 Psyllography is becoming an outdated technique. We still do conventional psyllography on many of our patients. There is a push towards cross-sectional psyllography, but it hasn't really gained momentum. There is some thought that a conventional psyllogram has some therapeutic effect. That is sometimes you can wash out debris when you do a psyllogram, and the patients will feel better. However, the presence of psyllendoscopy has really put psyllography on a back burner, and there are fewer and fewer indications for this technique. This is an example of conventional psyllography of the submandibular gland. We begin by doing scout films to look for stones, and then we cannulate through the puncta. In this case, the puncta of Wharton's duct is right on either side of the frenulum and the floor of mouth. We inject our contrast material, and we take our psyllographic pictures like this one, and then we give a sealogog, usually lemon juice, to drain all that contrast back out and make sure that none of it is entrapped within the ducts. The contrast material that we use has changed over time. We used to use an oil-based contrast material, but it has become prohibitively expensive. A single dose of that now costs 1,000 US dollars. It is prohibitive for this use, and so we have moved to water-based contrast agents. They are different, and they have some different properties to them. We have experimented a bit with CT Psyllography, where we use diluted water-based contrast agent, or MR Psyllography, where we use diluted gadolinium contrast and inject it the same way. But again, these have not really caught on as much as the conventional psyllography. This was an example, let me go back. This is an example of a normal psyllogram. Notice that we have a uniformly tapering duct with very smooth walls. There is a regular branching pattern within the gland where each of the daughter ducts is smaller than its parent duct, and there is no displacement of the ducts within the gland itself. Here's an example of an abnormal parotid psyllogram. Notice here that the main stencils duct has areas of dilatation and stenosis. We call this beading or a string of pearls appearance. Notice that some of the daughter branches within the gland are larger than their parent. These are the signs of chronic inflammation. Now it doesn't tell us what caused the chronic inflammation. It may be autoimmune. It may be recurrent infections, but we know that this patient has had severe chronic inflammation of that gland. I wanna point out one extra duct here. This duct is coming off very early, way before the rest of the gland. That is the duct leading to the accessory lobe of the product which we discussed earlier.