Kroll T, Finkensieper M, Hauk H, Guntinas-Lichius O, Wittekindt C
Klinik für Hals-Nasen-Ohrenheilkunde, Kopf-Halschirurgie und plastische Operationen des Universitätsklinikums Giessen & Marburg, Standort Giessen, Justus-Liebig-Universität Giessen, Giessen, Germany.
Laryngorhinootologie. 2012 Sep;91(9):561-5. doi: 10.1055/s-0032-1314880. Epub 2012 Jul 6.
Sialendoscopy is an established, minimal-invasive technique to diagnose and treat obstructive diseases of major salivary glands. Knowledge on learning curve and distribution in Germany is limited. MATERIAL UND METHODS: An 11 item questionnaire on Sialendoscopy was sent to all 159 German ent-hospitals. To determine the learning curve, all patients that underwent sialendoscopy during a 1-year-period after invention of sialendoscopy in our department were prospectively followed and evaluated.
Sialendoscopy is currently performed in a minority (24%) of ent-departments in Germany. Denial was justified by technical problems, a lack of cost-benefit and small number of patients in descending order. A significant reduction of intervention time (61.0 ± 32.7 min to 43.2 ± 33.6 min, p=0.013) and less frequent aborted operations were noted after comparison of the first vs. the second half amount of interventions as indicators of a learning curve. Complications were not found to be significantly raised in the first half of interventions.
The fact that sialendoscopy is provided in only a minority of ent-departments will in the future most likely be overcome by technical improvements. A learning curve has to be anticipated.
唾液腺内镜检查是一种成熟的诊断和治疗大唾液腺阻塞性疾病的微创技术。关于其学习曲线及在德国的开展情况的相关知识有限。
向德国所有159家耳鼻喉科医院发送了一份关于唾液腺内镜检查的11项问卷。为确定学习曲线，对我科开展唾液腺内镜检查后1年内接受该检查的所有患者进行前瞻性随访和评估。
目前德国只有少数（24%）耳鼻喉科科室开展唾液腺内镜检查。拒绝开展的理由按出现频率从高到低依次为技术问题、缺乏成本效益和患者数量少。将首次干预与第二次干预的后半部分进行比较，作为学习曲线的指标，发现干预时间显著缩短（从61.0±32.7分钟降至43.2±33.6分钟，p = 0.013），手术中止的频率也降低。未发现前半部分干预的并发症显著增加。
未来，技术改进很可能会克服唾液腺内镜检查仅在少数耳鼻喉科科室开展的现状。必须预见到存在学习曲线。
