Pace Christopher G, Hwang Kyung-Gyun, Papadaki Maria E, Troulis Maria J
Instructor, Department of Oral and Maxillofacial Surgery; and AO/Synthes Fellow, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, MA.
Professor, Division of Oral and Maxillofacial Surgery, Department of Dentistry, Hanyang University College of Medicine, Seoul, South Korea.
J Oral Maxillofac Surg. 2015 Sep;73(9):1748-52. doi: 10.1016/j.joms.2015.03.012. Epub 2015 Mar 18.
The aim of the present study was to evaluate the effectiveness of interventional sialendoscopy in the management of non-stone obstructive sialadenitis.
In the present retrospective study, we assessed the treatment outcomes of 51 patients (34 women and 17 men) who had been diagnosed with sialadenitis without salivary duct stones. The included patients had an obstructive duct condition coupled with recurrent episodes of swelling or pain in a major salivary gland. The patients who had a sialolith detected during the sialendoscopic procedure or by preoperative imaging were excluded from the present study. The outcomes assessment was based on successful removal of the obstructive etiology during the endoscopic procedure and the absence of clinical symptoms after 6 months. The involved glands included 16 submandibular glands and 35 parotid glands.
The sialendoscopic navigation was successful in 43 of 51 patients (84%). Of the 43 patients, 37 (86%) were free of symptoms from the obstructive gland after the endoscopic procedure. Of the 6 patients who were still symptomatic after the procedure, 5 had involvement of the parotid gland. Finally, 1 of the original 37 symptom-free patients developed recurrent symptoms and denied additional treatment, resulting in 36 of 43 patients (84%) remaining asymptomatic 6 months after endoscopic navigation.
The outcomes of the present study suggest that interventional sialendoscopy can provide symptomatic improvement in most subjects. Clinicians should consider sialendoscopy as a useful and minimally invasive procedure to treat sialadenitis without sialolithiasis.
本研究旨在评估介入性涎腺内镜检查在非结石性阻塞性涎腺炎治疗中的有效性。
在本回顾性研究中，我们评估了51例（34例女性和17例男性）被诊断为无涎腺导管结石的涎腺炎患者的治疗结果。纳入的患者存在导管阻塞情况，并伴有主要涎腺反复肿胀或疼痛发作。在涎腺内镜检查过程中或术前影像学检查中发现有涎石病的患者被排除在本研究之外。结果评估基于内镜检查过程中成功去除阻塞病因以及6个月后无临床症状。受累腺体包括16例下颌下腺和35例腮腺。
51例患者中有43例（84%）涎腺内镜导航成功。在这43例患者中，37例（86%）在内镜检查后阻塞腺体无症状。在术后仍有症状的6例患者中，5例累及腮腺。最后，最初37例无症状患者中有1例出现复发症状且拒绝进一步治疗，导致43例患者中有36例（84%）在内镜导航6个月后仍无症状。
本研究结果表明，介入性涎腺内镜检查可使大多数患者症状改善。临床医生应将涎腺内镜检查视为治疗无涎石病涎腺炎的一种有用且微创的方法。
