唾液腺内镜辅助下诊治腮腺导管结石的临床应用

Sialendoscopically Assisted Surgical Retrieval of Parotid Stones: a Preliminary Report

目的 :分析唾液腺内镜辅助下口内切口和口外切口联合诊治腮腺导管结石的有效性。方法 :29例经超声和CT诊断为腮腺结石,并接受唾液腺内镜辅助保留腺体治疗的患者。根据结石的位置和性质选择单纯使用唾液腺内镜取石、唾液腺内镜辅助下的口内切口或唾液腺内镜辅助下的口外切口取石。结果:9人通过唾液腺内镜成功取石,15人在唾液腺内镜辅助下口内切口取石成功,另5人在唾液腺内镜辅助下口外切口取石成功。所有患者术后无并发症,腮腺功能均恢复到正常水平。结论:在缺乏碎石设备的情况下,唾液腺内镜辅助下口内和口外切口是治疗腮腺结石的有效方法,能够降低腮腺切除的比率。

Objective： To analyze the clinical value of sialendoscopy assisted surgical removal of parotid sialolithiasis. Methods： This retrospective study included 29 patients , who were diagnosed with parotid gland sialolithiasis by ultra-sonography or CT, and required endoscopic-assisted gland preserving therapy. The use of interventional sialendoscopy, sialendoscopic-transoral, or sialendoscopic-transcutaneous procedures was determined by the size and location of the parotid gland stones. Results： The stones were retrieved by interventional sialendoscopy in nine patients. The transoral procedure was performed in 15 patients with large stones which were impacted in the ductal wall. The remaining five pa-tients were managed through an external approach via a local skin incision under sialendoscopy. No postoperative compli-cations occurred. The parotid glands functioned normally after the procedures. Conclusion：The combined sialendoscopic-transoral or sialendoscopic-transcutaneous operation appears to be a good alternative for the treatment of parotid gland sialolithiasis in the absence of lithotripsy devices. This type of therapy can decrease the rate of parotidectomy.