超声辅助腮腺导管深部结石翻瓣取石术5例报道  

Application of ultrasound assisted parotid flap sialolithotomy for deep parotid stones:report of 5 cases

作　　者：靳职雷 刘伟军 吴国荣 周琴[2] 石欢[2] JIN Zhi-lei;LIU Wei-jun;WU Guo-rong;ZHOU Qin;SHI Huan(Department of Stomatology,Yuncheng Central Hospital.Yuncheng 044000,Shanxi Province;Department of Oral surgery,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,College of Stomatology,Shanghai Jiao Tong University,National Center for Stomatology,National Clinical Research Center for Oral Diseases,Shanghai Key Laboratory of Stomatology.Shanghai 200011,China)

机构地区：[1]运城市中心医院口腔科,山西运城044000 [2]上海交通大学医学院附属第九人民医院口腔外科,上海交通大学口腔医学院,国家口腔医学中心,国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海200011

出　　处：《中国口腔颌面外科杂志》2022年第1期77-80,共4页China Journal of Oral and Maxillofacial Surgery

摘　　要：目的:探讨超声辅助腮腺翻瓣取石术治疗腮腺导管深部结石的临床应用价值。方法:收治2019年1月—2020年6月就诊于上海交通大学医学院附属第九人民医院口腔外科的5例腮腺深部导管结石患者,术前CT平扫明确结石位于咬肌前缘后方的腺内段导管。患者于全麻下行腮腺翻瓣取石术,术中B超辅助定点后,设计耳后S形小切口。术中通过解剖面神经下颌缘支,暴露结石所在腺内导管,切开管壁,取出结石,严密缝合导管。术后1周、3个月、12个月随访。结果:所有患者均成功取出结石,术后1例患者出现腮腺导管阻塞症状,冲洗、扩张治疗后好转。未出现面神经损伤、涎瘘、感染等并发症。随访12个月,术前症状完全得到缓解,疗效满意。结论:超声辅助腮腺翻瓣取石术治疗腮腺导管深部结石成功率高,疗效好,可在临床推广应用。PURPOSE:To explore the clinical value of ultrasound-assisted parotid flap sialolithotomy in the treatment of deep parotid duct stones.METHODS:From January 2019 to June 2020,five patients with deep parotid duct stones in the Department of Oral Surgery,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,were collected.Preoperative CT scan showed that the stones were located in the intraparenchymal duct,which was at the anterior edge of the masseter muscle.The patient underwent parotid flap stone extraction under general anesthesia.During operation,a small S-shaped incision was designed behind the ear with the aid of B-ultrasound.The marginal mandibular branch of the facial nerve was dissected to expose the duct in the gland where the stone was located.Then,the wall of the duct wall was cut to remove the stone,and the duct was sutured tightly.Follow-up data were collected at 1 week,3 months,and 12 months after operation.RESULTS:All stones were successfully removed.One patient developed symptoms of parotid duct obstruction after operation,which improved after washing and dilatation treatment.No facial nerve injury,salivary fistula,infection and other complications occurred.The clinical symptoms before surgery were completely relieved at 12-month follow-up,and the curative effect was satisfactory.CONCLUSIONS:Ultrasound-assisted parotid flap sialolithotomy for deep parotid duct stones has a high success rate,good curative effect,and is worth of wide application.

关 键 词：涎石病 腮腺 超声辅助 涎石取出术 

分 类 号：R781.7[医药卫生—口腔医学]