Pownell P H, Brown O E, Pransky S M, Manning S C
Department of Otorhinolaryngology, University of Texas Southwestern Medical Center, Dallas 75235-9035.
Int J Pediatr Otorhinolaryngol. 1992 Sep;24(2):161-9. doi: 10.1016/0165-5876(92)90142-c.
Five newborns presented with cystic lesions of the floor of mouth. Four of these patients proved to have congenitally imperforate submandibular salivary gland ducts and the other newborn proved to have a duplication anomaly of the submandibular gland duct and gland. The patients with imperforate Wharton's ducts underwent marsupialization with or without ductoplasty and have been without evidence of recurrence for up to three years. The duplication anomaly of the submandibular gland duct responded to simple excision. The diagnosis of congenital anomalies of the submandibular gland and duct can be made on physical examination. Magnetic resonance imaging can be helpful in differentiating congenital imperforate submandibular duct and duplication anomalies of the ductal system. Treatment of the former consists of duct marsupialization in the floor of mouth with or without ductoplasty. Treatment of the duplicated ductal system may best be treated with excision. A failure in diagnosis and treatment may result in ranula formation or sialoadenitis requiring more extensive therapy.
五名新生儿出现口腔底部囊性病变。其中四名患者被证实先天性下颌下唾液腺导管闭锁，另一名新生儿被证实存在下颌下腺导管及腺体重复畸形。沃顿管闭锁的患者接受了袋形缝合术，可选择是否同时进行导管成形术，随访三年均无复发迹象。下颌下腺导管重复畸形通过单纯切除即可治愈。通过体格检查可诊断下颌下腺及导管的先天性异常。磁共振成像有助于鉴别先天性下颌下导管闭锁与导管系统重复畸形。前者的治疗方法是在口腔底部进行导管袋形缝合术，可选择是否同时进行导管成形术。重复导管系统的治疗最好采用切除术。诊断和治疗失误可能导致舌下囊肿形成或涎腺炎，需要更广泛的治疗。
