下颌下腺导管畸形伴多发结石病例报道及文献复习  

Malformation of Wharton′s duct with multiple sialoliths: a case report and literature review

作　　者：李瑞春 景凯岸 王丽娜 马瑞[2] 景捷[2] 马坚[2] LI Ruichun;JING Kaian;WANG Lina;MA Rui;JING Jie;MA Jian(Oral Medicine School of Stomatology,NingXia Medical University,Yinchuan 750000,China;Department of Oral&Maxillofacial Surgery,General Hospital of Ningxia Medical University,Yinchuan 750000,China.)

机构地区：[1]宁夏医科大学口腔医学院,宁夏银川750000 [2]宁夏医科大学总医院口腔颌面外科,宁夏银川750000

出　　处：《口腔疾病防治》2020年第2期93-96,共4页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：国家自然科学基金项目（81600853）;宁夏高等教育科学研究项目（NGY2016121）

摘　　要：目的探讨下颌下腺导管畸形伴多发结石的诊治方法。方法对1例罕见的下颌下腺导管畸形伴多发结石患者的临床资料、诊断及治疗进行总结,并回顾相关文献。结果该患者查体及CBCT检查发现左侧口底区肿物,通过术中探查发现患者左侧口底肿物为下颌下腺导管畸形伴多发结石形成,切除下颌下腺及肿物。术后病理检查报告为:(左侧下颌下)涎腺组织导管扩张并导管上皮增生,可见导管结石,导管周围大量淋巴细胞增生,术后1月随访愈合良好。通过文献回顾分析发现,下颌下腺导管畸形伴多发结石的病例较少见,应与口底区动静脉畸形仔细鉴别。下颌下腺导管结石可以经口行下颌下腺导管切开取石或经颌下行下颌下腺并导管结石切除,对一些直径较小的结石也可通过唾液腺内镜治疗。结论下颌下腺导管畸形伴多发结石的病例需同时行口内及口外切口切除下颌下腺并导管结石。Objective To explore the diagnosis and treatment of ductal malformations of the submandibular gland with multiple stones.Methods A case of a malformation of Wharton′s duct with multiple sialoliths according to the clinical data,diagnosis and treatment of the patient was analyzed retrospectively.Results The patient′s physical exam⁃ination and CBCT showed a tumor on the left floor of the mouth.In this case,it was found that the mass was a malformation of Wharton′s duct with multiple sialoliths according to operative exploration.The postoperative pathological examination showed(left submaxillary)salivation gland tissue,duct dilation and duct epithelia hyperplasia,duct calculus,and a large number of lymphocytes proliferating around the duct;1 month after the follow⁃up,the patient had healed well.Through literature review and analysis,it was found that cases of submandibular ductal malformation with multiple stones were rare and should be carefully differentiated from arteriovenous malformation at the base of the mouth.Calculi of the submandibular gland can be removed by incision through the oral submandibular duct or by combined resection of the submandibular gland and ductal calculi,and some smaller calculi can also be treated by endoscopy of the salivary gland.Conclusion In cases of submandibular ductal malformation with multiple stones,intraoral and extraoral incisions should be performed simultaneously to remove the associated ductal stones.

关 键 词：下颌下腺 下颌下腺导管 导管结石 导管畸形 多发结石 鉴别诊断 口底区动静脉畸形 治疗 预后 

分 类 号：R781.7[医药卫生—口腔医学]