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大唾液腺肿胀原因不明病例的唾液腺造影检查

Sialoscopy in cases of unclear swelling of the major salivary glands.

作者信息

Koch Michael, Zenk Johannes, Bozzato Alessandro, Bumm Klaus, Iro Heinrich

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, Friedrich-Alexander-University, Erlangen-Nuremberg, Germany.

出版信息

Otolaryngol Head Neck Surg. 2005 Dec;133(6):863-8. doi: 10.1016/j.otohns.2005.08.005.

Abstract

OBJECTIVE

Sialoscopy has developed into an important diagnostic and therapeutic tool for diseases of the major salivary glands.

STUDY DESIGN AND SETTING

We evaluated 103 patients with chronic swelling of the major salivary glands. Routine diagnostic measures revealed no clear diagnosis. The findings of 109 sialoscopies are described. A semi-rigid endoscope (with a diameter of 1.1 mm and 2 integrated working channels) was used for sialoscopy, 51.5% of the cases in Warthon's duct and 48.5% in Stensen's duct.

RESULTS

Pathologic findings resulted in 83.0% of the submandibular and in 96% of the parotid ducts. Obstruction neither due to sialolithiasis nor stenosis was observed in 56.3%, whereas sialolithiasis was observed in 20.3% of the patients. In 36 (35%) patients, an interventional sialoscopy was performed.

CONCLUSIONS

In cases of invisible salivary duct obstruction, especially in those with low mineralized calculi, strictures, stenoses, or postinflammatory changes, sialoscopy gives immediate and direct information about causal pathologies. Moreover, further therapy can be planned within the same procedure.

摘要

目的

唾液腺内镜检查已发展成为诊断和治疗大唾液腺疾病的重要工具。

研究设计与背景

我们评估了103例大唾液腺慢性肿胀患者。常规诊断措施未明确诊断。描述了109例唾液腺内镜检查的结果。使用半刚性内镜(直径1.1mm,有2个集成工作通道)进行唾液腺内镜检查,51.5%的病例在沃顿管,48.5%在腮腺导管。

结果

病理检查结果显示,下颌下腺导管占83.0%,腮腺导管占96%。56.3%未观察到因涎石病或狭窄导致的梗阻,而20.3%的患者观察到涎石病。36例(35%)患者进行了介入性唾液腺内镜检查。

结论

在唾液腺导管隐匿性梗阻的病例中,尤其是那些有低矿化结石、狭窄、缩窄或炎症后改变的病例,唾液腺内镜检查能直接提供有关病因病理的即时信息。此外,可在同一操作过程中规划进一步的治疗。

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