Capaccio Pasquale, Gaini Lorenzo Maria, Pagani Davide, Sambataro Giuseppe, Pignataro Lorenzo
Department of Otorhinolaryngological and Ophthalmological Sciences, Fondazione Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena IRCCS, University of Milan, 20122 Milano, Italy.
J Pediatr Surg. 2007 Sep;42(9):E5-7. doi: 10.1016/j.jpedsurg.2007.06.006.
Atresia of the submandibular ducts (particularly the duct orifice) is a rare occurrence that is mainly observed in newborns or infants; moreover, its differential diagnosis with other anomalies of the oral floor is sometimes difficult. Given the lack of data concerning the differences between atresia of the orifice of Wharton's duct and other anomalies of the submandibular duct system, we describe here the findings of videosialoendoscopic assessment of the salivary duct system in an infant who underwent traditional surgery for bilateral atresia of the orifice of Wharton's duct. During sialoendoscopy, a trifurcation of the main duct, a normal variant of the more common bifurcation of the secondary branches of the salivary duct system, was observed bilaterally. No other ductal anomalies were encountered. Complete resolution of the symptoms and complete patency of both ducts at 19-month follow-up evaluation were observed. In conclusion, although spontaneous resolution of the disease during feeding is possible, minimal incision of the orifice of the imperforated submandibular duct together with diagnostic videosialoendoscopy of the main salivary duct system may be considered as part of the modern approach to salivary obstructive disorders in pediatric age as is currently the case for sialolithiasis and recurrent juvenile parotitis.
下颌下腺导管闭锁（尤其是导管开口处）是一种罕见情况，主要见于新生儿或婴儿；此外，它与口腔底部的其他异常情况进行鉴别诊断有时存在困难。鉴于缺乏关于沃顿管开口处闭锁与下颌下腺导管系统其他异常之间差异的数据，我们在此描述了一名因双侧沃顿管开口处闭锁接受传统手术的婴儿唾液导管系统的视频唾液内镜评估结果。在唾液内镜检查期间，双侧均观察到主导管的三叉分支，这是唾液导管系统较常见的二级分支二分法的一种正常变异。未发现其他导管异常。在19个月的随访评估中观察到症状完全缓解且两条导管均完全通畅。总之，尽管在喂养过程中疾病有可能自行缓解，但对于小儿唾液阻塞性疾病的现代治疗方法，可考虑对未穿孔的下颌下腺导管开口进行最小切口并同时对主要唾液导管系统进行诊断性视频唾液内镜检查，目前涎石病和复发性青少年腮腺炎的治疗就是如此。
