Su Chin-Hui, Lee Kuo-Sheng, Tseng Te-Ming, Hung Shih-Han
Department of Otorhinolaryngology, Mackay Memorial Hospital, New Taipei City, Taiwan.
Department of Otolaryngology, School of Medicine, Taipei Medical University, Taipei, Taiwan.
Eur Arch Otorhinolaryngol. 2016 Jan;273(1):189-95. doi: 10.1007/s00405-015-3500-5. Epub 2015 Jan 8.
With damage to a duct or papilla after sialendoscopy, a stent may be necessary to prevent re-stenosis and for maintaining the salivary duct open after complete sialendoscopy. However factors affecting outcomes and complications after stent placement remain unclear. This study aimed to report preliminary experiences in salivary duct stent placement after sialendoscopy. Data from 35 procedures in 33 patients who received sialendoscopy with salivary duct stent placements at Mackay Memorial Hospital between October 2013 and June 2014 were recorded and compared for clinical data, as well as procedural techniques, findings, and outcomes. In the 35 stent placement procedures, the hypospadias silastic stent tubes were used in 27 and the Fr. 5 pediatric feeding tubes were used in the remaining eight. When the hypospadias silastic stent tubes were used for stenting, the stent obstruction and irritation rates were higher compared to those who used the Fr. 5 pediatric feeding tube (100 vs. 0 % and 67 vs. 33 %, respectively). None of the stents secured by a 5-0 nylon suture were complicated by dislocation but when the stents were secured by 6-0 nylon sutures, the dislocation rate went as high as 47.4 %. The duration needed for salivary duct stent placement might be potentially shortened to only 2 weeks. If a salivary duct stent is intended to be placed for a certain period before its scheduled removal, a suture strength equivalent or stronger than the 5-0 nylon suture should be considered for stent fixation.
在唾液腺内镜检查后若导管或乳头受损，可能需要放置支架以预防再狭窄，并在唾液腺内镜检查完成后保持唾液导管通畅。然而，影响支架置入后结局和并发症的因素仍不明确。本研究旨在报告唾液腺内镜检查后唾液导管支架置入的初步经验。记录并比较了2013年10月至2014年6月在马偕纪念医院接受唾液腺内镜检查并放置唾液导管支架的33例患者35次手术的临床数据、操作技术、检查结果和结局。在35次支架置入手术中，27次使用了尿道下裂硅橡胶支架管，其余8次使用了5号法国小儿喂食管。与使用5号法国小儿喂食管的患者相比，使用尿道下裂硅橡胶支架管进行支架置入时，支架阻塞率和刺激率更高（分别为100%对0%和67%对33%）。用5-0尼龙缝线固定的支架均未出现脱位并发症，但用6-0尼龙缝线固定支架时，脱位率高达47.4%。唾液导管支架置入所需时间可能可潜在缩短至仅2周。如果打算在预定取出前一段时间放置唾液导管支架，则应考虑使用强度等同于或强于5-0尼龙缝线的缝线进行支架固定。
