Concierge head-and-neck imaging · London
Sialogram, contrast imaging of the salivary duct system.
A sialogram uses X-ray or MRI contrast delivered through the salivary duct opening — the definitive test for salivary duct strictures, stones, sialectasis and duct anatomy before sialoendoscopy. Complements salivary gland ultrasound.
Why patients choose us
- 01
The right hands
A consultant head-and-neck radiologist performs the cannulation and reports the study — one clinician, one answer.
- 02
Often answers same-day
Findings — and, where indicated, therapeutic duct dilatation — can frequently be discussed immediately.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Key facts
What to know about sialogram.
A concise, clinically calibrated brief — the six things worth knowing before your appointment.
- 01
Contrast imaging of the salivary duct
A sialogram delivers contrast through the salivary duct opening to map the duct system directly.
- 02
20–30 minute outpatient test
A focused radiology appointment — no admission, no general anaesthetic.
- 03
Radiology-led
Cannulation, imaging and reporting by a consultant head-and-neck radiologist.
- 04
X-ray or MR sialography
Fluoroscopic X-ray for classical duct detail; MR sialography where radiation is best avoided.
- 05
Diagnostic and therapeutic in one
Contrast injection can also dilate a stenosed duct — diagnosis and treatment in a single visit.
- 06
Complements salivary gland ultrasound
Ultrasound triages the gland; sialography defines the ductal system before sialoendoscopy.
The journey
From consultation to plan — what happens, in order.
One clinical pathway from ENT consultation through cannulation, imaging and structured plan.
Phase 1 · Before your scan
ENT clinical work-up
Phase 2 · On the day
Cannulation, contrast, imaging
Phase 3 · After
Report and plan
- 01
Before
ENT consultation
A short consultation with a head-and-neck ENT surgeon: history, prior imaging, red-flag screen and consent.
- 02
On the day
Salivary duct cannulation
The duct orifice inside the mouth is identified and a fine cannula is passed under direct vision.
- 03
On the day
Contrast injection
Water-soluble iodinated contrast (X-ray) or MRI-compatible contrast is gently injected to fill the duct system.
- 04
On the day
Fluoroscopy or MR imaging
Live fluoroscopic X-ray images or MR sialography sequences are acquired as the duct fills and drains.
- 05
On the day
Interpretation by head-and-neck radiologist
The reporting consultant characterises duct calibre, strictures, filling defects and sialectasis.
- 06
After
Structured report
A written report — duct anatomy, pathology, comparison with prior imaging and a clear impression.
- 07
After
Structured plan
A named next step — sialoendoscopy, lithotripsy, surgery or MDT — with the clinician who will deliver it.
Typical end-to-end: 1–5 days. Urgent cases: same day.
What it shows
What a sialogram picks up.
Sialography defines the ductal system directly — calibre, strictures, stones, sialectasis and drainage — the map sialoendoscopy and surgery rely on.
-
Duct stricture
Focal narrowing of Wharton’s or Stensen’s duct — the commonest cause of recurrent mealtime swelling.
-
Ductal stone (calculus)
A filling defect in the duct with proximal dilatation — the classical sialographic finding.
-
Sialectasis pattern
Punctate, globular or cavitary dilatation of the terminal ductules seen in chronic sialadenitis.
-
Sjögren’s sialectasis
Bilateral punctate contrast pooling — the characteristic sialographic signature of Sjögren’s.
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Chronic sialadenitis
Irregular duct calibre, pruning of secondary branches and delayed contrast clearance.
-
Duct dilatation (obstruction)
Uniform ductal dilatation proximal to a stone, stricture or extrinsic compression.
-
Post-radiation duct atrophy
Attenuated, pruned duct system following head-and-neck radiotherapy.
-
Red flag: obstructing stone with sepsis — urgent ENT
An impacted stone with facial swelling, fever or pus at the duct orifice needs same-day ENT review.
Treatment options
What follows a sialogram.
The sialogram is the map — these are the routes that map opens up, from same-visit duct dilatation to MDT-directed surgery.
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Sialoendoscopic stone retrieval
Minimally invasive ductal endoscopy for stone extraction, sparing the gland.
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Balloon duct dilatation
Transductal balloon dilatation of a benign duct stricture, often at the same visit as the sialogram.
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Extracorporeal shock-wave lithotripsy
Focused shock waves to fragment larger salivary stones for spontaneous or endoscopic clearance.
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Surgical excision (recurrent stones)
Transoral or open removal of impacted or recurrent duct stones when endoscopy is not sufficient.
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Superficial parotidectomy
Removal of the superficial parotid lobe for refractory duct disease or associated tumour.
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Rituximab (Sjögren’s)
B-cell-directed therapy for selected patients with active systemic Sjögren’s syndrome.
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Structured ENT follow-up
Serial clinical and imaging review to track duct patency and gland function.
-
Multi-disciplinary team review
Head-and-neck MDT for complex, recurrent or oncologically suspicious duct disease.
Our vetted London network
A small panel of clinics, we picked them.
Partners across central, north, west and south London. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every clinic in our network.
