下颌下腺手术中通往沃顿氏管方法的比较分析:回顾性病例对照研究

IF 1.7 4区 医学 Q2 OTORHINOLARYNGOLOGY
Michael Vaiman, Yuval Mizrakli, Haim Gavriel
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引用次数: 0

摘要

方法回顾性病例对照分析法分析了一家医院耳鼻咽喉头颈外科进行的 271 例(2003-2022 年)霰粒肿手术。研究对两种方法进行了比较:(1) 保留沃顿氏管的纯内窥镜技术或针尖取石术;(2) 经口导管剥离或针尖取石技术,之后缩短导管。在选择手术方案时,考虑了结石的大小、结石的位置以及是否存在多发性结石。比较了并发症的发生率(舌神经麻痹、管道狭窄、流口水和咽鼓管炎)、异物的发生率以及随访≥18个月期间的复发率。在这 323 个结石中,第一种方法取出 150 个,第二种方法取出 173 个。结石直径从 2 毫米到 38 毫米不等,平均直径为 8.2 毫米。在所有 271 名患者中,复发率为 4.8%,但 11 例复发病例(8.7%)出现在第一种方法手术后,2 例(1.4%)出现在第二种方法手术后(P = 0.03)。结论手术切除颌下结石并缩短沃顿氏管可降低霰粒肿的复发率,但不会影响术后并发症的发生率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparative analysis of approaches to the Wharton's duct during surgery of the submandibular gland: A retrospective case–control study

Introduction

We investigated complications and recurrence rates after surgical techniques for sialolith removal with intact and resected Wharton's duct of the submandibular gland.

Methods

The retrospective case–control analysis of a series analysed 271 surgical operations (2003–2022) for sialolithiasis performed at a hospital department of Otolaryngology—Head and Neck Surgery. The study compared two approaches: (1) pure endoscopic technique or pinpoint stone removal with Wharton's duct left intact and (2) transoral duct dissection or pinpoint stone removal technique, after which the duct was shortened. While choosing the surgical option, the size of the stone, the location of the stone, and the presence of multiple stones were taken into account. The rates of complications (lingual nerve paraesthesia, duct stenosis, drooling, and sialoadenitis), the incidence of foreign bodies, and the rate of recurrence during follow-up of ≥18 months were compared.

Results

323 sialoliths were removed from 271 patients. Of these 323 calculi, 150 were removed by the first approach and 173 by the second approach. The calculi varied in diameter from 2 to 38 mm with an average diameter of 8.2 mm. For all 271 patients, the rate of recurrence was 4.8%, but 11 recurrent cases (8.7%) appeared after the first approach surgeries and 2 cases (1.4%) after the second approach surgeries (p = .03). Other variables did not show statistically significant differences.

Conclusions

Surgical removal of the submandibular calculi, ending with shortening of Wharton's duct, reduces the recurrence rate for sialolithiasis but does not affect the rate of postsurgical complications.

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来源期刊
Clinical Otolaryngology
Clinical Otolaryngology 医学-耳鼻喉科学
CiteScore
4.00
自引率
4.80%
发文量
106
审稿时长
>12 weeks
期刊介绍: Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with: current otorhinolaryngological practice audiology, otology, balance, rhinology, larynx, voice and paediatric ORL head and neck oncology head and neck plastic and reconstructive surgery continuing medical education and ORL training The emphasis is on high quality new work in the clinical field and on fresh, original research. Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject. • Negative/null results In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.
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