Li X, Su J Z, Zhang Y Y, Zhang L Q, Zhang Y Q, Liu D G, Yu G Y
Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China.
Department of Oral Radiology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2020 Jun 18;52(3):586-590. doi: 10.19723/j.issn.1671-167X.2020.03.029.
To investigate the inflammation grading of I radioiodine-induced sialadenitis based upon sialoendoscopic and sialographic appearances, and to evaluate the results of sialoendoscopic intervention.
The patients diagnosed with I radioiodine-induced sialadenitis and underwent sialoendoscopic exploration and intervention procedures in Peking University Hospital of Stomatology from Nov. 2012 to Oct. 2018 were included in this study. The appearances of sialogaphy and sialoendoscopy were analyzed and classified. The treatment options included irrigation with saline and dexamethasone and mechanical dilatation by sialoendoscope. The patients were followed up after treatment.
Forty-two patients with I radioiodine-induced sialadenitis were included. There were 5 males and 37 females, with a male-to-female ratio of 1 ∶7.4. Symptoms included recurrent swelling and pain in the parotid glands, and dry mouth. Sialography showed stenosis in the main duct,and in some cases nonvisua-lization of the branches. Sialoendoscopy showed narrowing of the main duct, and the branch duct atresia was seen. The appearances of sialogaphy and sialoendoscopy were analyzed and classified into 3 groups: (1) Mild inflammation: stenosis and ectasia occurred in the main duct, whereas the 0.9 mm sialoendoscope could pass through easily. (2) Moderate inflammation: one point of severe stricture could be seen in the main duct where 0.9 mm sialoendoscope could not be passed through. (3) Severe inflammation: two points or more of severe strictures or diffused strictures occurred in the main duct. Thirty-three patients with 65 affected glands were examined by both sialography and sialoendoscopy. Eight glands were classified as mild inflammation, 23 glands moderate inflammation, and 34 glands severe inflammation. The duration of follow-up ranged from 3-72 months. The clinical results were evaluated as good in 22 glands, fair in 22 glands, and poor in 19 glands, with an overall effective rate of 69.8% (44/63).
The clinical, sialographic and sialoendoscopic appearances of I radioiodine-induced sialadenitis showed their characteristics. We proposed an inflammation grading standard for the I radioiodine-induced sialadenitis based on the appearances of sialography and sialoendoscopy. Sialoendoscopy can significantly alleviate the clinical symptoms, which is an effective therapy, and better for early lesions.
基于唾液腺内镜和唾液腺造影表现研究¹³¹I放射性碘诱发涎腺炎的炎症分级，并评估唾液腺内镜干预的效果。
纳入2012年11月至2018年10月在北京大学口腔医院诊断为¹³¹I放射性碘诱发涎腺炎并接受唾液腺内镜探查及干预操作的患者。分析并分类唾液腺造影和唾液腺内镜的表现。治疗方法包括用生理盐水和地塞米松冲洗以及唾液腺内镜下机械扩张。治疗后对患者进行随访。
纳入42例¹³¹I放射性碘诱发涎腺炎患者。男性5例，女性37例，男女比例为1∶7.4。症状包括腮腺反复肿胀、疼痛及口干。唾液腺造影显示主导管狭窄，部分病例分支不显影。唾液腺内镜显示主导管狭窄，可见分支导管闭锁。分析并将唾液腺造影和唾液腺内镜表现分为3组：（1）轻度炎症：主导管出现狭窄及扩张，0.9mm唾液腺内镜可轻松通过。（2）中度炎症：主导管可见一处严重狭窄，0.9mm唾液腺内镜无法通过。（3）重度炎症：主导管出现两处或更多处严重狭窄或弥漫性狭窄。33例患者65个患腺接受了唾液腺造影和唾液腺内镜检查。8个腺体为轻度炎症，23个腺体为中度炎症，34个腺体为重度炎症。随访时间为3 - 72个月。临床效果评估为22个腺体良好，22个腺体一般，19个腺体较差，总有效率为69.8%（44/63）。
¹³¹I放射性碘诱发涎腺炎的临床、唾液腺造影及唾液腺内镜表现具有特征性。我们基于唾液腺造影和唾液腺内镜表现提出了¹³¹I放射性碘诱发涎腺炎的炎症分级标准。唾液腺内镜可显著缓解临床症状，是一种有效的治疗方法，对早期病变效果更佳。
