Baek Chung-Hwan, Jeong Han-Sin
Department of Otolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Am J Otolaryngol. 2006 Sep-Oct;27(5):306-9. doi: 10.1016/j.amjoto.2005.11.018.
Although submandibular sialadenectomy with a minimal incision improves overall cosmetic outcomes, visualization of the surgical field exposure is relatively limited as compared with that in the conventional procedure. To overcome this limitation, we applied the endoscope system to submandibular sialadenectomy. The aim of this study was to evaluate the technical feasibility and potential role of our endoscope-assisted submandibular sialadenectomy (EASS).
We performed EASS on 5 patients, 3 of whom had intraparenchymal sialolithiasis and 2 of whom had pleomorphic adenomas. The dissection was carried out by bipolar dissection with a 4-mm nasal endoscope system.
The procedure achieved successful results for all 5 patients except for 1 who had severe adhesion to the adjacent tissues; this patient suffered from postoperative lingual nerve paresthesia. All the patients achieved good cosmetic outcomes.
An EASS with bipolar dissection is technically feasible and secures a better surgical view through a minimal incision. However, for patients with severe adhesion to the adjacent tissues, conversion to the wide-open procedure would be safer.
尽管采用最小切口的下颌下腺切除术可改善整体美容效果，但与传统手术相比，手术视野暴露的可视化程度相对有限。为克服这一局限性，我们将内镜系统应用于下颌下腺切除术。本研究的目的是评估我们的内镜辅助下颌下腺切除术（EASS）的技术可行性及潜在作用。
我们对5例患者实施了EASS，其中3例患有腺实质内涎石病，2例患有多形性腺瘤。采用4毫米鼻内镜系统通过双极电凝进行解剖。
除1例与相邻组织严重粘连的患者外，其余5例手术均成功；该患者术后出现舌神经感觉异常。所有患者均获得了良好的美容效果。
采用双极电凝的EASS在技术上是可行的，并且通过最小切口可获得更好的手术视野。然而，对于与相邻组织严重粘连的患者，转为开放式手术会更安全。
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