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악하선 타석증의 치료: 타액선 내시경을 이용한 구강내 접근법

Management of Sialolithiasis of Submandibular Gland:Sialendoscopy-Assisted Intraoral Stone Removal

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참고문헌

키워드

주제분류이비인후과학

초록

Background and Objectives Intraoral removal is one of the most common treatments for sialolithiasis, and although newly introduced, sialendoscopy is becoming a popular tool for it. The aim of this study was to investigate the factors that influenced the removal of sialolithiais by sialendoscopy and also to compare its usefulness with intraoral removal alone. Subjects and Method We retrospectively reviewed surgical results of 89 patients who underwent therapeutic sialendoscopy and compared them with the result of 43 patients who underwent intraoral removal without sialendoscopy between June 2006 and February 2012. We analyzed the success rate of sialendoscopy for sialolithiasis by age, location, stone size, stone shape and stone mobility. Then we compared sialendoscopy-assisted intraoral removal group with intraoral removal alone group by location, size and mobility. Results Among the total 89 patients with sialolithiasis of submandibular gland who underwent sialendoscopy-assisted intraoral removal, 47 were successfully treated by therapeutic sialendoscopy alone (52.8%), and 84 by sialendoscopy-assisted intraoral removal (94.3%). In cases of proximal stones and those larger than 5 mm in size, sialendoscopy-assisted intraoral removal (95.0%) was more successful than intraoral removal alone (30%). The mean operation time (min) for sialendoscopy was 39 min and that for intraoral removal after sialendoscopy was 43 min. Sialendoscopy-assisted intraoral removal took 82 min and intraoral removal alone took 56 min. Conclusion Results of sialendoscopy assisted stone removal supports the less invasive therapy of proximal stones via intraoral route. We thus recommend considering sialendoscopic approach prior to considering other approaches.

Abstract

Background and Objectives Intraoral removal is one of the most common treatments for sialolithiasis, and although newly introduced, sialendoscopy is becoming a popular tool for it. The aim of this study was to investigate the factors that influenced the removal of sialolithiais by sialendoscopy and also to compare its usefulness with intraoral removal alone. Subjects and Method We retrospectively reviewed surgical results of 89 patients who underwent therapeutic sialendoscopy and compared them with the result of 43 patients who underwent intraoral removal without sialendoscopy between June 2006 and February 2012. We analyzed the success rate of sialendoscopy for sialolithiasis by age, location, stone size, stone shape and stone mobility. Then we compared sialendoscopy-assisted intraoral removal group with intraoral removal alone group by location, size and mobility. Results Among the total 89 patients with sialolithiasis of submandibular gland who underwent sialendoscopy-assisted intraoral removal, 47 were successfully treated by therapeutic sialendoscopy alone (52.8%), and 84 by sialendoscopy-assisted intraoral removal (94.3%). In cases of proximal stones and those larger than 5 mm in size, sialendoscopy-assisted intraoral removal (95.0%) was more successful than intraoral removal alone (30%). The mean operation time (min) for sialendoscopy was 39 min and that for intraoral removal after sialendoscopy was 43 min. Sialendoscopy-assisted intraoral removal took 82 min and intraoral removal alone took 56 min. Conclusion Results of sialendoscopy assisted stone removal supports the less invasive therapy of proximal stones via intraoral route. We thus recommend considering sialendoscopic approach prior to considering other approaches.

참고문헌 (9)

  1. Luers JC, "Sialoendoscopy: prognostic factors for endoscopic removal of salivary stones", Arch Otolaryngol Head Neck Surg, 137(4), pp.325~329 (2011)
  2. Eun YG, "Advantages of intraoral removal over submandibular gland resection for proximal submandibular stones: a prospective randomized study", Laryngoscope, 120(11), pp.2189~2192 (2010)
  3. Koch M, "Diagnosis and gland-preserving minimally invasive therapy for Wharton’s duct stenoses", Laryngoscope, 122(3), pp.552~558 (2012)
  4. Gillespie MB, "Endoscopic-assisted management of chronic sialadenitis", Head Neck, 33(9), pp.1346~1351 (2011)
  5. Luers JC, "Sialendoscopy for sialolithiasis: early treatment, better outcome", Head Neck, 34(4), pp.499~504 (2012)
  6. Dalkiz M, "Sialolithiasis (Salivary Stone)", Turk J Med Sci, 31(4), pp.177~179 (2001)
  7. Marchal F, "A combined endoscopic and external approach for extraction of large stones with preservation of parotid and submandibular glands", Laryngoscope, 117(2), pp.373~377 (2007)
  8. McGurk M, "Endoscopically assisted operative retrieval of parotid stones", Br J Oral Maxillofac Surg, 44(2), pp.157~160 (2006)
  9. Combes J, "Intraoral removal of proximal submandibular stones--an alternative to sialadenectomy?", Int J Oral Maxillofac Surg, 38(8), pp.813~816 (2009)

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