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唾液腺内镜技术在儿童复发性腮腺炎治疗中的应用

Sialendoscopic Approach in Management of Juvenile Recurrent Parotitis.

作者信息

Singh P P, Goyal M, Goyal A

机构信息

Department of Otorhinolaryngology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2017 Dec;69(4):453-458. doi: 10.1007/s12070-017-1223-1. Epub 2017 Oct 16.

Abstract

UNLABELLED

To assess the role of sialendoscopy as a diagnostic and therapeutic modality in juvenile recurrent parotitis. Juvenile recurrent parotitis (JRP) is the second most frequent salivary gland disease in childhood and is characterized by recurrent non suppurative and non obstructive parotid inflammation. These attacks influence the quality of life and can even lead to gland destruction, and there are no definitive treatment to avoid them. Sialendoscopic dilatation is emerging as the new treatment modality in this aspect.

STUDY DESIGN

retrospective study.

STUDY SETTING

Department of Otorhinolaryngology in tertiary care hospital. 17 cases of juvenile recurrent parotitis (i.e. children of age group 3-11 years presenting with complaints of recurrent parotid region swelling and pain, sometimes associated with fever) were included in the study during October 2012-September 2015. All cases underwent sialendoscopy under general anaesthesia. Diagnostic (classifying the ductal lesion) and interventional sialendoscopic procedure (dilatation with instillation of steroid) were carried out in single sitting. Follow up was done for a minimum of 6 months (range 6-36 months). 17 patients with mean age of 5.6 years and gender distribution of 47:53 (boys:girls) underwent sialendoscopy for JRP. 8 patients presented with unilateral parotitis and 9 with bilateral. The mean number of attacks in previous 1 year were 9.2. Average time for procedure was 20 min. All cases had ductal stenosis and ductal mucosa was pale in 15 cases on endoscopy. 1 patient underwent repeat endoscopy after 2 years. 50% had complete resolution of symptoms and 6 patients had one mild (swelling not associated with fever which subsided on its own) attack after treatment. Follow up period ranged from 6 months to 3 years. No complications were observed. Sialendoscopy has emerged as a viable option for assessment and treatment of JRP. Dilatation of the parotid duct and steroid instillation has significantly reduced the morbidity of this condition.

摘要

未标注

评估涎腺内镜检查在儿童复发性腮腺炎中的诊断和治疗作用。儿童复发性腮腺炎(JRP)是儿童期第二常见的涎腺疾病,其特征为腮腺反复出现非化脓性、非阻塞性炎症。这些发作影响生活质量,甚至可能导致腺体破坏,且尚无明确的治疗方法来避免发作。涎腺内镜扩张术正成为这方面的新治疗方式。

研究设计

回顾性研究。

研究地点

三级护理医院的耳鼻喉科。2012年10月至2015年9月期间,17例儿童复发性腮腺炎患者(即年龄在3至11岁,主诉腮腺区反复肿胀、疼痛,有时伴有发热的儿童)被纳入研究。所有病例均在全身麻醉下接受涎腺内镜检查。诊断性(对导管病变进行分类)和介入性涎腺内镜操作(扩张并注入类固醇)在一次就诊时完成。随访至少6个月(范围为6至36个月)。17例平均年龄为5.6岁、性别分布为47:53(男:女)的患者因JRP接受了涎腺内镜检查。8例为单侧腮腺炎,9例为双侧。过去1年的平均发作次数为9.2次。手术平均时间为20分钟。所有病例均有导管狭窄,内镜检查发现15例导管黏膜苍白。1例患者在2年后接受了再次内镜检查。50%的患者症状完全缓解,6例患者在治疗后有1次轻度发作(肿胀但不伴有发热,可自行消退)。随访期为6个月至3年。未观察到并发症。涎腺内镜检查已成为评估和治疗JRP的可行选择。腮腺导管扩张和类固醇注入显著降低了该病的发病率。

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Arch Otolaryngol Head Neck Surg. 2008 Jul;134(7):715-9. doi: 10.1001/archotol.134.7.715.
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Association between the occurrence of matrix metalloproteinases 2 and 9 in parotid saliva with the degree of parotid gland damage in juvenile recurrent parotitis.
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