Torroni Andrea A, Mustazza Maria Cristina, Bartoli Davina D, Iannetti Giorgio G
Department of Maxillo Facial Surgery, University of Rome La Sapienza, Rome, Italy.
J Craniofac Surg. 2007 May;18(3):613-21. doi: 10.1097/01.scs.0000249352.43849.04.
The submandibular glands are subject to several pathologies that require excision. The most common problem that affects these salivary glands is sialadenitis combined with sialolithiasis. This problem occurs in the submandibular gland 10 times more frequently than it does in the parotid gland. Other illnesses frequently involving the submandibular glands are represented by sialadenosis and benign, malign, and intermediate neoplasms. Diagnosis of any disturbance in the submandibular gland involves both a clinical and instrumental (echography, traditional radiography [ortopantomography] and eventually computed tomography (CT) or magnetic resonance imaging) assessment. Surgery is the usual method of treatment of both chronic sialadenitis and neoplasms in the submandibular gland. A submandibular gland surgical approach can be cervical, intraoral, or endoscopic. The authors present their clinical experience with a total of 40 patients with illnesses involving the submandibular gland treated with submandibular gland excision by a transcervical approach. Their experience suggests that this approach entails a relatively simple procedure, involves low risks for the nerve structure around the gland, permits wide resection margins for neoplasms, and incurs little aesthetic damage.
下颌下腺易患多种需要切除的病变。影响这些唾液腺的最常见问题是涎腺炎合并涎石病。这个问题在下颌下腺的发生频率比在腮腺高10倍。其他经常累及下颌下腺的疾病包括涎腺肿大以及良性、恶性和中间性肿瘤。下颌下腺任何病变的诊断都需要临床和仪器检查(超声、传统放射摄影[全景体层摄影术],最终可能还需要计算机断层扫描[CT]或磁共振成像)评估。手术是治疗下颌下腺慢性涎腺炎和肿瘤的常用方法。下颌下腺手术入路可以是颈部、口内或内镜入路。作者介绍了他们对40例下颌下腺疾病患者采用经颈部入路切除下颌下腺的临床经验。他们的经验表明,这种入路手术操作相对简单,对腺体周围神经结构的风险较低,允许对肿瘤进行广泛的切除边缘,并且造成的美学损伤较小。