唾液腺內視鏡之臨床應用

10.6666/ClinMed.2017.80.1.070

張嘉帆

唾液腺內視鏡(sialendoscopy) ； 唾液腺結石(sialolithiasis) ； 唾液腺狹窄(ductal stenosis) ； 唾液腺炎(sialadenitis) ； 修格蘭氏症候群(Sjogren's syndrome)

臨床醫學月刊

80卷1期（2017 / 07 / 28）

374 - 378

繁體中文

隨著微創手術之盛行，在耳鼻喉方面之應用，如經口機械手臂手術(transoral roboticsurgery)、經口二氧化碳雷射咽喉顯微手術(transoral CO2 laser microsurgery)及經鼻內視鏡顱底手術(transnasal endoscopic skull base surgery)等，藉由正常開口或微小切口，將大範圍之腫瘤切除，並避免周邊組織之傷害，達到器官保留之目的，同樣的唾液腺內視鏡(sialendoscopy)也是以微創之方式，經由約0.5公厘之口內開口，逐步擴張後，以直徑0.8至1.6公厘之半硬式內視鏡，進入唾液腺管徑，檢視可能之病灶，再將可能之病灶移除、擴張或給予藥物沖洗，試著恢復原有唾液腺分泌之功能，是同時兼具診斷及治療之手術；唾液腺內視鏡從1990年由歐洲開始施行，最初之模糊影像發展至今，已逐步接近到高畫質，目前主要應用在腮腺、下頷腺及一小部分舌下腺，適應症主包含阻塞性唾液腺炎，如唾液腺結石(sialolithiasis)、狹窄(ductal stenosis)或黏液栓塞(mucus plug)等，另包含幼年型復發性腮腺炎(juvenile recurrent parotitis)、放射性碘相關唾液腺炎(radioiodine-induced sialadenitis)及修格蘭氏症候群(Sjogren's syndrome)等，提供新的治療選擇，治療效果佳，並減少將唾液腺切除之需要，以及避免腺體移除之可能併發症。

1. Atienza, G,Lopez-Cedrun, JL(2015).Management of obstructive salivary disorders by sialendoscopy: a systematic review.Br J Oral Maxillofac Surg,53,507-519.
2. Bhayani, MK,Acharya, V,Kongkiatkamon, S(2015).Sialendoscopy for patients with radioiodine-induced sialadenitis and xerostomia.Thyroid,25,834-838.
3. Dingle, IF,Mishoe, AE,Nguyen, SA(2013).Salivary morbidity and quality of life following radioactive iodine for welldifferentiated thyroid cancer.Otolaryngol Head Neck Surg,148,746-752.
4. Erkul, E,Gillespie, MB(2016).Sialendoscopy for non-stone disorders: The current evidence.Laryngo Invest Otolaryngol,1,140-145.
5. Gillespie, MB,O'Connell, BP,Rawl, JW(2015).Clinical and quality-of-life outcomes following gland-preserving surgery for chronic sialadenitis.Laryngoscope,125,1340-1344.
6. Iro, H,Zenk, J(2014).Salivary gland disease in children.GMS Curr Top Otorhinolaryngol Head Neck Surg,13,Doc06.
7. Kim, JW,Han, GS,Lee, SH(2007).Sialoendoscopic treatment for radioiodine induced sialadenitis.Laryngoscope,117,133-136.
8. Kiringoda, R,Eisele, DW,Chang, JL(2014).A comparison of parotid imaging characteristics and sialendoscopic findings in obstructive salivary disorders.Laryngoscope,124,2696-2701.
9. Koch, M,Iro, H,Klintworth, N(2012).Results of minimally invasive gland-preserving treatment in different types of parotid duct stenosis.Arch Otolaryngol Head Neck Surg,138,804-810.
10. Koch, M,Kunzel, J,Iro, H(2014).Long-term results and subjective outcome after gland-preserving treatment in parotid duct stenosis.Laryngoscope,124,1813-1818.
11. Koch, M,Zenk, J,Iro, H(2009).Algorithms for treatment of salivary gland obstructions.Otolaryngol Clin North Am,42,1173-1192.
12. Lee, HN,An, JY,Lee, KM(2015).Salivary gland dysfunction after radioactive iodine (I-131)therapy in patients following total thyroidectomy: emphasis on radioactive iodine therapy dose.Clin Imag,39,396-400.
13. Mandel, SJ,Mandel, L(2003).Radioactive iodine and the salivary glands.Thyroid,13,265-271.
14. Patrick, J.(ed.),Bradley, OG-L(ed.)(2011).Salivary gland disorders and diseases: diagnosis and management.New York:Thieme.
15. Ramakrishna, J,Strychowsky, J,Gupta, M(2015).Sialendoscopy for the management of juvenile recurrent parotitis: a systematic review and meta-analysis.Laryngoscope,125,1472-1479.
16. Rasmussen, ER,Lykke, E,Wagner, N(2016).The introduction of sialendoscopy has significantly contributed to a decreased number of excised salivary glands in Denmark.Eur Arch Otorhinolaryngol,273,2223-2230.
17. Roby, BB,Mattingly, J,Jensen, EL(2015).Treatment of juvenile recurrent parotitis of childhood: an analysis of effectiveness.JAMA Otolaryngol Head Neck Surg,141,126-129.
18. Shacham, R,Puterman, MB,Ohana, N(2011).Endoscopic treatment of salivary glands affected by autoimmune diseases.Oral Maxillofac Surg,69,476-481.
19. Sigismund, PE,Zenk, J,Koch, M(2015).Nearly 3,000 salivary stones: some clinical and epidemiologic aspects.Laryngoscope,125,1879-1882.
20. Strychowsky, JE,Sommer, DD,Gupta, MK(2012).Sialendoscopy for the management of obstructive salivary gland disease.Arch Otolaryngol Head Neck Surg,138,541-547.
21. Vashishta, R,Gillespie, MB(2013).Salivary endoscopy for idiopathic chronic sialadenitis.Laryngoscope,123,3016-3020.

1. 鄭佩茹(Pei-Ru Jeng);蘇芝庭(Chih-Ting Su);袁秋榮(Chiou-Rung Yuan)(2022)。照顧一位行唾液腺內視鏡手術病人之即日手術全期護理經驗。榮總護理。39(4)。377-382。