 The parotid gland is drained by Stensen's duct, or you can say the parotid duct, or Stensen's duct, if you like the eponym. The submandibular gland is drained by Wharton's duct. And the sublingual gland sometimes will join in with the submandibular gland and join into Wharton's duct, and sometimes it will drain all by itself individually into the oral cavity. And the minor salivary glands obviously drain directly into the mucosa. So let's talk about the parotid gland. The parotid gland has deep and superficial lobes, right, and they are divided by the facial nerve. The problem is we can't see the facial nerve on most imaging. And so what we do is we use the retromandibular vein as a radiologic marker, approximating where that facial nerve is located, and we'll use that retromandibular vein to divide the superficial and deep lobes of the parotid gland. There's an important anatomic concept at play here, and that is the concept of the styloid process and the mandible. And in between the styloid process and the mandible is the stylomandibular tunnel. The deep lobe of the parotid extends through that stylomandibular tunnel. And so it is easiest to find in that location. The parotid gland itself has an intermediate density between the underlying masseter muscle and the overlying subcutaneous fat in most people. Now in children, the density is similar to the underlying muscle, and sometimes it's hard to distinguish the gland from the muscle. As we age, there's fatty atrophy of the gland and it becomes more and more fatty the older we get until eventually it's difficult to distinguish the gland from the overlying subcutaneous fat. But in most people it's somewhere in between and easy to distinguish both from the fat and from the underlying muscle. There is a third lobe to the parotid gland that only appears in some people and may only appear on one side or the other or on both sides called the accessory lobe. The accessory lobe sits on top of the masseter muscle, and if it's asymmetric, maybe clinically mistaken for a mass, but it's a normal third lobe, inconstant lobe of the parotid gland. Remember that the parotid gland is the only of the submandibular glands to contain its own lymph nodes. Now the submandibular glands, they live in the submandibular triangle, lateral to the anterior belly of the digastric muscle. But remember that there is a small part of the submandibular gland that loops up and around the back of the myelohyroid muscle and thus comes into the floor of mouth. So we think of the submandibular gland as living in the submandibular triangle, and most of it does, but there's a small lip coming around the back that we must remember and a communication between the floor of mouth and the submandibular triangle along where the submandibular gland runs. Another important anatomic relationship is to the anterior facial vein. The anterior facial vein runs between the submandibular gland and the submandibular lymph nodes, and so it is a useful marker when we're trying to distinguish a mass in this location and decide whether it arose from the gland and is thus behind the facial vein or arose from the lymph nodes and is pushing the facial vein posteriorly, an important anatomic structure. The sublingual gland lives in the floor of mouth and it runs along the lingual surface of the mandible. One thing that I want to emphasize about the sublingual gland in this location is that there is often a small amount of ectopic salivary tissue along a line between the submandibular gland and the sublingual gland, and if you draw a line along there, you will see small, occasionally, small amounts of ectopic salivary tissue, and all of that is normal. It's a normal variant to find anywhere along that line. This can be confusing. It can look like a mass. It is enhancing, but if you look carefully, it will have the same characteristics as the glands themselves, and that will help you identify this ectopic salivary tissue. So what modalities do we use to evaluate the salivary glands? Well, we often use CT, particularly if we're looking for stones. CT is very good for identifying small calculi, and CT is, for the most part, our go-to modality. MRI has been said to be better to establish the extent of masses in the glands. I'm not sure if that's really true. CT does a very good job of that, but some of my surgeons prefer MRI before they do surgery to evaluate the extent of the disease. Psyallography is becoming an outdated technique. We still do conventional Psyallography on many of our patients. There is a push towards cross-sectional Psyallography, but it hasn't really gained momentum. There is some thought that a conventional Psyallogram has some therapeutic effect. That is, sometimes you can wash out debris when you do a Psyallogram and the patients will feel better. However, the presence of Psyallendoscopy has really put Psyallography on a back burner, and there are fewer and fewer indications for this technique.