Levent YÜCEL, Zahide ÇİLER BÜYÜKATALAY, Ozan Bağış ÖZGÜRSOY

Sialendoskopide Başarının Göstergeleri

Amaç: Tükürük bezi taşları, tükürük bezi hastalıklarının yaklaşık %50’sini oluşturur. Sialendoskopi, küçük kalibreli bir endoskop aracılığıyla tükürük kanalının doğrudan görüntülenmesine ve tükürük bezi taşlarının tedavisine olanak sağlar. Gelişen teknoloji ve tekniklere rağmen, sialendoskopik yaklaşımda bazı zorluklar veya sınırlamalar olabilir. Bu çalışmanın amacı, bölümümüzde sialendoskopik işlemlerin sonuçlarını değerlendirmektir. Gereç ve Yöntem: Aralık 2015 ile Eylül 2018 tarihleri arasında sialendoskopi yapılan 34 hastanın tıbbi kayıtları geriye dönük olarak incelendi ve cerrahi veriler, başarı oranları, taş özellikleri ve komplikasyonlar not edildi. Bulgular: Sialendoskopi 26 (%76,5) hastada submandibuler bezde, kalan 8 (%23,5) hastada parotis bezinde yapıldı. Ortalama taş boyutu ve sayısı sırasıyla 6,5 mm ve 1,5 idi. Taşlar 22 hastada (%64,7) kanalda ve 12 hastada (%35,3) hilumda yerleşimliydi. Taşlar 15 hastada (%44,1) hareketli, 11 hastada (%32,4) hareketsizdi. Tanı ve tedavi amaçlı sialendoskopi sırasıyla 33 (%97,1) ve 25 (%73,5) hastada başarıyla uygulandı. Başarı oranları ile taş boyutları arasında istatistiksel olarak anlamlı bir fark yoktu (p>0,05). Ancak, taşların lokalizasyonu ve hareketliliği dikkate alındığında başarı oranları arasında istatistiksel olarak anlamlı bir fark bulundu (p=0,004, p=0,018). Sonuç: Sialendoskopi boyut, lokalizasyon, hareketlilik, taş sayısı, cerrahın deneyimi ve sialendoskopik ekipmanın mevcudiyeti gibi birçok faktörden etkilenebilen tükürük bezi taşlarının tedavisinde minimal invaziv ve güvenilir bir cerrahi tekniktir.

Predictors of Success in Sialendoscopy

Objectives: Sialolithiasis accounts for about 50% of major salivary gland diseases. Sialendoscopy allows direct visualization of the salivary duct through a small-caliber endoscope and treatment of sialolithiasis. In spite of developing technologies and techniques, there may be some difficulties or limitations in the sialendoscopic approach. The purpose of this study is to evaluate the outcomes of sialendoscopic procedures at our department. Materials and Methods: Medical records of 34 patients, who underwent sialendoscopy between December 2015 and September 2018, were retrospectively reviewed, and surgical data, success rates, stone characteristics and complications were noted. Results: Sialendoscopy was performed in the submandibular gland in 26 (76.5%) patients and in the parotid gland in the remaining 8 (23.5%) patients. The mean sialolith size and number were 6.5 mm and 1.5, respectively. The sialoliths were located in the duct in 22 (64.7%) patients and in the hilum in 12 (35.3%) patients. The sialoliths were mobile in 15 (44.1%) patients and immobile in 11 (32.4%) patients. Diagnostic and therapeutic sialendoscopy were successfully performed in 33 (97.1%) patients and 25 (73.5%) patients, respectively. There was not statistically significant difference between success rates and sialolith dimensions (p>0.05); however, a statistically significant difference was found between success rates when the localization and mobility of sialoliths were taken into account (p=0.004, p=0.018). Conclusion: Sialendoscopy is a minimally invasive and reliable surgical technique in the treatment of sialolithiasis, which can be affected by many factors such as size, localization, mobility, number of sialoliths, surgeon’s experience, and the availability of the sialendoscopic equipment.

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