectively review sialo-CBCT cases performed in patient with known past ICM hypersensitivity.
Materials and Methods: We retrospectively reviewed all sialo-CBCT scans performed in the maxillofacial imaging center in Hadassah-Hebrew University Medical Center, between the years 2015-2018 for patients with known ICM hypersensitivity. Reports were reviewed for possible side effects during or after the procedure, other than localized pain or swelling relevant to the examined gland region.
Results: We found 13 patients out of ~300 sialo-CBCT with a label of ICM hypersensitivity. Most patients (77%) were females and their reports unveiled that IV port had been inserted, prior to the procedure, in all ICM patients. Intra ductal injection volume was approximately 3-5 ml per patient. No clinical features related to ICM hypersensitivity were reported either during or after the procedure.
Conclusions: Our study demonstrates that ICM used in sialography did not induced any adverse reaction during and after the procedure even for patients which previously labelled as "allergic". Therefore we suggest that sialography should not be contraindicated in ICM hypersensitive patients.
