经唾液内镜与不经唾液内镜的下颌下腺结石取出术的结果比较。
Outcomes of Submandibular Stone Removal With and Without Salivary Endoscopes.
机构信息
Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, U.S.A.
出版信息
Laryngoscope. 2022 Apr;132(4):754-760. doi: 10.1002/lary.29815. Epub 2021 Aug 11.
OBJECTIVES/HYPOTHESIS: For patients with submandibular sialolithiasis, there are many gland-preserving treatment options including sialendoscopy. Sialendoscopy, however, requires expensive instrumentation with limited availability, which may not be required for routine cases. The objective of this study is to compare the outcomes of patients with submandibular sialolithiasis undergoing sialendoscopy versus those undergoing transoral incisional sialithotomy.
STUDY DESIGN
Longitudinal, prospective study of patient undergoing gland-preserving therapy for submandibular sialolithiasis.
METHODS
The study was a prospective, nonrandomized trial of 30 patients with submandibular sialolithiasis who received gland-preserving treatment by either sialendoscopy-assisted techniques (Scope group; 14 patients) or transoral sialithotomy with or without dochoplasty (No Scope group; 16 patients). Factors analyzed between the two groups included age, race, gender, size of stone, location of stone, gland(s) involved, surgical method, and modified salivary Oral Health Impact Profile (sOHIP) scores before and after therapy.
RESULTS
There were no significant differences between the Scope and No Scope groups regarding age, race, or gender. There was a significant difference in stone size between the groups, with the No Scope group having larger stones on average. Both treatments led to statistically significant symptomatic improvement in sOHIP scores. There was no statistically significant difference in salivary quality of life improvement between the Scope and No Scope groups (P = .33).
CONCLUSIONS
Sialendoscopy is an important diagnostic and therapeutic tool in the management of salivary disorders, but is not associated with improved outcomes in gland-preserving treatments for routine submandibular sialolithiasis. Transoral stone removal alone may have equivalent symptomatic outcomes in the management of select sialoliths.
LEVEL OF EVIDENCE
3 Laryngoscope, 132:754-760, 2022.
目的/假设：对于下颌下涎石病患者，有许多保留腺体的治疗选择，包括涎腺内镜。然而，涎腺内镜需要昂贵的仪器，且可用性有限，对于常规病例可能不需要。本研究的目的是比较接受涎腺内镜治疗与接受经口切开涎石切除术治疗的下颌下涎石病患者的结果。
研究设计
对接受保留腺体治疗的下颌下涎石病患者进行的纵向前瞻性研究。
方法
该研究是一项前瞻性、非随机试验，纳入了 30 例接受保留腺体治疗的下颌下涎石病患者，他们接受了涎腺内镜辅助技术（Scope 组；14 例）或经口切开涎石切除术联合或不联合窦道成形术（No Scope 组；16 例）治疗。分析两组之间的因素包括年龄、种族、性别、结石大小、结石位置、受累腺体、手术方法以及治疗前后改良唾液口腔健康影响简表（sOHIP）评分。
结果
Scope 组和 No Scope 组在年龄、种族或性别方面无显著差异。两组之间的结石大小存在显著差异，No Scope 组的结石平均较大。两种治疗方法均导致 sOHIP 评分在统计学上显著改善。Scope 组和 No Scope 组之间在唾液生活质量改善方面无统计学差异（P=0.33）。
结论
涎腺内镜是管理唾液腺疾病的重要诊断和治疗工具，但在保留腺体治疗常规下颌下涎石病方面与改善结果无关。单独经口取石可能在处理特定涎石时具有等效的症状改善结果。
证据水平
3 级喉镜，132：754-760，2022 年。
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