Submandibuler siyalolityazise yaklaşımımız
Submandibular bez siyalolityazis tanısıyla kliniğimize baş- başvuran 20 hastanın dosyasını retrospektif olarak değerlendirdik. Olgularımızın tanısında anamnez ve klinik muayenenin yanısıra ultrasonografi (USG) ve siyalogra- finin önemini de araştırdık. Submandibuler siyalolityazis olgularının tedavisinde intraoral yol ile eksternal boyun yaklaşımının hangi vakalarda yapılabileceğini tartıştık. En sık karşılaşılan anamnez bulgusu 20 hastada (%100) submandibuler bölgede şişlik ve 16 (%80) hastada yemekle birlikte ağrılı şişliğin artmasıydı. Tüm hastalara USG yapıldı ve hastaların 17’sinde taşa ait bulgular saptandı. Eksternal boyun yolu ile yaklaşılan 15 hasta-dan 13’ünde siyalografide taş bulguları vardı. Hastaların 5’ine intraoral girişimle taş ekzisyonu ve kanal ekspo-zisyonu, geriye kalan 15’ine ise boyun eksplorasyonu ile bez ekzisyonu yapıldı. Submandibuler siyalolityazis tanı-sında anamnez en önemli rolü oluşturmaktadır. Subman-dibuler bölgede şişlik ile başvuran hastada özellikle şişliğin yemekle ilgisi varsa siyalolityazis olabileceğini düşünmek gerekir. Eğer palpasyonla submandibular bez kanalında taş tespit ediliyorsa taşın intraoral çıkarılması öncelikle planlanmalıdır, aksi halde eksizyon tercih edilmelidir.
Our approach to submandibular sialolithiasis
At the E.N.T. Department of Atatürk Training and Research Hospital, we searched 20 patient’s file who applied for submandibular sialolithiasis. We evaluated the role of history and clinical examination also USG and sialography. We discussed which to prefer; intraoral way or external neck approach in the treatment of submandibular sialolithiasis. The most common symptom is swelling of gland in 20 patients (100%) and increasing of swelling with pain after meals in 16 patients (80%). All the patients underwent to USG, in 17 patients, there were ultrasonography findings about the concretion. We used intraoral way to remove the calculi and duct exposition in 5 patients and external neck approach and gland excision in 15 patients. Patients history has the most important role in diagnoses of the submandibular sialolithiasis. If the patients who have submandibular swelling have had concern about meals, we should remember sialolithiasis. We advice intraoral excision if concreation can be diagnosed by Wharton duct palpation, otherwise the excision is preferred.
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