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Speichelgangsendoskopie in der Diagnostik und Therapie von obstruktiven Speicheldrüsenerkrankungen

Diagnostic and interventional sialoscopy in obstructive diseases of the salivary glands

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Zusammenfassung

Hintergrund

Bei obstruktiven Erkrankungen der Kopfspeicheldrüsen kann mittels der konventionellen bildgebenden Verfahren in bis zu 10% aller Fälle die Diagnose nicht sicher gestellt werden. Mithilfe der Speicheldrüsenendoskopie (SGE) können Befunde intraduktal direkt sichtbar gemacht werden. Sie kann so entscheidend für die Diagnosestellung und die weitere Therapieplanung werden.

Material und Methoden

Zwischen 2001 und 2005 wurden bei 318 Patienten insgesamt 369 Sialoskopien in unserer Klinik durchgeführt. Es wurden semiflexible Endoskope mit einem Durchmesser von 0,7–1,7 mm verwendet.

Ergebnisse

Bei 34,9% aller Patienten waren konservative Maßnahmen ausreichend. In 65,1% aller Fälle wurde, basierend auf dem Ergebnis der SGE, die weitere Therapie (interventionelle SGE, ESWL, oder Gangschlitzung etc.) geplant. Von insgesamt 133 durchgeführten interventionellen SGE waren 83,5% erfolgreich.

Schlussfolgerung

Die Sialoskopie stellt eine wertvolle Ergänzung in der Diagnostik von Speicheldrüsenkrankheiten dar. Aufgrund ihrer hohen Erfolgsraten sollte die interventionelle SGE im Konzept einer speicheldrüsenerhaltenden Therapie einen festen Platz haben.

Abstract

Background

In 5–10% of all cases with an obstructive disease of the major salivary glands, a diagnosis cannot be established by conventional radiological imaging or ultrasound. Using sialendoscopes, intraductal pathology can made visible to the surgeon, aiding in diagnosis and adequate treatment.

Material and methods

Between 2001 and 2005, 369 sialoscopies were performed on 318 patients in the ENT department of the University of Erlangen-Nuremberg. Semi-rigid sialoscopes with an external diameter of between 0.7 and 1.7 mm were used.

Results

In 34.9% of cases conservative treatment was necessary. In 65.1%, based on the sialoscopic findings, further therapeutic procedures such as extracorporeal shock wave lithotripsy, interventional sialoscopy or duct slitting were required and planned. Of 133 performed interventional sialoscopies, 83.5% were successful.

Conclusions

Sialoscopy is a useful diagnostic and therapeutic tool in obstructive salivary gland disease. Interventional sialoscopy has been performed with high success rates and has proven to be an important part in our concept of a gland preserving therapeutic regime.

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Authors and Affiliations

  1. Hals- Nasen-, Ohrenklinik, Kopf- und Hals-Chirurgie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Waldstraße 1, 91054, Erlangen, Deutschland

    M. Koch, J. Zenk & H. Iro

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  1. M. Koch
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  2. J. Zenk
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  3. H. Iro
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Correspondence to M. Koch.

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Koch, M., Zenk, J. & Iro, H. Speichelgangsendoskopie in der Diagnostik und Therapie von obstruktiven Speicheldrüsenerkrankungen. HNO 56, 139–144 (2008). https://doi.org/10.1007/s00106-007-1563-3

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