口内取石后内镜导管探查治疗下颌下腺导管后部结石

Removal of salivary calculi through oral approach followed by sialendoscopy examination and treatment for the posterior calculi in submandibular gland duct

目的:探讨下颌下腺导管后部结石的治疗方法。方法:对40例下颌下腺导管后部结石口底黏膜切口,导管切开取石,应用涎腺内镜探查导管,使其通畅,随访术后腺体恢复和导管分泌情况。结果:36例局麻下取石,4例因肥胖手术视野较差和局麻下手术患者配合困难而采用全身麻醉,40例患者均成功取石。随访35例术后6月～1年没有再出现进食后下颌下肿胀,下颌下腺质地逐渐变软,舌下肉阜处导管口有清亮液分泌28例。结论:口内取石简便了取石方法,联合内镜导管探查有助于下颌下腺导管通畅,有利于取石后恢复和保存腺体功能。

Objective： To report our experience in the treatment of the posterior calculi in submandibular gland duct. Methods： 40 patients with posterior calculi in submandibular gland duct were included. Removal of the salivary calculi was conducted through oral approach. Then the duct of the gland was explorated by sialendoscopy. The calculi residue and tissue embolus were removed. The situ- ation of secretion and reduction of gland were evaluated by follow- up. Results： The calculi were removed successfully in the 40 pa- tients. 35 patients were no longer suffering from submandibular swelling after meal during 1-year follow-up. Transparent liquid dis- charge from the orifice of submandibular gland duct was observed in 28 patients. Conclusion： Removal salivary calculis through oral approach aided by exploration of duet with sialendoscopy is effective in the treatment of sialolithiasis of submandibular gland.