Goodstein Lindsay, Galinat Lauren, Curry Joseph, Luginbuhl Adam, Cognetti David
1 Department of Otolaryngology, Head & Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Ann Otol Rhinol Laryngol. 2017 Mar;126(3):216-218. doi: 10.1177/0003489416684846. Epub 2017 Jan 5.
To present a unique series of sublingual gland sialolithiasis treated with sialendoscopy.
A retrospective chart review of patients at a single tertiary care academic center undergoing sialendoscopy.
We present a series of 4 patients who presented with 1 episode each of sialadenitis without preceding postprandial symptoms. In each case, sialendoscopy identified the calculi embedded within the sublingual duct of Bartholin at its emptying point into Wharton's duct. The large size of the stones did not permit endoscopic removal, and transoral excision was performed via a floor of mouth incision. All patients recovered well with resolution of preoperative symptoms.
Sublingual gland sialolithiasis has a distinct presentation that is not associated with obstructive symptoms and may be successfully treated with a combined endoscopic and transoral approach. Sialendoscopy allows identification of the location of the sialolith to guide removal and helps identify stone fragments and additional stones remaining after sialolithotomy. Transoral resection of the sublingual gland in this scenario facilitates stone removal and may minimize long-term chance of ranula formation.
介绍一系列采用唾液腺内镜治疗的舌下腺涎石病病例。
对一家三级医疗学术中心接受唾液腺内镜检查的患者进行回顾性病历审查。
我们报告了4例患者，每位患者均出现1次涎腺炎发作，无先前的餐后症状。在每例病例中，唾液腺内镜检查发现结石嵌顿在巴多林舌下腺导管汇入沃顿管的排空点处。结石体积较大，无法通过内镜取出，遂经口底切口进行经口切除。所有患者恢复良好，术前症状均得到缓解。
舌下腺涎石病有独特的表现，与梗阻症状无关，可通过内镜和经口联合方法成功治疗。唾液腺内镜可确定涎石位置以指导取出，并有助于识别涎石切开术后残留的结石碎片和其他结石。在这种情况下，经口切除舌下腺有助于取出结石，并可将舌下囊肿形成的长期几率降至最低。
