Walvekar Rohan R, Carrau Ricardo L, Schaitkin Barry
Department of Otolaryngology and Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA.
Am J Otolaryngol. 2009 May-Jun;30(3):153-6. doi: 10.1016/j.amjoto.2008.03.007. Epub 2008 Oct 1.
To identify factors that may influence successful retrieval of salivary stones with interventional sialendoscopy.
A retrospective chart review of sialendoscopy procedures performed in the Department of Otolaryngology at the University of Pittsburgh from July 2005 to August 2007 was conducted. We identified thirty consecutive cases of sialolithiasis treated with sialendoscopy.
The mean age at presentation was 45 years (range, 7-77 years) with a male-to-female sex ratio of 1:1.5. The most common presentation was recurrent or persistent salivary gland swelling (53%), followed by salivary gland swelling associated with meals (37%). All these procedures were performed under sedation or general anesthesia. Size of the stones ranged from 0.2 to 1.2 cm. Our success rate for their endoscopic removal was 74% (14/19). Four patients (4/30) required a planned combined technique for stone removal.
Sialendoscopy is a reasonable minimally invasive option to treat sialolithiasis that avoids the need for salivary gland excision. Salivary stones larger than 4 mm for submandibular cases and 3 mm for parotid cases may be amenable to endoscopic removal provided their largest dimension is orientated favorably along the length of the duct.
确定可能影响介入性涎腺内镜成功取出涎石的因素。
对2005年7月至2007年8月在匹兹堡大学耳鼻咽喉科进行的涎腺内镜手术进行回顾性病历审查。我们确定了连续30例接受涎腺内镜治疗的涎石病病例。
就诊时的平均年龄为45岁（范围7 - 77岁），男女比例为1:1.5。最常见的表现是反复或持续性涎腺肿胀（53%），其次是与进食相关的涎腺肿胀（37%）。所有这些手术均在镇静或全身麻醉下进行。结石大小范围为0.2至1.2厘米。我们内镜取出结石的成功率为74%（14/19）。4例患者（4/30）需要采用计划好的联合技术取出结石。
涎腺内镜是治疗涎石病的一种合理的微创选择，可避免涎腺切除。对于下颌下腺病例，大于4毫米的涎石以及对于腮腺病例，大于3毫米的涎石，若其最大直径沿导管长度方向有利地定位，则可能适合内镜取出。
