Diagnostic and treatment effects of sialendoscopy for patients with swelling of the parotid gland when sialoliths are undetected with computed tomography
Diagnostic and treatment effects of sialendoscopy for patients with swelling of the parotid gland when sialoliths are undetected with computed tomography
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DOI：
10.1016/j.anl.2017.11.004
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发表时间：
2018-08-01
影响因子：
1.7
通讯作者：
Nonaka, Manabu
中科院分区：
文献类型：
--
作者：
Kondo, Norio;Yoshihara, Toshio;Nonaka, Manabu
2009年8月至2016年5月，74例患者接受了涎腺内窥镜手术。32例患者有腮腺疾病，9例患者有间歇性腮腺肿胀，CT成像未检测到涎石。4例诊断为特发性Stensen管狭窄。2例经内镜检查证实为Stensen管狭窄。而另2例患者因Stensen管开口狭窄而无法插入涎腺内窥镜。在这2例患者中进行了导管球囊扩张，在1例患者中向导管内注射了类固醇药物。1例接受涎腺内窥镜治疗的患者完全缓解。3例患者有涎石症。观察到微涎石和/或白色漂浮物，并使用涎内镜进行清除。所有患者均获得完全缓解。在干燥综合征和复发性腮腺炎的病例中，进行了涎腺内窥镜手术，但症状没有改善。对于微小涎石患者，当CT成像未发现涎石时，涎内镜可能是最有用的诊断和治疗方法。目前，涎腺内窥镜手术在治疗Stensen管狭窄方面存在局限性，在治疗干燥综合征和复发性腮腺炎方面可能同样存在局限性。(C)2017 Elsevier B. V.版权所有。
Between August 2009 and May 2016, 74 patients underwent sialoendoscopic surgery. 32 patients had parotid gland disease and 9 patients had intermittent swelling of the parotid gland and sialoliths were not detected with CT imaging. 4 patients were diagnosed with idiopathic Stensen's duct stenosis. Sialendoscopy directly confirmed Stensen's duct stenosis in 2 patients. However, the sialendoscope was unable to be inserted in the other 2 patients, who had stenosis of the orifice of the Stensen's duct. Balloon expansion of the duct was performed in these 2 patients and a steroid drug was injected into the duct in one patient. Complete remission was archived in one patient treated with sialendoscopy. Three patients had sialolithiasis. Microsialoliths and/or white floating matter was observed and removed using sialendoscopy. All patients experienced complete remission. In cases of Sjogren syndrome and recurrent parotitis, sialendoscopic surgery was performed, but the symptoms showed no improvement. For patients with microsialoliths, sialendoscopy may be most useful for diagnosis and treatment when the sialoliths are not detected with CT imaging. At present, sialendoscopic surgery have limitation in the treatment of Stensen's duct stenosis and may similarly have limitation in the treatment of Sjogren's syndrome and recurrent parotitis. (C) 2017 Elsevier B.V. All rights reserved.