chronic obstructive sialadenitis & sialendoscopy
TRANSCRIPT
![Page 1: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/1.jpg)
Chronic Obstructive Chronic Obstructive
SialadenitisSialadenitis
&&
SialendoscopySialendoscopy
Chronic Obstructive Chronic Obstructive
SialadenitisSialadenitis
&&
SialendoscopySialendoscopy
![Page 2: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/2.jpg)
Parotid Ductal System
Nicolaus Stenonius
1660
Anatomy--Salivary gland Anatomy--Salivary gland
Stensen’s duct
![Page 3: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/3.jpg)
• Submandibular Ductal System
Thomas Wharton, 1659
• Sublingual Ductal System
Casparus Bartholinus, 1690
Anatomy--Salivary glandAnatomy--Salivary gland
Wharton’s duct
Bartholin’s duct
![Page 4: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/4.jpg)
Chronic Obstructive Chronic Obstructive SialadenitisSialadenitis
Chronic Obstructive ParotitisChronic Obstructive Parotitis
Submandibular sialadenitisSubmandibular sialadenitis
![Page 5: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/5.jpg)
Chronic Obstructive Chronic Obstructive ParotitisParotitis
EtiologyEtiology
Clinical manifestationsClinical manifestations
DiagnosisDiagnosis
TreatmentTreatment
![Page 6: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/6.jpg)
Etiology ofEtiology of
Chronic Obstructive Chronic Obstructive
ParotitisParotitis ScarScar
SialolithiasisSialolithiasis
AnatomyAnatomy
![Page 7: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/7.jpg)
Clinical Clinical manifestationsmanifestations
Recurrent swelling and pain Recurrent swelling and pain
of the gland of the gland
Purulent dischargePurulent discharge
![Page 8: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/8.jpg)
Diagnostic methodsDiagnostic methods Plain radiographsPlain radiographs
SialographySialography
UltrasoundUltrasound
Scintigraphy(Scintigraphy( 闪烁扫描法闪烁扫描法 ) )
CT CT
MRIMRI
![Page 9: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/9.jpg)
SialographySialography
“Sausage like” appearance of enlarged duct“Sausage like” appearance of enlarged duct
![Page 10: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/10.jpg)
MRIMRI
Appearance of enlarged duct
![Page 11: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/11.jpg)
Sialography EndoscopySialography Endoscopy Sialography EndoscopySialography Endoscopy
DilationDilation StenosisStenosis
SialendoscopySialendoscopy
![Page 12: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/12.jpg)
Differentiating Differentiating diagnosisdiagnosis
Chronic recurrent parotitis
SjÖgren syndrome
Chronic recurrent parotitis
SjÖgren syndrome
![Page 13: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/13.jpg)
TreatmentTreatment systemic antibiotic administration
Sialogogues(促唾剂 )
Gland massage
Drug lavage(灌洗 ) and perfusion
systemic antibiotic administration
Sialogogues(促唾剂 )
Gland massage
Drug lavage(灌洗 ) and perfusion
Duct ligation
Parotidectomy
Tympanic(鼓室 ) neurectomy
Duct ligation
Parotidectomy
Tympanic(鼓室 ) neurectomy
![Page 14: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/14.jpg)
Submandibular Submandibular
sialadenitis sialadenitis
and and
SialolithiasisSialolithiasis
Submandibular Submandibular
sialadenitis sialadenitis
and and
SialolithiasisSialolithiasis
![Page 15: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/15.jpg)
Etiology of Etiology of
Submandibular Submandibular
sialadenitis sialadenitis SialolithiasisSialolithiasis
TraumaTrauma
InfectionInfection
Foreign bodyForeign body
![Page 16: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/16.jpg)
SialolithiasisSialolithiasis Reasons of Reasons of arisingarising
1. Anatomy1. Anatomy
Upwarding routeUpwarding route Longer ductLonger duct Curve duct Curve duct
2.Components of saliva2.Components of saliva
Mucus proteinMucus protein Calcium contentCalcium content
![Page 17: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/17.jpg)
ManifestationsManifestationsManifestationsManifestations
Intermittent swelling of the Intermittent swelling of the
glandgland
Aggravating with taking foodAggravating with taking food
Acute infectionAcute infection
![Page 18: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/18.jpg)
Diagnostic methodsDiagnostic methods
plain radiographsplain radiographs sialographysialography ultrasoundultrasound CT scan CT scan SialoendoscopySialoendoscopy
![Page 19: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/19.jpg)
Plain radiographsPlain radiographs
One Two Three
![Page 20: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/20.jpg)
