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[新版德国医学科学院关于阻塞性涎腺炎治疗的指南(简评版)]

[The new S2k AWMF guideline for the treatment of obstructive sialadenitis in commented short form].

作者信息

Al-Nawas B, Beutner D, Geisthoff U, Naujoks C, Reich R, Schröder U, Sproll C, Teymoortash A, Ußmüller J, Vogl T, Wittekindt C, Zenk J, Guntinas-Lichius O

机构信息

Klinik und Poliklinik für Mund-Kiefer- und Gesichtschirurgie, Plastische Operationen, Universitätsmedizin Mainz, Mainz.

ENT, Head and Neck, University of Cologne, Cologne.

出版信息

Laryngorhinootologie. 2014 Feb;93(2):87-94. doi: 10.1055/s-0033-1351285. Epub 2013 Aug 8.

Abstract

A new and interdisciplinary S2k AWMF guideline for the treatment of obstructive sialadenitis has been published. There have been several technical achievements, for instance in the field of ultrasonography, via sialendoscopy, or by MR-sialography, that have increased the possibilities for diagnosis and treatment of patients with obstructive sialadenitis. In the past, the treatment of choice in case of unsuccessful medical treatment was a complete extirpation of the affected salivary gland. Nowadays, using a variety of modern treatment options (like sialendoscopy, or extracorporeal shock-waves lithotripsy sometimes combined with salivary duct incision), it is possible in most patients, especially in cases of sialolithiasis, to preserve the affected gland. A functional recovery after gland-sparing surgery is described but more data is needed to finally evaluate the long-time results. The new guideline describes all relevant steps to diagnose an obstructive sialadenitis and values all diagnostic tools critically. Finally, all recommendable therapy options are described and valued, too.

摘要

一项全新的跨学科德国医学协会(AWMF)关于阻塞性涎腺炎治疗的S2k指南已发布。在超声检查、涎腺内镜检查或磁共振涎腺造影等领域取得了多项技术成果,这些成果增加了阻塞性涎腺炎患者的诊断和治疗可能性。过去,药物治疗失败时的首选治疗方法是将受影响的涎腺完全摘除。如今,通过多种现代治疗选择(如涎腺内镜检查,或有时结合涎腺导管切开术的体外冲击波碎石术),在大多数患者中,尤其是涎石病患者,有可能保留受影响的腺体。文献中描述了保留腺体手术后的功能恢复情况,但还需要更多数据来最终评估长期效果。新指南描述了诊断阻塞性涎腺炎的所有相关步骤,并对所有诊断工具进行了批判性评估。最后,还描述并评估了所有推荐的治疗方案。

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