Markiewicz M R, Margarone J E, Tapia J L, Aguirre A
School of Dental Medicine, University at Buffalo, Buffalo, NY, USA.
J Laryngol Otol. 2007 Feb;121(2):182-5. doi: 10.1017/S0022215106003525. Epub 2006 Nov 1.
Treatment of salivary stones includes both surgical and non-surgical techniques. Surgical approaches range from excision of the sialolith, for those near the duct orifice, to removal of the affected salivary gland and its associated duct, for stones near the hilum of the gland. We present a case of two sialoliths triggering an acute infection in a residual Wharton's duct, 12 years after the removal of the associated submandibular gland. Excision of the sialoliths and treatment of the infected duct via sialodochoplasty was successfully performed in this patient. If the Wharton's duct is not removed with the associated submandibular gland, the potential for infection and continuous growth of dormant calcifications exists. We also address the aetiology, pathogenesis, and management of patients with sialolithiasis in the absence of a major salivary gland.
涎石病的治疗包括手术和非手术技术。手术方法多种多样,对于靠近导管口的涎石,可采用涎石切除术;对于靠近腺体门部的结石,则需切除受影响的涎腺及其相关导管。我们报告一例在切除相关下颌下腺12年后,两颗涎石引发残留沃顿管急性感染的病例。该患者成功进行了涎石切除及通过涎管成形术对感染导管的治疗。如果沃顿管未与相关下颌下腺一并切除,就存在感染以及潜伏钙化持续生长的可能性。我们还探讨了无大涎腺情况下涎石病患者的病因、发病机制及治疗方法。