涎腺内镜辅助颌下腺腺门结石取出术疗效分析

Sialoendoscopically-assisted sialolithectomy for the hilar stones of the Wharton＇s duct

目的 分析涎腺内镜辅助颌下腺导管腺门段结石取出术的疗效.方法 2005年12月至2011年3月在北京大学口腔医学院·口腔医院经影像检查发现的颌下腺腺门结石患者80例,采用涎腺内镜探查颌下腺导管,观察结石及导管炎症情况,并在内镜辅助下取石.术后随访3～6个月,分析内镜辅助下取石的效果及术后并发症.结果 80例颌下腺腺门结石患者中,71例结石被完全取出,5例结石大部分取出,4例结石未取出,取石成功率为95％ （76/80）.76例结石成功取出者中 8例由网篮套索取出；59例采用了涎腺内镜辅助下口内切开取石术；9例经网篮套索及口内切开法取出结石.术后并发症主要为暂时性舌神经麻痹（1例）及舌下腺囊肿（2例）.结论 涎腺内镜技术对于颌下腺腺门结石是一种安全有效的诊疗手段,可减少并发症的发生,并可避免结石残留.

Objective To investigate the clinical effects of sialoendoscopically-assisted sialolithectomy for the sialolithiasis in the hilum of the submandibular glands.Methods Between December 2005 and March 2011, treated 80 cases of radiography-verified sialiolithiasis in the hilum of the submandibular glands,The patients included 42 males and 38 females aged from 13 to 68 years.All these patients underwent sialoendoscopic observation and sialoendoscopically-assisted sialolithectomy and were followed up periodically for 3-6 months after operation. The success rate of stone removal,postoperative complications and clinical effects were analysed.Results The stones were completely removed in 71 cases,and almost completely removed in 5 cases,with a successful rate of 95% （76/80）.Among 76 successful cases,8 were treated by basket entrapment,59 by intraoral open surgery and 9 by both of these two techniques.Within 3-6 months＇ follow-up,1 case suffered temporary lingual nerve parenthesis and two suffered ranula formation.Conclusions Sialoendoscopically-assisted sialolithectomy is a safe and effective gland-preservation technique for the patients with the hilum of the submandibular glands.