Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.
J Craniomaxillofac Surg. 2013 Oct;41(7):648-51. doi: 10.1016/j.jcms.2013.01.001. Epub 2013 Jan 31.
The purpose of this study was to explore any association between anatomical variances in the ductal system and sialolith formation using sialoendoscopy and acrylic resin replication of the ductal system.
A retrospective study of 372 submandibular gland sialoendoscopies was performed to review the findings of the submandibular gland duct anatomy. Using sialoendoscopy and replicated casts, a high rate of hilar widening was noted in patients with submandibular sialolithiasis.
Sialolithiasis was detected in 326 of the patients who presented with obstructive symptoms. Around 67% (285/426) of the stones were located in the distal third of the ducts or at the hilum of the submandibular gland. During the sialoendoscopic procedure, the anatomy of the ductal system was examined and 285/326 (87.4%) of the hilums were noted to be widened like a basin. The anatomy of the duct from the replicated casts demonstrated a treelike structure and the basin-like widening of the hilum was found in all the excised submandibular glands.
Using sialoendoscopy, a high number of patients presenting with sialolithiasis in the submandibular gland seem to have an anatomical variance in the hilar region. The reproduced ductal system from excised glands also demonstrated this abnormal widening of the hilum. Although further studies need to be performed, we try and explain why there is such a high prevalence of hilar widening in patients with submandibular sialolithiasis.
本研究旨在通过涎腺内镜和导管系统的丙烯酸树脂复制，探讨导管系统的解剖变异与涎石形成之间的任何关联。
对 372 例下颌下腺涎腺内镜检查进行回顾性研究，以回顾下颌下腺导管解剖的发现。使用涎腺内镜和复制模型，在患有下颌下腺涎石症的患者中发现了很高的门部增宽率。
在出现阻塞症状的 326 名患者中检测到涎石症。大约 67%（285/426）的结石位于导管的远三分之一或下颌下腺门部。在涎腺内镜检查过程中，检查了导管系统的解剖结构，发现 326 例中的 285 例（87.4%）门部像盆一样增宽。从复制模型中展示的导管解剖结构呈树状结构，所有切除的下颌下腺中均发现门部呈盆状增宽。
使用涎腺内镜，大量出现下颌下腺涎石症的患者似乎在门部区域存在解剖变异。从切除的腺体中复制的导管系统也显示出这种异常的门部增宽。尽管需要进一步研究，但我们试图解释为什么在患有下颌下腺涎石症的患者中门部增宽如此普遍。
