Delagnes Elise A, Zheng Melissa, Aubin-Pouliot Annick, Chang Jolie L, Ryan William R
School of Medicine, University of California-San Francisco, San Francisco, California, U.S.A.
Department of Otolaryngology-Head and Neck Surgery, Salivary Gland Surgery Center, University of California-San Francisco, San Francisco, California, U.S.A.
Laryngoscope. 2017 Dec;127(12):2770-2776. doi: 10.1002/lary.26665. Epub 2017 Jul 17.
To prospectively assess short-term symptom change after sialendoscopy-assisted salivary duct surgery (SASDS) for salivary duct stenosis.
Prospective cohort study.
Patients with obstructive sialadenitis from duct stenosis completed the 20-item Chronic Obstructive Sialadenitis Symptoms (COSS) Questionnaire (scored 0-100) prior to SASDS and 3 months postoperatively.
Thirty glands in 19 patients with endoscopically confirmed salivary duct stenosis showed overall symptom improvement, with a mean COSS score reduction of 12.9 points (standard deviation [SD] 13.1) to a mean postoperative score of 25.1 (range 0-75.5) (P < 0.001) with six (20%) glands (5 patients) achieving complete symptom resolution. Symptoms improved significantly for parotid glands (n = 20) by 16.6 points (SD 15.9) (P < 0.0001). For distal duct stenoses (n = 25), significant symptom improvement was seen in cases treated with dilation only (n = 17; partial stenoses) with a mean 20.6 point COSS reduction (SD 19.0) (P < 0.0005) and in cases treated with sialodochoplasty (n = 5; 4 complete, 1 partial stenosis) with a mean 13.8 point reduction (SD 4.7) (P < 0.005). Symptom scores did not improve after SASDS in proximal stenoses (n = 3) and distal stenoses cases not amenable to treatment (n = 3).
SASDS for salivary duct stenosis often can improve obstructive salivary symptoms; however, many patients report persistent symptoms after surgery. Partial duct stenoses or distal duct stenoses are associated with the greatest improvements in COSS scores after SASDS.
前瞻性评估涎腺内镜辅助涎腺导管手术（SASDS）治疗涎腺导管狭窄后短期症状的变化。
前瞻性队列研究。
因导管狭窄导致阻塞性涎腺炎的患者在SASDS术前及术后3个月完成20项慢性阻塞性涎腺炎症状（COSS）问卷（评分0 - 100）。
19例经内镜确诊涎腺导管狭窄患者的30个腺体总体症状改善，COSS评分平均降低12.9分（标准差[SD]13.1），术后平均评分为25.1分（范围0 - 75.5）（P < 0.001），其中6个（20%）腺体（5例患者）症状完全缓解。腮腺（n = 20）症状显著改善，改善16.6分（SD 15.9）（P < 0.0001）。对于远端导管狭窄（n = 25），仅行扩张治疗的病例（n = 17；部分狭窄）COSS评分平均降低20.6分（SD 19.0）（P < 0.0005），行涎腺导管成形术的病例（n = 5；4例完全狭窄，1例部分狭窄）COSS评分平均降低13.8分（SD 4.7）（P < 0.005），症状有显著改善。SASDS术后近端狭窄（n = 3）及无法治疗的远端狭窄病例（n = 3）症状评分未改善。
SASDS治疗涎腺导管狭窄通常可改善阻塞性涎腺症状；然而许多患者术后仍有持续症状。部分导管狭窄或远端导管狭窄在SASDS后COSS评分改善最大。
4。《喉镜》，127:2770 - 2776，2017年。
