Qi Senrong, Liu Xiaoyong, Wang Songlin
Salivary Gland Disease Center, Faculty of Stomatology, Capital University of Medical Sciences, Beijing, China.
Laryngoscope. 2005 Mar;115(3):541-5. doi: 10.1097/01.mlg.0000157832.23380.df.
OBJECTIVES/HYPOTHESIS: To study the sialographic changes related to sialoendoscopic and irrigation fluid findings in chronic obstructive parotitis.
The sialographic changes were classified according to previous studies and related to sialoendoscopic and irrigation fluid findings.
This study included 26 patients with a long history of parotid swelling. All patients were examined by radiography and sialography and were diagnosed as having chronic obstructive parotitis without sialolithiasis. Sialoendoscopy was used to observe the ductal system and perform an irrigation treatment. The irrigated liquid was centrifuged, and the fluid deposits were stained and observed using light microscopy.
In all cases, sialoendoscopic examination showed the ductal system was filled with fiber-like substances and hyperemia of the ductal wall. Although a few of the thin and short fiber-like substances were found in the chronic obstructive parotitis patients with sialographic type I and type II changes, many thick and long wadding or lumpy fiber-like substances were revealed in chronic obstructive parotitis patients with sialographic type III and IV changes. Microstones were found in two chronic obstructive parotitis patients with sialographic type III changes, which were stained and identified using light microscopy. Irrigation fluid examination showed that the fiber-like substance was composed of desquamative duct epithelial cells, neutrophils, lymphocytes, and acidophils. Also, some epithelial cells were found in two microliths.
Sialoendoscopy can provide direct and more detailed observation of the ductal system compared with sialography. Fiber-like substances in the lumen of the ductal system are considered one of the obstructive factors associated with chronic obstructive parotitis.
目的/假设：研究慢性阻塞性腮腺炎中与唾液腺内镜及冲洗液检查结果相关的涎腺造影改变。
根据既往研究对涎腺造影改变进行分类，并与唾液腺内镜及冲洗液检查结果相关联。
本研究纳入26例有腮腺肿胀病史的患者。所有患者均行X线摄影和涎腺造影检查，诊断为无涎石病的慢性阻塞性腮腺炎。采用唾液腺内镜观察导管系统并进行冲洗治疗。将冲洗液离心，对液体沉淀物进行染色并使用光学显微镜观察。
所有病例中，唾液腺内镜检查显示导管系统充满纤维样物质且导管壁充血。在涎腺造影I型和II型改变的慢性阻塞性腮腺炎患者中虽发现少数细短纤维样物质，但在涎腺造影III型和IV型改变的慢性阻塞性腮腺炎患者中发现许多粗大且长的絮状或块状纤维样物质。在2例涎腺造影III型改变的慢性阻塞性腮腺炎患者中发现微结石，通过光学显微镜进行染色和鉴定。冲洗液检查显示纤维样物质由脱落的导管上皮细胞、中性粒细胞、淋巴细胞和嗜酸粒细胞组成。在2个微结石中也发现了一些上皮细胞。
与涎腺造影相比，唾液腺内镜可对导管系统进行更直接、更详细的观察。导管系统管腔内的纤维样物质被认为是与慢性阻塞性腮腺炎相关的阻塞因素之一。
