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唾液腺内镜检查:技术回顾与细微差别

Sialoendoscopy: Review and Nuances of Technique.

作者信息

Chandra Srinivasa Rama

机构信息

Division of OMFS, Department of Surgery, Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, 984125, Omaha, Nebraska 68198 USA.

出版信息

J Maxillofac Oral Surg. 2019 Mar;18(1):1-10. doi: 10.1007/s12663-018-1141-0. Epub 2018 Aug 14.

Abstract

INTRODUCTION

Sialoendoscopy is a nuanced technique of transluminal management of obstructive and nonneoplastic pathology of the major salivary glands. Techniques have been refined in the last two decades due to advances in optical and endoscopic instrumentation. This minimally invasive technique has both diagnostic and therapeutic applications. Obstructive salivary gland disease due to mineralized stones causes the majority of salivary duct-related pathology. Mucus plugs and strictures are the other causes. Submandibular gland sialolithiasis comprises the majority of salivary ductal pathology, with less than ten percent of obstructive symptoms related to parotid gland.

OBJECTIVE

The aim of this review is to comprehensively understand the scope of practice, the methodology of management, and the techniques for a successful outcome in sialoendoscopy. Anatomy of the salivary glands and the ductal system is reviewed for a successful outcome. Guidance for patient selection, indications, investigations, and preprocedure preparation for sialoendoscopy are discussed. Algorithms and an instrument checklist are provided in table format in the manuscript for clinical utility.

CONCLUSION

The author simplifies the various systems of sialoendoscopes and the utility of the instruments. The future of transluminal and intraluminal salivary procedures is within the oral and maxillofacial surgical realm with simulators and multidimensional imaging and navigational advances.

摘要

引言

唾液腺内镜检查是一种用于处理大唾液腺阻塞性和非肿瘤性病变的腔内精细技术。由于光学和内镜器械的进步,该技术在过去二十年中得到了改进。这种微创技术具有诊断和治疗应用。由矿化结石引起的阻塞性唾液腺疾病是大多数唾液导管相关病变的原因。黏液栓和狭窄是其他原因。下颌下腺涎石病占唾液导管病变的大多数,与腮腺相关的阻塞性症状不到10%。

目的

本综述的目的是全面了解唾液腺内镜检查的实践范围、管理方法以及实现成功结果的技术。为了获得成功结果,对唾液腺和导管系统的解剖结构进行了回顾。讨论了唾液腺内镜检查的患者选择、适应症、检查和术前准备的指导。手稿中以表格形式提供了算法和器械清单以供临床实用。

结论

作者简化了唾液腺内镜的各种系统及其器械的用途。随着模拟器以及多维成像和导航技术的进步,腔内和管腔内唾液腺手术的未来在于口腔颌面外科领域。

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