识别下颌下(沃顿)导管泪点通常会阻碍内窥镜检查;然而,关于沃顿氏导管乳头的外观是否影响鼻内镜手术的证据很少。基于宏观外观的沃顿氏导管乳头分类,扩张探头的尺寸,本文提出了鼻内镜方法。描述乳头的四种主要类型的分类,A,B,C,D,对315例患者的351例沃顿氏导管乳头进行了前瞻性评估。对于每种乳头类型,人口统计学/临床数据,术中并发症,分析了鼻内镜导入所需的时间。自发性结石挤压后常见入口状乳头(A型),没有术中并发症,并且引入鼻内镜所需的时间最短。正常乳头(B型)是最常见的乳头(48.1%),反映了不同的潜在病理学,而困难的乳头(C型)通常与下颌骨或口腔底部的不利解剖变化有关。基本上闭合的乳头(D型)的术中并发症发生率最高,即,用假通道穿孔,并且需要最长的时间来引入内窥镜。在7名患者(2.0%)中,只有通过瘘管才能进入导管,而8例患者(2.3%)的鼻窦内镜导入失败。总之,沃顿氏导管乳头的出现可能受潜在病理的影响。根据提出的分类,乳头分型会影响鼻内镜导入的持续时间,并可能影响术中并发症的发生频率。
Identifying a submandibular (Wharton\'s) duct punctum often hinders sialendoscopy; however, there is a paucity of evidence on whether the appearance of Wharton\'s duct papilla impacts the sialendoscopic procedure. A classification of Wharton\'s duct papillae based on the macroscopic appearance, size of dilatation probes, and sialendoscopic approach was proposed herein. The classification describing four main types of papillae, A, B, C, and D, was prospectively evaluated on 351 Wharton\'s duct papillae in 315 patients. For each papillae type, the demographic/clinical data, intraoperative complications, and time required for sialendoscope introduction were analyzed. Estuary-like papilla (type A) was commonly seen after spontaneous stone extrusion, had no intraoperative complications noted, and had the shortest time required for the sialendoscope introduction. Normal papilla (type B) was the most frequently observed papilla (48.1%), reflecting diverse underlying pathology, while difficult papilla (type C) was often associated with unfavorable anatomical variations of the mandible or floor of the mouth. Substantially closed papilla (type D) had the highest rate of intraoperative complications, namely, perforation with a false passage, and required the longest time for the sialendoscope introduction. In seven patients (2.0%), the entrance into the duct was feasible only through the fistula, while the sialendoscope introduction failed in eight patients (2.3%). In conclusion, the appearance of Wharton\'s duct papillae may be influenced by the underlying pathology. Based on the proposed classification, papilla typology affects the duration of sialendoscope introduction and may influence the frequency of intraoperative complications.