ENT Department, K. Marcinkowski Medical University, Przybyszewski Street 49, 60355, Poznan, Poland.
Eur Arch Otorhinolaryngol. 2013 Jan;270(1):219-23. doi: 10.1007/s00405-012-2145-x. Epub 2012 Aug 9.
The introduction of minimally invasive surgical procedures has significantly reduced the rate of major salivary gland removal due to sialolithiasis. The aim of this study is to assess the effectiveness of sialoendoscopy, rate of salivary fistula or natural ostium stenosis in parotid sialolithiasis treatment. The endpoint was to analyse the efficiency of a combined transcutaneous and endoscopic approach in the removal of refractory and impacted stones in most difficult cases.
prospective study, tertiary university centre, between XII 2008 and XI 2011, 185 sialendoscopies (SE) were performed in 162 patients. Within the group of 29 patients with parotid sialolithiasis endoscopy was the definite treatment in 15 cases (53 %), in 9 cases lithotripsy (ESWL) was necessary and in 5 patients who failed SE and lithotripsy, a combined approach was performed. This approach comprised both SE and open surgery. We observed no salivary fistula formation after the incision of the duct. Stenosis of the natural ostium thanks to the insertion of stent was observed only in one case. Sialoendoscopy is the method of choice with a high rate of success and gland preservation in small and medium stones. The combined transcutaneous and endoscopic approach is indicated for large stones, for complications after and contraindications in using minimally invasive procedures. Short and medium term follow up shows that surgery can be performed with a high rate of success.
评估涎腺内镜治疗腮腺涎石病的有效性、涎瘘或自然开口狭窄的发生率。方法：这是一项前瞻性研究，在 2008 年 12 月至 2011 年 11 月期间，在三级大学中心进行，纳入了 162 名患者共 185 例涎腺内镜检查。其中 29 例为腮腺涎石病，内镜检查是 15 例（53%）的明确治疗方法，9 例（31%）需要行体外冲击波碎石术（ESWL），5 例患者经内镜检查和碎石术治疗失败，行联合治疗（内镜检查联合开放手术）。术中切开导管未见涎瘘形成，仅 1 例因支架置入出现自然开口狭窄。结论：涎腺内镜治疗小、中结石成功率高，可保留腺体，是首选方法。对于大结石、微创治疗的并发症或禁忌证，采用经皮内镜联合治疗。短期和中期随访显示，手术成功率高。
