Submandibular diagnostic and interventional sialendoscopy: New procedure for ductal disorders
Submandibular diagnostic and interventional sialendoscopy: New procedure for ductal disorders
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DOI：
10.1177/000348940211100105
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发表时间：
2002-01-01
影响因子：
1.4
通讯作者：
Lehmann, W
中科院分区：
文献类型：
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作者：
Marchal, F;Dulguerov, P;Lehmann, W
我们提出了我们的初步经验，下颌下涎腺内窥镜，一种新的治疗方法的疾病沃顿氏管。我们回顾了所使用的涎腺内窥镜，并讨论了它们各自的优点。我们评估并治疗了129例疑似导管疾病的连续患者。诊断性涎腺内窥镜用于将导管病变分类为涎腺结石、狭窄、涎腺导管炎或息肉。介入性涎腺内窥镜检查用于治疗这些疾病。所用内镜的类型、所用涎石清除和/或取出器械的类型、手术总次数、麻醉类型以及取出涎石的数量和大小是因变量，结果变量是导管树的内镜清理和症状的缓解。135个腺体中的131个（97%）可以进行诊断性唾液腺内窥镜检查，平均（+/-SD）持续时间为28 +/- 15分钟。在110例病例中尝试了介入性涎腺内窥镜检查，平均持续时间为71 ± 41分钟，成功率为82%。25%的病例需要多次涎腺内窥镜检查，12%的病例需要全身麻醉。4%行颌下腺切除术。结石的平均大小为4.9 ± 2.9 mm。31例（29%）发现多个涎石。26%的患者需要进行涎石破碎。较大和多个结石通常需要更长的时间和多次手术以及全身麻醉，并且更经常导致失败。半硬性内镜的成功率（85%）高于软性内镜（54%）。并发症大多是轻微的，但在10%的病例中遇到。诊断性涎腺内窥镜检查是一种新的诊断涎腺导管疾病的技术，其发病率低。介入性涎腺内窥镜检查允许在大多数患者中提取唾液腺石，从而防止开放性腺体切除。
We present our initial experience with submandibular sialendoscopy, a new therapeutic approach for disorders of Wharton's duct. We review the sialendoscopes used and discuss their respective merits. We evaluated and treated 129 consecutive patients with suspected ductal disorders, Diagnostic sialendoscopy was used for classifying ductal lesions as sialolithiasis, stenosis, sialodochitis, or polyps. Interventional sialendoscopy was used to treat these disorders. The type of endoscope used, the type of sialolith fragrnentation and/or extraction device used, the total number of procedures, the type of anesthesia, and the number and size of the sialoliths removed were the dependent variables, The outcome variable was the endoscopic clearing of the ductal tree and resolution of symptoms. Diagnostic sialendoscopy was possible in 131 of 135 glands (97%), with an average (+/-SD) duration of 28 +/- 15 minutes. Interventional sialendoscopy was attempted in 110 cases, with an average duration of 71 +/- 41 minutes, with a success rate of 82%. Multiple sialendoscopies were necessary in 25% of cases, General anesthesia was used in 12% of cases. Submandibular gland resection was performed in 4%. The average size of the stones was 4.9 +/- 2.9 mm. Multiple sialoliths were found in 31 cases (29%). Sialolith fragmentation was required in 26%. Larger and multiple stones often required longer and multiple procedures and general anesthesia, and more often resulted in failures. Semirigid endoscopes had a higher success rate (85%) than flexible sialendoscopes (54%). Complications were mostly minor, but were encountered in 10% of cases. Diagnostic sialendoscopy is a new technique for evaluating salivary duct disorders that is associated with low morbidity. Interventional sialendoscopy allows the extraction of sialoliths in most patients, thus preventing open gland excision.