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儿童唾液腺内镜检查

Sialendoscopy in children.

作者信息

Jabbour Noel, Tibesar Robert, Lander Timothy, Sidman James

机构信息

Otolaryngology Department, University of Minnesota, Minneapolis, MN, USA.

出版信息

Int J Pediatr Otorhinolaryngol. 2010 Apr;74(4):347-50. doi: 10.1016/j.ijporl.2009.12.013. Epub 2010 Feb 8.

Abstract

BACKGROUND

The definitive cause of most cases of recurrent salivary gland inflammation in children remains unknown. Relatively little has been written about the use of sialendoscopy as a diagnostic and therapeutic tool in children.

OBJECTIVE

To evaluate the safety and efficacy of sialendoscopy as a diagnostic and therapeutic tool for recurrent salivary gland inflammation in children.

STUDY DESIGN

Retrospective case series.

METHODS

Medical records of all patients who underwent sialendoscopy for recurrent salivary gland inflammation from a single tertiary-care pediatric otolaryngology practice were reviewed. Comparison of pre-procedure vs. post-procedure frequency and severity of disease was reviewed. Operative reports, images, and video were analyzed for causes of inflammation.

RESULTS

Six patients (aged 3-16 years old) underwent sialendoscopy (3/6 bilateral parotid, 2/6 unilateral parotid, 1/6 unilateral submandibular). There were no complications. No post-operative recurrence was noted in 3/6 patients; decreased frequency of recurrence was noted in 2/6 patients; repeat sialendoscopy was required in 1/6. Operative findings from sialendoscopy from 10 parotid glands showed fibrinous debris (7/10), mucoid debris (1/10), purulent debris (1/10), or duct stenosis (1/10). No stones were noted.

CONCLUSIONS

Sialendoscopy is a safe, minimally invasive procedure that may decrease the frequency of recurrences for salivary gland inflammation in children. In contrast to previously published work, the most common cause of salivary gland obstruction in this series was debris, rather than stones. Increased use of sialendoscopy as a diagnostic and therapeutic tool will allow for improved understanding of the causes of and management for recurrent salivary gland inflammation in children.

摘要

背景

儿童复发性唾液腺炎大多数病例的确切病因仍不清楚。关于涎腺内镜检查作为儿童诊断和治疗工具的应用,相关文献相对较少。

目的

评估涎腺内镜检查作为儿童复发性唾液腺炎诊断和治疗工具的安全性和有效性。

研究设计

回顾性病例系列研究。

方法

回顾了一家三级儿科耳鼻喉科诊所所有因复发性唾液腺炎接受涎腺内镜检查的患者的病历。比较术前与术后疾病的发作频率和严重程度。分析手术报告、图像和视频以确定炎症原因。

结果

6例患者(年龄3 - 16岁)接受了涎腺内镜检查(双侧腮腺3例/6例,单侧腮腺2例/6例,单侧下颌下腺1例/6例)。无并发症发生。6例患者中有3例未出现术后复发;2例患者复发频率降低;6例中有1例需要再次进行涎腺内镜检查。对10个腮腺进行涎腺内镜检查的手术结果显示有纤维蛋白碎片(7/10)、黏液样碎片(1/10)、脓性碎片(1/10)或导管狭窄(1/10)。未发现结石。

结论

涎腺内镜检查是一种安全、微创的手术,可能会降低儿童唾液腺炎的复发频率。与先前发表的研究不同,本系列中唾液腺阻塞的最常见原因是碎片,而非结石。增加涎腺内镜检查作为诊断和治疗工具的应用,将有助于更好地理解儿童复发性唾液腺炎的病因及治疗方法。

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