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This article discusses a rare clinical case of differential diagnosis between salivary stone disease and calcinosis, which developed against the background of autoimmune pathology. Diagnosis of these pathologies causes difficulties for practitioners, and treatment methods have fundamental differences. In this regard, the description of this case is relevant and significant. The algorithm of the main and additional research methods to confirm the diagnosis is described.

A report on the primary application of the modern technique of plastic removal of stricture of the Stenonic duct. A clinical case of surgical intervention in the localization of stricture and salivary stone is considered. The analysis of the patient's medical history, ultrasound diagnostics, multispiral computed tomography of the maxillofacial region was carried out. Based on the results of the examination, the choice of the surgical intervention technique was made.

We investigated the value of ultrasonography (USG) and ultrasound-guided aspirations in diagnosis and treatment of acute inflammation of soft tissues in maxillofacial region and neck. We performed 174 USG in 136 patients (73 with abscesses and phlegmons, 27 with acute lymphadenitis, 16 with inflamed cysts, 12 with parotitis, 3 with sialolithiasis and 5 with diseases, simulated acute inflammation). Ultrasound-guided aspirations performed in 35 patients. We considered USG to be useful diagnostic tool in acute inflammation of soft tissues in maxillofacial region and neck. USG allowed to determine localization and stage of inflammation, discriminate it from non-inflammatory diseases and improve assessment of its dynamics. Ultrasound-guided aspirations was a valuable tool for diagnostic and treatment purposes in inflamed cysts.

33 patients with complaints of hyposalivation (21 in a 33 with syaloadenopatya and 12 in a 33 with syalosis out of the acute stage of disease) were examined. Complex examination of the saliva glands, analysis of the haemokynes in the various mediums of organism and thyoles compounds in the blood plasma was carried out. Tendency to increase in contents of haemokynes in the mixed saliva and in the tissue samples (from low in the syaloadenopatya to expressed in the syalosis) was revealed. Reduction of thyosulfide index in the blood plasma of these patients was determined. Use of antioxidant remedy in complex treatment of syaloadenopatya and syalosis was substanciated in this paper.

We studied echograms of lymph nodes and clinically similar tumors of the neck in 194 patients. A complex of echographic signs providing the best diagnostic indicators: a minimal size of the node, volume, maximal to minimal size ratio and form. Accuracy of differential diagnosis of benign and malignant lymphadenopathies was 80.4%, sensitivity -- 94.3%, specificity -- 69.4%. In duration of the disease less than 1 month use of computer processing of echograms raised diagnostic accuracy by 9.5%.

The results of X-ray examination of 25 (2.8%) out of 899 patients were analyzed. The changes of their neck mass were due to the conditions of non-tumoral and non-inflammatory nature. These states were not always clinically clear and were not infrequently considered as a neoplastic process. The causes of them can include developmental anomaly of neck organs, post-radiation and postoperative alterations, atherosclerosis, degenerative-dystrophic alterations in the cervical portion of the vertebral column etc. To establish the character of the neck mass changes it is necessary to perform a complex radiation examination, its first and sometimes the only stage being USI. Choice of the following methods (CT, MRT and so on) depends on the results of USI and the clinical picture.

The differential diagnosis of lateral cysts of the neck, metastatically altered lymph nodes and malignant tumors sometimes is difficult because their X-ray images as well as their clinical manifestations can be alike. The data of examination of 55 patients were analyzed. They included 43 cases of cysts of the neck (26 lateral and 17 median), 10 cases of cystically altered metastases into the lymph nodes, 2 cases of malignant tumors. The examination included US investigation (USI), computed tomography (CT), USI controlled aspiration biopsy. The diagnosis was histologically verified in 46 patients, in 7 cases the material was investigated cytologically. The "atypical" echographic picture was noted in 30.9% of cases with lateral cysts and in 23.6% of cases with median cysts. They had irregular shape, defective contours, echostructure of the tissues with repeated complications in anamnesis, weak "dorsal reinforcement". The clinical investigation of cases with lateral cysts was exact in 76.9%, with median cysts--in 82.4%. The USI examination was exact in 96.2% of cases with lateral cysts and in 94.1% with median cysts. CT was exact in 94.4% of cases with lateral cysts, and in 100% with median cysts. Thus, USI is thought to be necessary as the first step of X ray examination when cyst of the neck was suspected. Large sizes, spread of the cyst into deep areas and into the larynx lumen are considered as indications to CT. Both the echographic and computed tomography picture of the neck cysts depend on their localization, character of the content and the presence of inflammatory symptoms. The USI controlled aspiration biopsy can make the "atypical" USI picture of the mass nature more exact.

Neck tumors may be caused by a variety of both inflammatory and non-inflammatory lesions in organs and tissues. US and CT are successfully used to detect neck pathology but misdiagnosis still occurs. To analyze the situation, the data on 124 patients with tumors, cysts, inflammatory lesions and metastasis (after surgery and radiotherapy) were evaluated. The two categories of factors were identified: (1) poor quality of US and CT images due to anatomical peculiarities, thick layers of subcutaneous fatty tissue, deep location of lesions, and scars and edema produced by previous surgery and radiotherapy. As far as CT is concerned, imperfections may be due to artifacts and insignificant difference between tumor and normal tissue densities; (2) misinterpretation of images due to tumor and salivary gland merging to form one block, similarity of outlines of malignant and benign tumors, cysts and cyst-like metastases, neoplastic and inflammatory lesions. The ways of improving the quality of US and CT images are suggested. In particular, FNAB should be used to differentiate between malignant and benign tumors.