Abstract：
OBJECTIVE: To assess the evidence for pediatric sialolithiasis, including its demographic characteristics, diagnosis, and demonstrate the shift in its treatment paradigm.
METHODS: A systematic review of sources from the Medline and Embase databases was conducted from inception to Dec 4, 2020. Two researchers independently extracted data and assessed quality.
METHODS: Patients under the age of 18 with sialolithiasis were included.
METHODS: Study design, cohort size, age, sex, symptoms, stone characteristics, diagnostic modality and intervention were collected data points.
RESULTS: Forty-one studies with 243 patients were included in the review, of which 40 were case reports or series. Most stones were found in the submandibular gland (n = 210, 85.4%) and were single stones (n = 101, 71.1%). Average stone size was 7.7 mm. The most common diagnostic imaging modality used was ultrasound (n = 73, 47.4%), shifting from plain radiograph which was favoured in earlier years. Similarly, open gland excision was historically preferred, but since 2000, sialoendoscopy comprised 40.5% of all treatment modalities and continues to increase in prevalence, up to 52.1% by 2020. Extracorporeal shock wave lithotripsy was associated with the highest complication rate of 54.2%.
CONCLUSIONS: The pediatric sialolithiasis diagnostic and therapeutic landscape has changed with ultrasound replacing plain radiographs, and sialoendoscopy replacing submandibular gland excision. Further high-level quality evidence research is required to refine the indications, effectiveness, and safety of sialoendoscopy in pediatric sialolithiasis.
METHODS: A systematic review of sources from the Medline and Embase databases was conducted from inception to Dec 4, 2020. Two researchers independently extracted data and assessed quality.
METHODS: Patients under the age of 18 with sialolithiasis were included.
METHODS: Study design, cohort size, age, sex, symptoms, stone characteristics, diagnostic modality and intervention were collected data points.
RESULTS: Forty-one studies with 243 patients were included in the review, of which 40 were case reports or series. Most stones were found in the submandibular gland (n = 210, 85.4%) and were single stones (n = 101, 71.1%). Average stone size was 7.7 mm. The most common diagnostic imaging modality used was ultrasound (n = 73, 47.4%), shifting from plain radiograph which was favoured in earlier years. Similarly, open gland excision was historically preferred, but since 2000, sialoendoscopy comprised 40.5% of all treatment modalities and continues to increase in prevalence, up to 52.1% by 2020. Extracorporeal shock wave lithotripsy was associated with the highest complication rate of 54.2%.
CONCLUSIONS: The pediatric sialolithiasis diagnostic and therapeutic landscape has changed with ultrasound replacing plain radiographs, and sialoendoscopy replacing submandibular gland excision. Further high-level quality evidence research is required to refine the indications, effectiveness, and safety of sialoendoscopy in pediatric sialolithiasis.
摘要：
目的：评估儿童唾液管结石的证据，包括它的人口特征，诊断,并展示其治疗模式的转变。
方法：从开始到2020年12月4日，对Medline和Embase数据库的来源进行了系统评价。两名研究人员独立提取数据并评估质量。
方法：纳入18岁以下的唾液酸结石患者。
方法：研究设计，队列大小，年龄,性别,症状,石材特性,收集诊断模式和干预措施的数据点.
结果：共有243例患者的41项研究被纳入综述，其中40例是病例报告或系列。大多数结石位于下颌下腺（n=210，85.4％），为单个结石（n=101，71.1％）。平均结石大小为7.7mm。最常用的诊断成像方式是超声（n=73，47.4％），从早些年受到青睐的普通射线照片转变过来。同样，开腺切除术历来是首选，但是自2000年以来，唾液内镜检查占所有治疗方式的40.5%，并且患病率继续增加，到2020年将达到52.1%。体外冲击波碎石术的并发症发生率最高，为54.2%。
结论：随着超声取代X线平片，小儿唾液管结石的诊断和治疗格局发生了变化，鼻内镜取代颌下腺切除术。需要进一步的高质量证据研究来完善适应症，有效性,儿童唾液管结石的唾液内镜检查的安全性。
方法：从开始到2020年12月4日，对Medline和Embase数据库的来源进行了系统评价。两名研究人员独立提取数据并评估质量。
方法：纳入18岁以下的唾液酸结石患者。
方法：研究设计，队列大小，年龄,性别,症状,石材特性,收集诊断模式和干预措施的数据点.
结果：共有243例患者的41项研究被纳入综述，其中40例是病例报告或系列。大多数结石位于下颌下腺（n=210，85.4％），为单个结石（n=101，71.1％）。平均结石大小为7.7mm。最常用的诊断成像方式是超声（n=73，47.4％），从早些年受到青睐的普通射线照片转变过来。同样，开腺切除术历来是首选，但是自2000年以来，唾液内镜检查占所有治疗方式的40.5%，并且患病率继续增加，到2020年将达到52.1%。体外冲击波碎石术的并发症发生率最高，为54.2%。
结论：随着超声取代X线平片，小儿唾液管结石的诊断和治疗格局发生了变化，鼻内镜取代颌下腺切除术。需要进一步的高质量证据研究来完善适应症，有效性,儿童唾液管结石的唾液内镜检查的安全性。
