内镜辅助腮腺结石取出术67例疗效分析

Endoscopy-assisted sialolithectomy for the calculus of the Stensen＇s duct

目的 探讨腮腺涎石病内镜辅助取石术的疗效.方法 2005年8月至2013年7月对67例腮腺结石或异物患者采用唾液腺内镜探查腮腺导管,并在内镜辅助下取石.术后定期随访,分析内镜辅助取石的疗效.结果 67例腮腺结石或异物患者中,58例结石完全取出,3例大部取出,成功率为87％（58/67）.61例取出者中24例为网篮或抓钳抓取后经导管口取出;21例为网篮抓取后经导管口切开取出;8例为网篮抓取后经管口邻近切开取出;2例经颊部切口取出;6例经腮腺翻瓣取出.61例随访6～90个月（平均23个月）,2例失访;48例患侧腮腺分泌良好,无不适;7例患侧腮腺分泌良好,偶有不适;3例导管闭塞;1例存在腮腺区麻木.结论 唾液腺内镜技术对于腮腺涎石病是一种安全有效的诊疗手段.

Objective To investigate the clinical effects of endoscopy-assisted sialolithectomy for the calculus in the Stensen＇s duct.Methods From August 2005 to July 2013,67 consecutive patients with calculus （or foreign bodies） in the Stensen＇s duct underwent explorative and interventional endoscopy in our hospital.The stones （or foreign bodies） were removed by endoscopy-assisted technique.After operation,the patients were followed-up periodically,and treatment effects were analyzed.Results Among the 67 patients,the stones （or foreign bodies） were completely removed in 58 cases,and almost completely removed in 3 cases,with a success rate of 87％ （58/67）.Among the 61 stone-removed cases,treatment options included direct removal with aid of basket or forceps（24 cases）,basket entrapment and opening-up of the ostium （21 cases）,basket entrapment and mucosal incision near the ostium （8 cases）,open removal via buccal incision （2 cases） and open removal via pre-auricular flap （6 cases）.During the 6-90 months＇ follow-up of the 61 cases,48 cases were asymptomatic,7 had mild symptoms,3 developed ductal obturation,1 had numbness in the parotid region,and the remaining 2 were missed.Conclusions Endoscopy-assisted sialolithectomy is a safe and effective gland-preservation technique for the patients with parotid gland calculus.