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Consultant head-and-neck radiologists with a sialography practice
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X-ray fluoroscopic and MR sialography options under one referral
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Same-day report, with images available for onward review
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Onward ENT, sialoendoscopy or head-and-neck MDT pathway for complex findings
Red flags
When a salivary duct problem needs urgent review.
Most duct problems are benign — but a small number of presentations should not wait for a routine slot.
-
Obstructing stone with sepsis
Impacted duct stone with fever, pus or systemic upset — same-day ENT and antibiotics.
-
Impacted stone with facial swelling
Acute painful gland swelling that will not settle — urgent duct clearance.
-
Post-radiation duct necrosis
Non-healing duct or oral cavity ulceration after radiotherapy — urgent head-and-neck opinion.
-
Sjögren’s MALT lymphoma
Focal mass in a Sjögren’s gland — MALT lymphoma until proven otherwise; urgent biopsy.
-
Chronic parotitis in HIV
Bilateral cystic parotid enlargement in HIV — requires specialist review and imaging.
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Immunosuppressed with duct sepsis
Transplant recipients or long-term immunosuppression with duct infection — low threshold for admission.
-
Post-parotidectomy fistula
Persistent salivary leak or sialocele after surgery — urgent surgical review.
-
Recurrent salivary stones
Repeated stone formation despite treatment — refer for structured metabolic and duct assessment.
-
Suspected duct malignancy
Irregular strictures, contrast extravasation or associated mass — urgent MDT referral.
Reading your report
A sialogram report can look intimidating. It isn’t.
Whatever the finding, the report keeps to the same four parts.
A quiet reminder
The report is written for your doctor, not for you — and that’s normal.
If you would like us to talk you through it before your follow-up, just ask.
- 01 Header
Indication and clinical context
Your details, presenting symptoms, prior imaging and the clinical question being answered.
- 02 Technique
Cannulation, contrast and modality
Which duct was cannulated, contrast type and volume, and whether X-ray fluoroscopy or MR sialography was used.
- 03 Findings
Duct anatomy, strictures, stones, sialectasis
Vessel-by-vessel description of the duct system, filling defects, ductal calibre and drainage.
- 04 Impression
The conclusion: read this first
Benign versus obstructive versus suspicious, and the concrete next step — read this first.
Recognised by major UK insurers
Cover depends on your policy and clinic; we confirm with your insurer before booking.
Frequently asked
Everything we get asked about sialogram.
Short, honest answers on discomfort, X-ray versus MR, therapeutic dilatation and when to escalate.
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What is a sialogram?
A sialogram is a contrast study of the salivary duct system. A fine cannula is placed in the duct orifice inside the mouth, contrast is injected, and the duct is imaged with either fluoroscopic X-ray or MR sialography.
-
Is it painful?
Cannulation of the duct is briefly uncomfortable — most patients describe pressure rather than pain. Local anaesthetic gel is used at the duct orifice, and the contrast injection is slow and controlled.
-
X-ray sialogram or MR sialography — which will I have?
X-ray fluoroscopy gives the highest ductal detail and allows immediate therapeutic duct dilatation. MR sialography is preferred where radiation is best avoided or where the surrounding soft tissues need mapping. The radiologist chooses based on your case.
-
What will the sialogram show?
Duct strictures, salivary stones, sialectasis (including the classical Sjögren’s pattern), chronic sialadenitis, obstruction and post-radiation duct atrophy — the ductal information sialoendoscopy or surgery needs.
-
Can the sialogram also treat the problem?
Yes, in many cases. Gentle contrast injection can dilate a benign duct stricture, and balloon duct dilatation can be performed at the same visit when appropriate.
-
When should I see an ENT surgeon urgently?
Any obstructing stone with fever or systemic upset, impacted stone with facial swelling, post-radiation duct necrosis or a new focal mass in a Sjögren’s gland — urgent ENT and head-and-neck MDT review.
Sources
The guidance behind this page.
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British Society of Head and Neck Radiology
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European Society of Head and Neck Radiology
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American Head and Neck Society
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British Sjögren’s Syndrome Association
Published 2026-07-30 · Reviewed 2026-07-30 · Next review 2027-07-30 · 4-minute read
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In practice, in London
The honest picture around sialogram in London
With sialogram, the London question is usually about report turnaround and the radiologist reading it — not whether the scan is available. The NHS route for sialogram is thorough, but the queue is real. Most patients we speak with have been told to expect anywhere from a handful of weeks to several months, depending on their local trust and how the referral is graded. Going private in London usually collapses that window to a matter of days — often the same week if the diary allows. It isn’t about jumping a queue so much as buying time back while you still have the flexibility to plan around it.
A typical private booking for sialogram in London starts with a consultant conversation — sometimes in person on Harley Street or Marylebone, sometimes on video if that suits better. Any imaging or diagnostics happen at a nearby CQC-registered facility, and reports usually land within 24 to 72 hours. The whole loop, from first call to written report, is often done inside a fortnight. For sialogram specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.
Fit matters more than people expect. For sialogram, the right consultant depends on what you actually need — a second opinion, a definitive diagnosis, a bridge into treatment, or reassurance that nothing’s being missed. We match on that, not on who has the biggest brochure. If a test isn’t the right next step, we’ll say so before you book anything.