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- Title
Treatment strategy of hilar and intraglandular stones in wharton's duct: A 12-year experience.
- Authors
Zhao, Ya‐Ning; Zhang, Ya‐Qiong; Zhang, Li‐Qi; Xie, Xiao‐Yan; Liu, Deng‐Gao; Yu, Guang‐Yan; Zhao, Ya-Ning; Zhang, Ya-Qiong; Zhang, Li-Qi; Xie, Xiao-Yan; Liu, Deng-Gao; Yu, Guang-Yan
- Abstract
<bold>Objectives/hypothesis: </bold>To suggest a strategy for transoral removal of hilar and intraparenchymal submandibular stones.<bold>Study Design: </bold>Retrospective case series.<bold>Methods: </bold>Retrospective evaluation was performed for 514 consecutive patients with hilar and intraparenchymal submandibular stones treated via endoscopy-assisted surgery from January 2006 to June 2018. Three patients had bilateral stones. The stones were classified as: hilar (type I), posthilar (type II), intraparenchymal (type III), and multiple stones (type IV).<bold>Results: </bold>The affected glands included 311 with type I, 84 with type II, 65 with type III, and 57 with type IV stones. Stones were successfully removed in 478 glands (92.5%, 478/517). Main treatment techniques included hilum ductotomy in 311 glands, intraparenchymal ductotomy in 68, submandibulotomy in 14, intraductal retrieval in 74, and hilum ductotomy accompanied by intraductal retrieval in 11. At a mean 40-months follow-up of 478 successful cases, clinical outcomes were good in 425, fair in 27, and poor in 26 glands. Postoperative sialograms in 75 stone-free patients were categorized as: type I, normal (n = 6); type II, ectasia or stenosis in the main duct and no persistent contrast on functional films (n = 44); type III, ectasia or stenosis in the main duct and mild contrast retention (n = 15); and type IV, poor shape of the main duct and evident contrast retention (n = 10). Postoperative sialometry of 32 patients revealed no significant differences of the gland function between the two sides.<bold>Conclusions: </bold>Appropriate use of various endoscopy-assisted approaches helps preserve the gland and facilitates recovery of gland function in patients with different depths of hilo-parenchymal submandibular stones.<bold>Level Of Evidence: </bold>4 Laryngoscope, 130:2360-2365, 2020.
- Subjects
SUBMANDIBULAR gland; GLANDS; PERCUTANEOUS nephrolithotomy; RETROSPECTIVE studies; SALIVARY gland radiography; SALIVARY gland diseases; ENDOSCOPY
- Publication
Laryngoscope, 2020, Vol 130, Issue 10, p2360
- ISSN
0023-852X
- Publication type
journal article
- DOI
10.1002/lary.28361