Specificity of parotid sialendoscopy
Specificity of parotid sialendoscopy
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DOI：
10.1097/00005537-200102000-00015
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发表时间：
2001-02-01
期刊：
影响因子：
2.6
通讯作者：
Lehmann, W
中科院分区：
文献类型：
--
作者：
Marchal, F;Dulguerov, P;Lehmann, W
目的：介绍腮腺导管鼻内窥镜检查的初步经验。研究设计：方法：分别对79例和55例患者进行诊断性和介入性鼻内镜检查。诊断性涎腺内镜用于将导管病变分为涎石症、狭窄、涎腺炎和息肉。采用介入性鼻内镜治疗这些疾病。使用的内窥镜类型、使用的唾液石碎裂和/或取出装置类型、手术总数、麻醉类型以及取出的唾液石的数量和大小是因变量。结果变量是内镜下导管树的清除和症状的缓解。结果：所有病例均可进行鼻内镜诊断，平均时间26 +/- 14分钟，无并发症。介入性鼻内镜检查成功率为85%，平均时间为73 +/- 43分钟（±标准差）。多次手术占45%，全身麻醉占24%，腮腺切除术占2%。在58%的导管中发现多发涎石，并与更多的全麻手术和更长时间的手术有关。唾液石的平均粒径为3.2 +/ ~ 1.3 mm；更大的结石与更多的全麻手术、更长时间和多次手术、使用碎片和咽镜检查失败有关。10%的病例需要将唾液结石碎片化，其中70%的成功率为半刚性唾液内窥镜优于柔性唾液内窥镜。并发症大多轻微，但在12%的病例中遇到。结论：诊断性涎腺内镜检查是一种诊断涎腺导管疾病的新技术，其发病率低，介入性涎腺内镜检查大多数患者可取出涎结石，避免开放性腺体切除。
Objective: To present our initial experience with sialendoscopy of the parotid duct. Study Design: Methods: Diagnostic and interventional sialendoscopy procedures were performed in 79 and 55 cases, respectively. Diagnostic sialendoscopy was used to classify ductal lesions into sialolithiasis, stenosis, sialodochitis, and polyps. Interventional sialendoscopy was used to treat these disorders. The type of endoscope used, the type of sialolithiasis fragmentation 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. Results: Diagnostic sialendoscopy was possible in all cases, with an average duration of 26 +/- 14 minutes and no complications. Interventional sialendoscopy was successful in 85% of cases, with an average duration of 73 +/- 43 minutes (+/- standard deviation). Multiple procedures were performed in 45% of cases, general anesthesia was used in 24%, and parotidectomy in 2%. Multiple sialoliths were found in 58% of ducts and associated with more procedures under general anesthesia and longer operations. The average size of sialoliths was 3.2 +/- 1.3 mm; larger stones were associated with more procedures under general anesthesia, longer and multiple procedures, use of fragmentation, and sialendoscopy failures. Sialolithiasis fragmentation was required in 10% of cases, with a success rate of 70% Semirigid sialendoscopes performed better than flexible ones. Complications were mostly minor but were encountered in 12% of cases. Conclusions: Diagnostic sialendoscopy is a new technique for evaluating salivary duct disease, a technique which is associated with low morbidity, Interventional sialendoscopy allows the extraction of sialoliths in most patients, preventing open gland excision.