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介入性涎腺内镜治疗儿童复发性腮腺炎

Interventional sialendoscopy for treatment of juvenile recurrent parotitis.

作者信息

Gary Celeste, Kluka Evelyn A, Schaitkin Barry, Walvekar Rohan R

机构信息

Department of Otolaryngology Head Neck Surgery, LSU Health Sciences Center, New Orleans, LA.

出版信息

J Indian Assoc Pediatr Surg. 2011 Oct;16(4):132-6. doi: 10.4103/0971-9261.86865.

Abstract

OBJECTIVE

To evaluate our preliminary experience with interventional sialendoscopy for the diagnosis and treatment of juvenile recurrent parotitis (JRP).

MATERIALS AND METHODS

Three consecutive pediatric patients with JRP who underwent interventional sialendoscopy were identified. Interventional sialendoscopy consisted of serial dilation of the Stenson's duct, endoscopy of the ductal system and saline irrigation followed by instillation of triamcinolone acetate. Clinical, demographic, procedure-related data and complications were documented. End points of the study were technical success, defined as completion of the procedure, subjective improvement in symptoms as indicated by the patients or their parents and assessment of safety in terms of complications.

RESULTS

Three male patients with a mean age of 9 years (range 6-11 years) underwent interventional sialendoscopy for JRP. Endoscopic findings included a blanched stenotic duct with intraductal debris in those who were symptomatic. Technical success was 100%. The mean number of episodes of JRP in the year prior to presenting to our service among the three patients was 5 (range 4-6 per year). There were no new episodes of JRP reported at the last follow-up. There were no major complications.

CONCLUSION

Our preliminary experience concurs with the current literature and suggests that interventional sialendoscopy is effective for the management of JRP and can be considered for patients who fail conservative medical management.

摘要

目的

评估我们在介入性涎腺内镜检查诊断和治疗青少年复发性腮腺炎(JRP)方面的初步经验。

材料与方法

确定了3例连续接受介入性涎腺内镜检查的JRP儿科患者。介入性涎腺内镜检查包括对斯滕森导管进行连续扩张、对导管系统进行内镜检查和盐水冲洗,随后注入醋酸曲安奈德。记录临床、人口统计学、与手术相关的数据及并发症。研究终点为技术成功,定义为手术完成、患者或其父母表示症状有主观改善以及根据并发症评估安全性。

结果

3例平均年龄9岁(范围6 - 11岁)的男性患者接受了用于JRP的介入性涎腺内镜检查。内镜检查结果显示,有症状患者的导管呈白色狭窄,管腔内有碎屑。技术成功率为100%。这3例患者在到我们科室就诊前一年JRP的平均发作次数为5次(每年范围4 - 6次)。在最后一次随访时未报告有新的JRP发作。无重大并发症。

结论

我们的初步经验与当前文献一致,表明介入性涎腺内镜检查对JRP的治疗有效,对于保守药物治疗无效的患者可考虑采用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2583/3221154/9513ab7f5622/JIAPS-16-132-g001.jpg

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