Liu Deng-Gao, Jiang Lan, Xie Xiao-Yan, Zhang Zu-Yan, Zhang Lei, Yu Guang-Yan
Department of Oral Radiology, Peking University School and Hospital of Stomatology, Beijing, China.
J Oral Maxillofac Surg. 2013 Feb;71(2):295-301. doi: 10.1016/j.joms.2012.02.016. Epub 2012 Apr 20.
To assess the clinical effects of endoscopy-assisted sialolithectomy for submandibular hilar calculi.
The present study was undertaken in 70 patients with symptomatic stones in the hilum of submandibular glands who underwent endoscopy-assisted sialolithectomy from December 2005 through March 2011 in the Peking University School and Hospital of Stomatology. The operative data were analyzed retrospectively. All patients were followed periodically postoperatively. Submandibular gland function was investigated by postoperative symptoms, clinical examinations, sialography, and scintigraphy.
Submandibular stones were successfully removed in 65 patients, with a success rate of 92.9%. Temporary lingual nerve injury occurred in 1 patient. Two patients developed ranulae and underwent an uneventful sublingual gland excision. During a mean follow-up of 23 months (range, 6 to 55 mo), 52 of 65 patients were symptom free, whereas 11 patients complained of occasional swelling of the affected gland at mealtimes and 2 patients developed a recurrent stone. Thirty patients underwent postoperative sialography. The sialographic appearances included 4 types: 1) approximately normal; 2) the main duct was significantly dilated at the hilum, but no persistent contrast was seen on the functional film; 3) the main duct was significantly dilated in the hilar region, and persistent contrast was seen at the dilated hilum of the functional film; 4) the main duct was dilated or strictured, and persistent contrast was seen on the functional film. Three of the 4 patients who underwent scintigraphy exhibited good function.
Sialoendoscopy-assisted sialolithectomy is a safe and effective gland-preservation technique for patients with hilar stones of the Wharton's duct.
评估内镜辅助下涎石切除术治疗下颌下腺门部结石的临床效果。
本研究纳入了70例有症状的下颌下腺门部结石患者，这些患者于2005年12月至2011年3月在北京大学口腔医学院及口腔医院接受了内镜辅助下涎石切除术。对手术数据进行回顾性分析。所有患者术后定期随访。通过术后症状、临床检查、涎腺造影和闪烁扫描术来研究下颌下腺功能。
65例患者成功取出下颌下腺结石，成功率为92.9%。1例患者出现暂时性舌神经损伤。2例患者发生舌下囊肿，并顺利接受了舌下腺切除术。在平均23个月（范围6至55个月）的随访期间，65例患者中有52例无症状，而11例患者抱怨在进餐时患侧腺体偶尔肿胀，2例患者出现复发性结石。30例患者接受了术后涎腺造影。涎腺造影表现包括4种类型：1）大致正常；2）主导管在门部明显扩张，但功能片上未见造影剂滞留；3）主导管在门部区域明显扩张，功能片上在扩张的门部可见造影剂滞留；4）主导管扩张或狭窄，功能片上可见造影剂滞留。4例接受闪烁扫描术的患者中有3例功能良好。
涎腺内镜辅助下涎石切除术对于沃顿管门部结石患者是一种安全有效的保留腺体技术。
