The anatomical pattern of ductal arborization in parotid glands using cone-beam computerized sialography

Tevel Amiel, Oren Shauly, Ella Gilenson Istoyler, Michael Alterman, Naama Keshet, Sigal Mazor, Anna Pikovsky, Doron J. Aframian, Leo Joskowicz, Chen Nadler*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Cone-Beam Computed Tomography-Sialography (Sialo-CBCT) is used to demonstrate salivary ductal structure. This study aimed to conduct a volumetric analysis of the anatomical morphology of Normal-Appearing Glands (NAGs) in parotid sialo-CBCT. Our retrospective study included 14 parotid sialo-CBCT scans interpreted as NAGs in 11 patients with salivary gland impairment. The main duct length and width, as well as number and width of secondary and tertiary ducts were manually evaluated. We found that the main parotid duct showed an average width of 1.39 mm, 1.15 mm, and 0.98 mm, for the proximal, middle and distal thirds, respectively. The arborization pattern showed approximately 20% more tertiary (average number 11.1 ± 2.7) than secondary ducts (average number 9.0 ± 2.4) and approximately 8% narrower tertiary ducts (average width 0.65 ± 0.11 mm) compared to the secondary ducts (average width 0.77 ± 0.14 mm). Our anatomical analysis of NAGs in parotid sialo-CBCT demonstrated progressive narrowing of the main duct and increasing arborization and decreasing lumen size starting from the primary to the tertiary ducts. This is the most updated study regarding the anatomy of the parotid glands as demonstrated in sialo-CBCT. Our results may provide clinicians with the basic information for understanding aberration from normal morphology, as seen in salivary gland pathologies as well facilitate planning of treatment strategies, such as minimally invasive sialo-endoscopies, commonly practiced today.

Original languageEnglish
JournalClinical Anatomy
StateAccepted/In press - 2024

Bibliographical note

Publisher Copyright:
© 2024 The Authors. Clinical Anatomy published by Wiley Periodicals LLC on behalf of American Association of Clinical Anatomists and British Association of Clinical Anatomists.


  • cone-beam computed tomography
  • morphology
  • parotid gland
  • salivary ducts
  • sialography


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