Farhadi Mohammad, Mohebbi Saleh, Daneshi Ahmad, Jafaripanah Mohammad, Mirsalehi Marjan, Omidvari Ali
ENT And Head and Neck Research Center and Department, Hazrat Rasoul Hospital, The Five Senses Health Institute, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Skull Base Research Center, the Five Senses Institute, Iran University of Medical Sciences, Tehran, Iran.
Iran J Otorhinolaryngol. 2023 Mar;35(127):91-96. doi: 10.22038/IJORL.2023.63433.3174.
Recent advances have led to the development of sialendoscopy, an accurate, minimally invasive procedure with high diagnostic and therapeutic capabilities in treating sialolithiasis. This study aimed to evaluate the results and complications of sialendoscopy in patients suffering from sialoadenitis.
This study was a prospective interventional case series study on patients with sialoadenitis due to sludge or stone formation preoperatively confirmed by sonography or computed tomography (CT) scanning. Diagnostic sialendoscopy was performed, and the presence of stenosis, sludge, or stones inside the gland or duct was examined, and surgery was done. During follow-up time (18.8 ± 7.4 months), recurrence of symptoms, the need for reoperation, and postoperative complications were also assessed.
The sialendoscopy was performed in 51 patients, including 55 glands. Forty-five Patients (88.2%) reported pain relief, and 46 patients (90.2%) reported that the treatment using sialendoscopy was better than conservative methods. The duct restenosis also occurred in one patient requiring open surgery. In assessing the main factors predicting the need for reoperation, the site of involvement (parotid versus submandibular glands) and the size of the stone were identified as the main determinants. The best cut-off value for stone size in predicting reoperation requirement was 7.0mm, with a sensitivity of 100% and a specificity of 85.7%.
Intraoperative sialendoscopy is a successful diagnostic and therapeutic tool with minimal postoperative complications in salivary gland duct involvement patients.
近年来的进展促成了涎腺内镜检查的发展，这是一种在治疗涎石病方面具有高诊断和治疗能力的精确、微创的手术。本研究旨在评估涎腺内镜检查在涎腺炎患者中的结果及并发症。
本研究是一项前瞻性干预性病例系列研究，对象为术前经超声或计算机断层扫描（CT）证实因黏液或结石形成而患有涎腺炎的患者。进行诊断性涎腺内镜检查，检查腺体或导管内是否存在狭窄、黏液或结石，并实施手术。在随访期间（18.8±7.4个月），还评估了症状复发情况、再次手术的必要性以及术后并发症。
对51例患者（共55个腺体）进行了涎腺内镜检查。45例患者（88.2%）报告疼痛缓解，46例患者（90.2%）报告涎腺内镜检查治疗比保守治疗效果更好。1例患者发生导管再狭窄，需要进行开放手术。在评估预测再次手术必要性的主要因素时，受累部位（腮腺与颌下腺）和结石大小被确定为主要决定因素。预测再次手术所需的结石大小最佳截断值为7.0mm，敏感性为100%，特异性为85.7%。
术中涎腺内镜检查是一种成功的诊断和治疗工具，对于涎腺导管受累患者，术后并发症极少。
