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影像引导下经口腔入路联合涎腺内镜治疗腮腺主导管狭窄及主导管扩张症

Image-guided and sialendoscopy-assisted transoral approach for parotid duct stenosis and megaduct.

机构信息

Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.

出版信息

J Laryngol Otol. 2024 May;138(5):581-583. doi: 10.1017/S0022215123001731. Epub 2023 Oct 9.

Abstract

OBJECTIVE

The aim of this communication was to introduce a novel combined image (magnetic resonance and computed tomography-guided and sialendoscopy-assisted transoral approach for the treatment of a parotid duct stenosis with megaduct.

METHODS

A 46-year-old woman was referred to our department for recurrent infections of the right parotid gland following unsuccessful multiple transoral surgical approaches for a Stensen's duct stricture with megaduct. An image (magnetic resonance and computed tomography)-guided and sialendoscopy-assisted transoral sialodochoplasty was planned and performed.

RESULTS

No complications occurred. The patient was discharged 2 days after surgery. No more swelling or infections occurred. The patient is currently symptom-free after a follow up of 11 months.

CONCLUSION

Although imaging navigation means more technical effort and costs, this novel approach can be considered a viable surgical opportunity for distal and mid-third parotid duct stenosis with concomitant megaduct, particularly in cases of persistent inflammation or iatrogenic scars due to previous surgery.

摘要

目的

本交流旨在介绍一种新的联合图像(磁共振和计算机断层扫描引导联合涎腺内镜辅助经口入路治疗腮腺导管狭窄伴巨管)。

方法

一名 46 岁女性因右侧腮腺反复感染,经多次经口手术治疗 Stensen 导管狭窄伴巨管失败后,转至我科。计划并进行了图像(磁共振和计算机断层扫描)引导联合涎腺内镜辅助经口涎管成形术。

结果

无并发症发生。患者术后 2 天出院。无肿胀或感染发生。随访 11 个月后,患者目前无症状。

结论

尽管影像学导航需要更多的技术努力和成本,但对于伴有巨管的远端和中三分之一腮腺导管狭窄,特别是在由于先前手术导致持续炎症或医源性瘢痕的情况下,这种新方法可以被认为是一种可行的手术机会。

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