Nahlieli Oded, Shacham Rachel, Zaguri Ami
Department of Oral and Maxillofacial Surgery, Barzilai Medical, Center, Ashkelon, Israel.
J Oral Maxillofac Surg. 2010 Feb;68(2):347-53. doi: 10.1016/j.joms.2009.09.041.
To assess a combined external lithotripsy-sialoendoscopy method developed for advanced salivary gland sialolithiasis.
A total of 94 patients (43 males and 51 females) underwent these treatment methods. Of these 94 patients, 60 had pathologic features in the submandibular gland and 34 in the parotid gland. A miniature external lithotripter was used, combined with multifunctional sialoendoscopes and endoscopic-assisted techniques, to achieve effective removal/elimination of the stones in these difficult cases.
Total elimination of the stone using lithotripsy alone was achieved in 32% of the cases; in 29%, intraductal endoscopic assistance was needed. In the remaining 39%, the removal of a stone was achieved with the help of an endoscopy-assisted extraductal approach (37 cases). At 6 months of follow-up, all patients who had undergone lithotripsy or lithotripsy plus intraductal endoscopy had an absence of symptoms. Of the 37 patients who had undergone an endoscopy-assisted extraductal approach, 35 (95%) remained asymptomatic.
Lithotripsy plus intraductal or extraductal endoscopic treatment of sialolithiasis is a highly effective surgical method of eliminating/removing salivary stones, especially those attached to the surrounding tissue and in the secondary ducts. This method helps to avoid resection of the salivary glands and represents an additional development of minimal invasive surgical techniques.
评估一种为晚期涎腺涎石病开发的体外碎石术联合唾液腺内镜检查方法。
共有94例患者（43例男性和51例女性）接受了这些治疗方法。在这94例患者中，60例下颌下腺有病理特征，34例腮腺有病理特征。使用微型体外碎石机，结合多功能唾液腺内镜和内镜辅助技术，以有效清除这些疑难病例中的结石。
32%的病例仅通过碎石术实现了结石的完全清除；29%的病例需要导管内内镜辅助。在其余39%的病例中，通过内镜辅助导管外途径（37例）实现了结石清除。在随访6个月时，所有接受碎石术或碎石术加导管内内镜检查的患者均无症状。在37例接受内镜辅助导管外途径的患者中，35例（95%）仍无症状。
涎石病的碎石术联合导管内或导管外内镜治疗是一种高效的清除唾液腺结石的手术方法，尤其是那些附着于周围组织和位于二级导管的结石。该方法有助于避免切除唾液腺，代表了微创外科技术的进一步发展。
