Chopra Vidhi, Singh P P, Arora Vipin
Department of Otolaryngology and Head and Neck Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.
Indian J Otolaryngol Head Neck Surg. 2025 Jan;77(1):135-142. doi: 10.1007/s12070-024-05126-4. Epub 2024 Nov 1.
To assess the success of sialendoscopy assisted intraoral approach for removal of hilar stone of submandibular gland. To evaluate the ductal system for any concomitant pathology. Conventionally the treatment for submandibular hilar stones has been gland excision. Being an open procedure, sialadenectomy has its own range of complications. After the advent of sialendoscopy there has been a paradigm shift in the management of hilar stones. The current study was done to evaluate the success of sialendoscopy assisted intraoral approach for removal of submandibular hilar stones. The sample size was 30. A diagnostic sialendoscopy was performed followed by intraoral dissection using "the surgical triangle approach" defined by Park et al. The light of sialendoscope was used as a marker of intraoral incision which was given lateral to sublingual gland in the floor of mouth corresponding to the last three teeth. The surgical triangle was exposed which was bounded by the lingual nerve, medial border of mandible and posterior border of mylohyoid muscle. The hilum lies within this triangle and hence incision was given on the duct and stone retrieval was done. 88.8% of palpable submandibular hilar stones and 66.7% of the non palpable stones could be removed. 87.5% of hilar stones and 83.3% of hiloparenchymal stones could be removed. 86.7% of the glands can be preserved by this approach for management of large submandibular hilar and hiloparenchymal stones. Using this approach non palpable stones can also be removed.
评估唾液腺内镜辅助经口入路切除下颌下腺门部结石的成功率。评估导管系统是否存在任何并发病变。传统上，下颌下腺门部结石的治疗方法是腺体切除。作为一种开放性手术，涎腺切除术有其自身一系列的并发症。唾液腺内镜出现后，门部结石的治疗模式发生了转变。本研究旨在评估唾液腺内镜辅助经口入路切除下颌下腺门部结石的成功率。样本量为30例。先进行诊断性唾液腺内镜检查，然后采用Park等人定义的“手术三角入路”进行口内解剖。唾液腺内镜的灯光用作口内切口的标记，切口位于口腔底部舌下腺外侧，对应于最后三颗牙齿。暴露手术三角，其边界为舌神经、下颌骨内侧缘和颏舌骨肌后缘。门部位于该三角内，因此在导管上做切口并取出结石。88.8%可触及的下颌下腺门部结石和66.7%不可触及的结石能够被取出。87.5%的门部结石和83.3%的门部实质结石能够被取出。通过这种方法，86.7%的腺体可得以保留，用于治疗较大的下颌下腺门部和门部实质结石。采用这种方法，不可触及的结石也能够被取出。
