Ino C, Matsuyama K, Ino M, Yamashita T, Kumazawa T
Department of Otolaryngology, Kansai Medical University, Osaka, Japan.
Acta Otolaryngol Suppl. 1993;500:121-5. doi: 10.3109/00016489309126194.
Since parotid swelling is the most informative symptom of sialadenosis, we examined parotid swelling with sialography as a means of diagnosing sialadenosis. An X-ray was taken from a fixed position relative to the body, using a focus film distance (FFD) of 70 cm. To determine an "index" of parotid swelling, the distance between the submandibular bone ridge and the end of the main duct was measured on X-ray. After examination of 30 normal parotids, abnormal swelling was defined as an "index" exceeding 1.9 cm. Sixteen of 24 patients suspected of having sialadenosis showed swelling exceeding 1.9 cm. Six of 7 patients who were histologically diagnosed with sialadenosis showed swelling in excess of 1.9 cm. Our method is reproducible and recurrence of parotid swelling correlating with sialadenosis can be objectively demonstrated. Furthermore, serum amylase levels in patients who were diagnosed with sialadenosis were measured before and after sialography. After sialography serum amylase levels increased remarkably higher than those of normal subjects. Thus if a patient with underlying diseases has an "index" over 1.9 cm and his serum amylase level after sialography increases remarkably, a diagnosis of sialadenosis is likely.
由于腮腺肿大是涎腺症最具诊断价值的症状，我们采用涎腺造影术检查腮腺肿大情况，以此作为诊断涎腺症的一种方法。使用70厘米的焦片距，从相对于身体的固定位置进行X线拍摄。为确定腮腺肿大的“指标”，在X线片上测量下颌骨嵴与主导管末端之间的距离。在检查了30例正常腮腺后，将异常肿大定义为该“指标”超过1.9厘米。24例疑似涎腺症的患者中有16例肿大超过1.9厘米。7例经组织学诊断为涎腺症的患者中有6例肿大超过1.9厘米。我们的方法具有可重复性，并且可以客观地证明与涎腺症相关的腮腺肿大复发情况。此外，对诊断为涎腺症的患者在涎腺造影术前和术后测量血清淀粉酶水平。涎腺造影术后，患者血清淀粉酶水平显著高于正常受试者。因此，如果患有基础疾病的患者该“指标”超过1.9厘米，且涎腺造影术后血清淀粉酶水平显著升高，则很可能诊断为涎腺症。