Sialography Sialography && CT CT
Sialolith
![Page 21: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/21.jpg)
SialoendoscopySialoendoscopy
Stone in main ductStone in second branch duct
Stone embedded
![Page 22: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/22.jpg)
Differentiating diagnosisDifferentiating diagnosis
Tumor in sublingual glandTumor in sublingual gland
Tumor in submandibular glandTumor in submandibular gland
KKÜÜtter tumortter tumor
Space infection in submandibular regionSpace infection in submandibular region
LymphadenopathyLymphadenopathy
![Page 23: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/23.jpg)
Traditional treatmentTraditional treatment
Intraoral routeIntraoral route
Sialadenectomy via external Sialadenectomy via external
approachapproach
![Page 24: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/24.jpg)
New technique New technique
SialendoscopySialendoscopy
Diagnostic SialendoscopyDiagnostic Sialendoscopy
Interventional SialendoscopyInterventional Sialendoscopy
![Page 25: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/25.jpg)
History of the History of the
SialendoscopySialendoscopy 19911991 KatzKatz Flexible mini-endoscopeFlexible mini-endoscope
19931993 KonigsbergerKonigsberger Endoscopic intracorporeal lithotripsyEndoscopic intracorporeal lithotripsy
19941994 Arzoz Arzoz Endoscopic intracorporeal lithotripsyEndoscopic intracorporeal lithotripsy
Nahlieli Nahlieli SialendoscopySialendoscopy
1995 1995 Marchal Marchal SialendoscopySialendoscopy
1999 1999 Our Dept.Our Dept. YuYu
![Page 26: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/26.jpg)
Diagnostic Diagnostic SialendoscopySialendoscopy
First generation branches Second generation branches
![Page 27: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/27.jpg)
Types of obstructionsTypes of obstructions
SialolithSialolith
Polyps Polyps
StrictureStricture
KinkKink
Foreign bodyForeign body
Anatomic malformationAnatomic malformation
SialolithSialolith
Polyps Polyps
StrictureStricture
KinkKink
Foreign bodyForeign body
Anatomic malformationAnatomic malformation
![Page 28: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/28.jpg)
SialolithSialolith
Main ductFirst branch of duct
80%~90% in Submandibular gland
![Page 29: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/29.jpg)
Polyps and Mucous Polyps and Mucous PlugPlug
Sialolith
10%~30% in Parotid gland
Mucous Plug Sialolith?
![Page 30: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/30.jpg)
Interventional SialendoscopyInterventional Sialendoscopy
Grasping wire basketGrasping wire basket
Biopsy forcepsBiopsy forceps
Balloon-tipped catheterBalloon-tipped catheter
Custom papilla dilatorCustom papilla dilator
Electrohydraulic lithotripterElectrohydraulic lithotripter
Holmium laser probeHolmium laser probe
![Page 31: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/31.jpg)
Grasping wire basketGrasping wire basket
diameter<4mmdiameter<4mm
![Page 32: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/32.jpg)
Balloon-tipped catheterBalloon-tipped catheter
Stenosis in the second branchStenosis in the second branch
Ductal StenosisDuctal Stenosis
Close-up view of the same site
Close-up view of the same site
![Page 33: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/33.jpg)
diameter>4mmdiameter>4mm • Stone was fragmentized by Lithotripter
• Debris extracted by wire basket
• Stone was fragmentized by Lithotripter
• Debris extracted by wire basket
Electrohydraulic Shockwave Electrohydraulic Shockwave LithotripsyLithotripsy
![Page 34: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/34.jpg)
Holmium laser probeHolmium laser probe
Laser fragmentationLaser fragmentation
Stone debris extracted by wire basketStone debris extracted by wire basket
![Page 35: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/35.jpg)
Sialendoscopy in our Sialendoscopy in our departmentdepartment
1999 2002 2003
![Page 36: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/36.jpg)
Sialolith removal by Sialolith removal by graspergrasper
![Page 37: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/37.jpg)
Radiolucent sialolithRadiolucent sialolith
![Page 38: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/38.jpg)
Mucus plug---Lavage and Mucus plug---Lavage and dilationdilation
![Page 39: Chronic Obstructive Sialadenitis & Sialendoscopy](https://reader036.vdocument.in/reader036/viewer/2022081419/56649f275503460f94c3e818/html5/thumbnails/39.jpg)
Thank youThank youThank youThank you