颌下腺及Wharton导管同期切除治疗涎石病  

Excision of Submandibular Gland and Its Associated Wharton's Duct for Sialolithiasis Treatment

作　　者：高莺[1] 张晓敏[1] 田淳[1] 张瑞[1] GAO Ying;ZHANG Xiaomin;TIAN Chun;ZHANG Rui(Department of Stomatology, First Hospital of Shanxi Medical University, Taiyuan 030001, China.)

机构地区：[1]山西医科大学第一医院口腔科,山西太原030001

出　　处：《口腔医学研究》2020年第11期1031-1035,共5页Journal of Oral Science Research

基　　金：山西省自然科学基金(编号:2014011045-2);山西医科大学第一医院中青年学术技术带头人培育项目(编号:YD1621)。

摘　　要：目的:探讨颌下腺及Wharton导管同期切除治疗涎石病的临床疗效。方法:对需要进行颌下腺切除术的60例涎石病患者分别进行传统颌下腺切除术、颌下腺及Wharton导管同期切除术,评价其手术效果及并发症。结果:传统颌下腺切除组术中切除Wharton导管平均长度为(2.33±0.42)cm,颌下腺及Wharton导管同期切除组为(4.31±0.43)cm,二者之间有统计学差异;传统颌下腺切除组术后Wharton导管结石复发患者为2例,颌下腺及Wharton导管同期切除组为0例,二者之间有统计学差异;两组病例在舌神经损伤、吞咽困难、舌下腺囊肿、慢性舌下腺炎、舌下神经损伤、面神经下颌缘支损伤、残余导管炎等并发症方面未发现差异。结论:颌下腺及Wharton导管同期切除治疗涎石病临床疗效满意,切除尽可能长的Wharton导管有助于最大程度减少结石复发可能性,对于涎石复发高风险患者可能具有一定临床价值。Objective:To investigate the efficacy of excision of submandibular gland and its associated Wharton's duct in the treatment of sialolithiasis.Methods:A total of sixty patients with sialolithiasis underwent excision of submandibular gland via a transcervical incision combined with or without surgical resection of its associated Wharton's duct via an intraoral incision.The therapeutic effects and postoperative complications were evaluated.Results:Mean length of the resected Wharton's duct was significantly shorter in the traditional surgery group[(2.33±0.42)cm]than in the modified surgery group[(4.31±0.43)cm].Ratio of sialoliths recurrence was significantly higher in the traditional surgery group(2/30)than in the modified surgery group(0/30).However,there was no significant difference in the postoperative complications such as lingual never damage,swallowing pain,hypoglossal gland cyst,chronic sublinguitis,hypoglossal never injury,facial nerve injury,and inflammation of the residual Wharton's duct between two groups.Conclusion:Excision of the submandibular gland and its associated Wharton's duct was safe and feasible for the treatment of sialolithiasis,which may be applied as an option for the patients with high risk of sialoliths recurrence.

关 键 词：涎石病 颌下腺 颌下腺导管 并发症 

分 类 号：R78[医药卫生—口腔医学]