Abstract：
BACKGROUND: We investigated complications and recurrence rates after surgical techniques for sialolith removal with intact and resected Wharton\'s duct of the submandibular gland.
METHODS: The retrospective case-control analysis of a series analysed 271 surgical operations (2003-2022) for sialolithiasis performed at a hospital department of Otolaryngology-Head and Neck Surgery. The study compared two approaches: (1) pure endoscopic technique or pinpoint stone removal with Wharton\'s duct left intact and (2) transoral duct dissection or pinpoint stone removal technique, after which the duct was shortened. While choosing the surgical option, the size of the stone, the location of the stone, and the presence of multiple stones were taken into account. The rates of complications (lingual nerve paraesthesia, duct stenosis, drooling, and sialoadenitis), the incidence of foreign bodies, and the rate of recurrence during follow-up of ≥18 months were compared.
RESULTS: 323 sialoliths were removed from 271 patients. Of these 323 calculi, 150 were removed by the first approach and 173 by the second approach. The calculi varied in diameter from 2 to 38 mm with an average diameter of 8.2 mm. For all 271 patients, the rate of recurrence was 4.8%, but 11 recurrent cases (8.7%) appeared after the first approach surgeries and 2 cases (1.4%) after the second approach surgeries (p = .03). Other variables did not show statistically significant differences.
CONCLUSIONS: Surgical removal of the submandibular calculi, ending with shortening of Wharton\'s duct, reduces the recurrence rate for sialolithiasis but does not affect the rate of postsurgical complications.
METHODS: The retrospective case-control analysis of a series analysed 271 surgical operations (2003-2022) for sialolithiasis performed at a hospital department of Otolaryngology-Head and Neck Surgery. The study compared two approaches: (1) pure endoscopic technique or pinpoint stone removal with Wharton\'s duct left intact and (2) transoral duct dissection or pinpoint stone removal technique, after which the duct was shortened. While choosing the surgical option, the size of the stone, the location of the stone, and the presence of multiple stones were taken into account. The rates of complications (lingual nerve paraesthesia, duct stenosis, drooling, and sialoadenitis), the incidence of foreign bodies, and the rate of recurrence during follow-up of ≥18 months were compared.
RESULTS: 323 sialoliths were removed from 271 patients. Of these 323 calculi, 150 were removed by the first approach and 173 by the second approach. The calculi varied in diameter from 2 to 38 mm with an average diameter of 8.2 mm. For all 271 patients, the rate of recurrence was 4.8%, but 11 recurrent cases (8.7%) appeared after the first approach surgeries and 2 cases (1.4%) after the second approach surgeries (p = .03). Other variables did not show statistically significant differences.
CONCLUSIONS: Surgical removal of the submandibular calculi, ending with shortening of Wharton\'s duct, reduces the recurrence rate for sialolithiasis but does not affect the rate of postsurgical complications.
摘要：
背景：我们调查了手术技术切除唾液酸石后的并发症和复发率，并切除了颌下腺的Wharton导管。
方法：回顾性病例对照分析分析了在耳鼻咽喉头颈外科医院进行的271例唾液石结石手术（2003-2022年）。该研究比较了两种方法：（1）纯内镜技术或精确取石，沃顿氏导管保留完整；（2）经口腔导管解剖或精确取石技术，之后管道缩短了。在选择手术选项时，石头的大小,石头的位置,并考虑了多块石头的存在。并发症的发生率(舌神经感觉异常，导管狭窄,流口水,和唾液腺炎)，异物的发生率，并比较≥18个月随访期间的复发率。
结果：从271例患者中取出323个唾液石。在这323个结石中，通过第一种方法去除150个，通过第二种方法去除173个。结石的直径从2到38毫米不等，平均直径为8.2毫米。对于所有271名患者，复发率为4.8%,但第一次入路手术后出现11例(8.7%)，第二次入路手术后出现2例(1.4%)(p=.03)。其他变量没有显示出统计学上的显著差异。
结论：下颌下结石的手术切除，以缩短沃顿的管道结束，降低了唾液酸结石的复发率，但不影响术后并发症的发生率。
方法：回顾性病例对照分析分析了在耳鼻咽喉头颈外科医院进行的271例唾液石结石手术（2003-2022年）。该研究比较了两种方法：（1）纯内镜技术或精确取石，沃顿氏导管保留完整；（2）经口腔导管解剖或精确取石技术，之后管道缩短了。在选择手术选项时，石头的大小,石头的位置,并考虑了多块石头的存在。并发症的发生率(舌神经感觉异常，导管狭窄,流口水,和唾液腺炎)，异物的发生率，并比较≥18个月随访期间的复发率。
结果：从271例患者中取出323个唾液石。在这323个结石中，通过第一种方法去除150个，通过第二种方法去除173个。结石的直径从2到38毫米不等，平均直径为8.2毫米。对于所有271名患者，复发率为4.8%,但第一次入路手术后出现11例(8.7%)，第二次入路手术后出现2例(1.4%)(p=.03)。其他变量没有显示出统计学上的显著差异。
结论：下颌下结石的手术切除，以缩短沃顿的管道结束，降低了唾液酸结石的复发率，但不影响术后并发症的发生率。
