Nahlieli O, Baruchin A M
Oral and Maxillofacial Surgery Department, Barzilai Medical Center, Ashkelon, Israel.
J Oral Maxillofac Surg. 1997 Sep;55(9):912-8;discussion 919-20. doi: 10.1016/s0278-2391(97)90056-2.
This article describes the use of endoscopy for treating sialolithiasis and compares this diagnostic method with other diagnostic methods.
Forty-six major salivary glands suspected for obstructive pathology (26 males and 20 females aged 12 to 65 years) were treated using a rigid mini endoscope. The indications for sialoendoscopy were 1) screening the ductal system for any residual calculi after sialolith removal, and 3) determining the status of the major duct lumens.
Of the 46 endoscopies attempted, 5 were immediate failures as a result of technical problems. Of the remaining 41 patients, 32 had salivary stones, and nine had sialadenitis without evidence of sialolith formation. Within the former group (22 submandibular and 10 parotid), there were four patients in whom sialolithotomy was unsuccessful (three submandibular and one parotid). Of the 22 patients with submandibular sialolithiasis, seven (32%) were undetected by imaging methods (conventional radiography, sialography, and ultrasound). In the 10 parotid ducts, seven (70%) sialoliths were undetected. In the 28 patients who underwent successful calculus removal, no major post-operative complications were noted. Interesting findings noted during endoscopy were a sphincter-like mechanism in the ductal system, evidence of ductal wall changes associated with the presence of salivary stones, peculiar connection between calculi and the ductal wall, a salivary stone forming around a hair inclusion, and the presence of polyps projecting into the duct lumen.
Endoscopy is a minimally invasive technique for removal of calculi from the salivary glands as well as an excellent diagnostic procedure.
本文描述了内镜在涎石病治疗中的应用，并将这种诊断方法与其他诊断方法进行比较。
使用硬式微型内镜对46个怀疑有阻塞性病变的大唾液腺进行治疗（26例男性和20例女性，年龄12至65岁）。涎腺内镜检查的适应证为：1）涎石取出术后筛查导管系统有无残留结石；3）确定主导管腔的状态。
在尝试的46例内镜检查中，5例因技术问题立即失败。在其余41例患者中，32例有涎石，9例有涎腺炎但无涎石形成的证据。在前一组（22例下颌下腺和10例腮腺）中，有4例涎石切除术未成功（3例下颌下腺和1例腮腺）。在22例下颌下涎石病患者中，7例（32%）影像学检查（传统X线摄影、涎管造影和超声）未发现。在10条腮腺导管中，7例（70%）涎石未被发现。在28例成功取出结石的患者中，未观察到重大术后并发症。内镜检查中发现的有趣现象包括导管系统中的类似括约肌的机制、与涎石存在相关的导管壁变化的证据、结石与导管壁之间的特殊连接、毛发包涵体周围形成的涎石以及突入导管腔的息肉的存在。
内镜检查是一种用于从唾液腺中取出结石的微创技术，也是一种优秀的诊断方法。
