鼻内窥镜辅助下取石术治疗不可触及的肺门及腺内颌下腺结石的临床疗效。

IF 2.2 3区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL
Laryngoscope Pub Date : 2025-02-20 DOI:10.1002/lary.32065
Han Cheol Lee, Ju Ha Park, Moon Su Kwak, Dae Hyun Kim, Young Min Park, Jae-Yol Lim
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引用次数: 0

摘要

目的:本研究旨在评估与传统的非内镜经口结石取出技术相比,鼻内镜在取出位于门部或更深实质的不可触及的下颌下结石方面的疗效。方法:70例不可触及的下颌骨门下或实质内结石患者行鼻内镜辅助结石取出术(SASR)。17例门静脉结石患者行非内镜下经口取石术(TOSR)作为对照组。评估的参数包括结石特征(大小、数量、位置、活动和可及性)以及结果(成功率、手术时间、并发症、复发率和功能恢复)。结果:SASR组有4个实质内腺结石,其中2个位于髓舌骨下。SASR组70例患者中有69例(98.57%)结石完全清除。然而,一名患者在实质内和下颌舌骨下有一个小于2mm的涎石,无法切除。TOSR手术专门用于清除门静脉结石。尽管如此,TOSR组中有1例患者未成功取出5毫米门静脉结石,总成功率为94.12%。SASR组的手术时间明显长于TOSR组。然而,TOSR组的急性并发症发生率(41.18%),如肿胀、疼痛或舌头麻木,明显高于SASR组(7.14%)。结论:鼻内窥镜是一种有价值的辅助手段,可作为经口联合入路的辅助手段,用于取出难以触及的下颌下结石,特别是那些位于门部或更深实质的结石。术前对结石位置的精确评估对于确定合适的手术干预至关重要。研究设计:回顾性研究。环境:两个学术三级医疗中心。证据等级:3;
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical Efficacy of Sialendoscopy-Assisted Stone Removal for Non-Palpable Hilar and Intraglandular Submandibular Sialoliths.

Objectives: This study aimed to assess the efficacy of sialendoscopy in retrieving non-palpable submandibular stones located in the hilum or deeper parenchyma compared to traditional non-endoscopic transoral stone removal techniques.

Methods: Seventy patients with non-palpable submandibular hilar or intraparenchymal stones underwent sialendoscopy-assisted stone removal (SASR). Seventeen patients with hilar stones treated with non-endoscopic transoral stone removal (TOSR) were the control group. Parameters evaluated included stone characteristics (size, number, location, mobility, and accessibility) as well as outcomes (success rate, operation time, complications, recurrence, and functional recovery).

Results: The SASR group had four stones in the intraparenchymal glands, two of which were located inferior to the mylohyoid. Complete stone removal was achieved in 69 out of 70 patients (98.57%) in the SASR group. However, one patient had a sialolith measuring less than 2 mm in the intraparenchymal and inferior to mylohyoid that could not be removed. TOSR procedures were exclusively performed to remove hilar stones. Nevertheless, one patient in the TOSR group was unsuccessful in retrieving a 5-mm hilar stone, resulting in an overall success rate of 94.12%. The operation duration was much longer in the SASR group than in the TOSR group. However, the TOSR group had a significantly higher incidence of acute complications (41.18%), such as swelling, pain, or tongue numbness, compared to the SASR group (7.14%).

Conclusion: Sialendoscopy is a valuable adjunct to the transoral combined approach for retrieving non-palpable submandibular stones, especially those in the hilum or deeper parenchyma. A precise preoperative assessment of stone location is crucial for determining the appropriate surgical intervention.

Study design: Retrospective review.

Setting: Two academic tertiary medical centers.

Level of evidence: 3:

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来源期刊
Laryngoscope
Laryngoscope 医学-耳鼻喉科学
CiteScore
6.50
自引率
7.70%
发文量
500
审稿时长
2-4 weeks
期刊介绍: The Laryngoscope has been the leading source of information on advances in the diagnosis and treatment of head and neck disorders since 1890. The Laryngoscope is the first choice among otolaryngologists for publication of their important findings and techniques. Each monthly issue of The Laryngoscope features peer-reviewed medical, clinical, and research contributions in general otolaryngology, allergy/rhinology, otology/neurotology, laryngology/bronchoesophagology, head and neck surgery, sleep medicine, pediatric otolaryngology, facial plastics and reconstructive surgery, oncology, and communicative disorders. Contributions include papers and posters presented at the Annual and Section Meetings of the Triological Society, as well as independent papers, "How I Do It", "Triological Best Practice" articles, and contemporary reviews. Theses authored by the Triological Society’s new Fellows as well as papers presented at meetings of the American Laryngological Association are published in The Laryngoscope. • Broncho-esophagology • Communicative disorders • Head and neck surgery • Plastic and reconstructive facial surgery • Oncology • Speech and hearing defects
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