Ab Rahim Nurul Asma Che, Liew Yew Toong, Ghauth Sakina, Narayanan Prepageran, Abu Bakar Zulkiflee
Jalan Universiti, 50603 Kuala Lumpur, Malaysia Department of Otorhinolaryngology, Faculty of Medicine, University of Malaya.
Indian J Otolaryngol Head Neck Surg. 2023 Jun;75(2):347-351. doi: 10.1007/s12070-022-03261-4. Epub 2022 Nov 7.
The purpose of this study was to conduct a cadaveric dissection study on the anatomical variation of the sublingual (SLG) excretory ducts and dictate an improved understanding of the anatomical communication between the SLG duct and submandibular (SMG) ducts. This study is carried out by standardized dissection of anterior floor of mouth in 6 formalin-fixed adult cadavers in Silent Mentor Workshop University Malaya in August 2020. The cadavers had no trace of scars, adhesions, signs of trauma or operation. SMG duct opening was identified lateral to the lingual frenulum through a papilla in the floor of mouth behind the lower incisor tooth. A horizontal incision line was done over floor of mouth just lateral to the opening. SMG duct and SLG was traced and skeletonized. Any presence of major duct arising from the SLG and its communication with SMG duct were investigated. We found there are 3 patterns of SLG excretory duct variants; (1) One major (Bartholin's) duct which open independently at its own orifice adjacent to the orifice of the Wharton's duct of SMG. (2) One major (Bartholin's) duct which joined into the Wharton's duct of SMG. (3) Absent of a major duct arising from SLG. The overall mean diameter of SLG ducts were 1.3 ± 0.41 and the mean length of SLG ducts were 18.5 ± 6.55. The overall mean diameter of SMG ducts was 2.6 ± 0.74 and the mean length of SMG ducts were 46.5 ± 6.57. Excretory ductal system of SLG showed great variations, not only between the different cadavers but also within the different sides of the same cadaver. Awareness of potential anatomical variations can aid in the accurate diagnosis and treatment of patients with salivary gland pathology as well as help surgeons reveal potential risk factor and avoid complications during surgical procedures in the floor of mouth.
本研究的目的是对舌下腺(SLG)排泄管的解剖变异进行尸体解剖研究,并加深对SLG导管与下颌下腺(SMG)导管之间解剖连通性的理解。本研究于2020年8月在马来亚大学无声导师工作坊对6具福尔马林固定的成年尸体的口腔前底部进行标准化解剖。尸体没有疤痕、粘连、创伤或手术迹象。通过下颌切牙后方口腔底部的乳头,在舌系带外侧确定SMG导管开口。在开口外侧的口腔底部做一条水平切口线。追踪并将SMG导管和SLG骨骼化。研究SLG产生的主要导管及其与SMG导管的连通情况。我们发现SLG排泄管变异有3种模式;(1)一条主要(巴托林氏)导管在其自身开口处独立开口,靠近SMG沃顿氏导管的开口。(2)一条主要(巴托林氏)导管汇入SMG的沃顿氏导管。(3)SLG未产生主要导管。SLG导管的总体平均直径为1.3±0.41,SLG导管的平均长度为18.5±6.55。SMG导管的总体平均直径为2.6±0.74,SMG导管的平均长度为46.5±6.57。SLG的排泄导管系统显示出很大的变异,不仅在不同尸体之间,而且在同一尸体的不同侧之间。了解潜在的解剖变异有助于准确诊断和治疗唾液腺疾病患者,也有助于外科医生揭示潜在风险因素并避免口腔底部手术过程中的并发症。