Marchal Francis, Dulguerov Pavel, Becker Minerva, Barki Gerard, Disant François, Lehmann Willy
Department of Otolaryngology-Head and Neck Surgery, Geneva University Hospital, Switzerland.
Ann Otol Rhinol Laryngol. 2002 Jan;111(1):27-35. doi: 10.1177/000348940211100105.
We present our initial experience with submandibular sialendoscopy, a new therapeutic approach for disorders of Wharton's duct. We review the sialendoscopes used and discuss their respective merits. We evaluated and treated 129 consecutive patients with suspected ductal disorders. Diagnostic sialendoscopy was used for classifying ductal lesions as sialolithiasis, stenosis, sialodochitis, or polyps. Interventional sialendoscopy was used to treat these disorders. The type of endoscope used, the type of sialolith fragmentation and/or extraction device used, the total number of procedures, the type of anesthesia, and the number and size of the sialoliths removed were the dependent variables. The outcome variable was the endoscopic clearing of the ductal tree and resolution of symptoms. Diagnostic sialendoscopy was possible in 131 of 135 glands (97%), with an average (+/-SD) duration of 28 +/- 15 minutes. Interventional sialendoscopy was attempted in 110 cases, with an average duration of 71 +/- 41 minutes, with a success rate of 82%. Multiple sialendoscopies were necessary in 25% of cases. General anesthesia was used in 12% of cases. Submandibular gland resection was performed in 4%. The average size of the stones was 4.9 +/- 2.9 mm. Multiple sialoliths were found in 31 cases (29%). Sialolith fragmentation was required in 26%. Larger and multiple stones often required longer and multiple procedures and general anesthesia, and more often resulted in failures. Semirigid endoscopes had a higher success rate (85%) than flexible sialendoscopes (54%). Complications were mostly minor, but were encountered in 10% of cases. Diagnostic sialendoscopy is a new technique for evaluating salivary duct disorders that is associated with low morbidity. Interventional sialendoscopy allows the extraction of sialoliths in most patients, thus preventing open gland excision.
我们介绍了我们在下颌下腺涎管镜检查方面的初步经验，这是一种治疗沃顿管疾病的新方法。我们回顾了所使用的涎管镜并讨论了它们各自的优点。我们对129例连续怀疑有导管疾病的患者进行了评估和治疗。诊断性涎管镜检查用于将导管病变分类为涎石病、狭窄、涎管炎或息肉。介入性涎管镜检查用于治疗这些疾病。所使用的内镜类型、涎石破碎和/或取出装置的类型、手术总数、麻醉类型以及取出的涎石数量和大小为因变量。结果变量是导管系统的内镜清理和症状的缓解。135个腺体中的131个（97%）可以进行诊断性涎管镜检查，平均（±标准差）持续时间为28±15分钟。110例尝试进行介入性涎管镜检查，平均持续时间为71±41分钟，成功率为82%。25%的病例需要多次涎管镜检查。12%的病例使用全身麻醉。4%的病例进行了下颌下腺切除术。结石的平均大小为4.9±2.9毫米。31例（29%）发现多个涎石。26%需要进行涎石破碎。较大和多个结石通常需要更长时间和多次手术以及全身麻醉，并且更常导致手术失败。半刚性内镜的成功率（85%）高于柔性涎管镜（54%）。并发症大多轻微，但在10%的病例中出现。诊断性涎管镜检查是一种评估涎腺导管疾病的新技术，发病率较低。介入性涎管镜检查在大多数患者中可以取出涎石，从而避免了开放性腺体切除。
