Holland Katie, Lee Jinnee U J, Gomeniouk Olga, Owen Grant S, Raad Richard, Bhayani Mihir
Department of Otolaryngology - Head & Neck Surgery, Rush University Medical Center, 1611 W Harrison St Suite 550, Chicago, IL, 60612, USA.
Chicago Medical School, Rosalind Franklin University of Medicine and Sciences, North Chicago, IL, USA.
Eur Arch Otorhinolaryngol. 2025 Jul;282(7):3707-3713. doi: 10.1007/s00405-025-09324-w. Epub 2025 Mar 18.
This study aimed to determine if there was a difference in postoperative outcomes and complications between patients who underwent traditional two-layer closure (ductoplasty and floor of mouth) after Wharton's duct sialolithatomy during hybrid sialendoscopy compared to those who underwent single layer closure of only the floor of mouth.
Retrospective case series of a single surgeon's patients who underwent hybrid sialendoscopy at an urban tertiary care hospital. Demographic, preoperative, intraoperative, and postoperative information was collected from patients who underwent hybrid sialendoscopy with transoral sialolithotomy of Wharton's duct from 2020 to 2023. Data included salivary glands explored, intraoperative complications, ductal repair, postoperative complications, and recurrence of salivary symptoms.
32 patients underwent hybrid sialendoscopy. Of those, 28.1% (n = 9) underwent traditional two-layer closure, and in 71.9% (n = 23) had single layer closure. 2.6% (n = 1) had a postoperative infection. There were no immediate postoperative complications reported in those with single layer closure. There was no statistical difference in postoperative complications between the two groups (p = 0.10). In patients with follow up, 86.7% of (n = 13) patients had documented salivary flow through the natural papilla after one layer closure compared to 80% (n = 4) in the two-layer group. There was no significant difference between the groups (p = 0.72).
The results of this study support that single layer closure without ductoplasty after hybrid sialendoscopy allows for ductal recanalization and may produce the same postoperative outcomes as traditional two-layer closure while increasing operative efficiency.
本研究旨在确定在混合唾液内镜检查期间，沃顿管涎石切除术后接受传统两层缝合（导管成形术和口底缝合）的患者与仅接受口底单层缝合的患者在术后结局和并发症方面是否存在差异。
对一家城市三级护理医院中一位外科医生的混合唾液内镜检查患者进行回顾性病例系列研究。收集了2020年至2023年接受经口沃顿管涎石切除术的混合唾液内镜检查患者的人口统计学、术前、术中和术后信息。数据包括探查的唾液腺、术中并发症、导管修复、术后并发症以及唾液症状复发情况。
32例患者接受了混合唾液内镜检查。其中，28.1%（n = 9）接受了传统两层缝合，71.9%（n = 23）接受了单层缝合。2.6%（n = 1）发生了术后感染。单层缝合患者未报告有立即术后并发症。两组术后并发症无统计学差异（p = 0.10）。在有随访的患者中，单层缝合后86.7%（n = 13）的患者记录到唾液通过自然乳头流出，而两层缝合组为80%（n = 4）。两组之间无显著差异（p = 0.72）。
本研究结果支持，混合唾液内镜检查后不进行导管成形术的单层缝合可实现导管再通，并且可能产生与传统两层缝合相同的术后结局，同时提高手术效率。
