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内镜辅助保留腺体治疗腮腺涎石病:我们的初步经验。

Endoscopic-assisted gland preserving therapy for the management of parotid gland sialolithiasis: Our preliminary experience.

作者信息

Zheng LingYan, Xie LiSong, Wang ZhiJun, Shi Huan, Cao NingNing, Yu ChuangQi

机构信息

Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.

Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.

出版信息

J Craniomaxillofac Surg. 2015 Oct;43(8):1650-4. doi: 10.1016/j.jcms.2015.07.016. Epub 2015 Jul 29.

Abstract

OBJECTIVE

To analyze the efficacy and safety of sialendoscopy and a combined transoral or transcutaneous and sialendoscopic approach in the removal of parotid gland sialoliths.

METHODS

This retrospective study included 29 patients diagnosed with parotid gland sialolithiasis who required endoscopic-assisted gland preserving therapy. Ultrasonography and computed tomography were used to diagnose parotid sialolithiasis. The use of interventional sialendoscopy, sialendoscopic-transoral, or sialendoscopic-transcutaneous procedures was determined by the characteristics of the parotid gland stones.

RESULTS

The stones were extracted by interventional sialendoscopy in nine patients. The transoral procedure was performed in 15 patients with large stones which were impacted in the ductal wall. The remaining five patients were managed through an external approach via a local incision under sialendoscopy. No postoperative complications occurred. The parotid glands were functioning normally after the procedures.

CONCLUSION

The combined sialendoscopic-transoral and sialendoscopic-transcutaneous operation appears to be a good alternative for parotid gland sialolithiasis in the absence of lithotripsy devices. This type of therapy can, therefore, decrease the rate of parotidectomy.

摘要

目的

分析唾液腺内镜检查以及经口或经皮联合唾液腺内镜检查方法在摘除腮腺涎石中的疗效及安全性。

方法

这项回顾性研究纳入了29例被诊断为腮腺涎石病且需要内镜辅助保腺治疗的患者。采用超声检查和计算机断层扫描来诊断腮腺涎石病。根据腮腺结石的特征决定采用介入性唾液腺内镜检查、经口唾液腺内镜检查或经皮唾液腺内镜检查。

结果

9例患者通过介入性唾液腺内镜检查取出结石。15例结石较大且嵌顿于导管壁的患者接受了经口手术。其余5例患者在唾液腺内镜检查下通过局部切口经外部途径进行治疗。术后未发生并发症。术后腮腺功能正常。

结论

在没有碎石设备的情况下,经口联合经皮唾液腺内镜手术似乎是腮腺涎石病的一种良好替代方法。因此,这种治疗方式可以降低腮腺切除术的发生率。

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