RESUMO
PURPOSE: The management of large hilar calculi is a technically challenging issue during sialoendoscopic surgery. The aim of the present study was to evaluate the clinical efficacy of sialoendoscopically assisted open sialolithectomy for the removal of large submandibular hilar calculi to avoid sialoadenectomy. PATIENTS AND METHODS: The present study was undertaken among patients with sialolithiasis scheduled for sialoendoscopic surgery from August 2005 to October 2008. When we failed to remove large submandibular hilar stones intraductally, we performed sialoendoscopically assisted open sialolithectomy. The clinical characteristics, pre- and intraoperative data, and outcomes were documented in a prospective fashion. RESULTS: Of 78 consecutive patients with submandibular sialolithiasis, 18 were treated with sialoendoscopically assisted open sialolithectomy immediately after failure of intraductal removal of calculi by sialoendoscopy. For 17 patients, large hilar sialoliths were successfully removed using this surgical technique. The surgery failed in 1 patient with multiple sialoliths, and the procedure was converted to open sialoadenectomy. Temporary numbness of the tongue for 1 week postoperatively was documented in 3 patients. The patients were followed up for a median period of 18 months without any symptoms or signs of recurrence. CONCLUSION: Our results suggest that sialoendoscopically assisted open sialolithectomy is an effective and safe surgical technique to remove large submandibular hilar calculi.
Assuntos
Endoscopia , Cálculos dos Ductos Salivares/cirurgia , Doenças da Glândula Submandibular/cirurgia , Adulto , Endoscópios , Feminino , Humanos , Procedimentos Cirúrgicos Minimamente Invasivos , Procedimentos Cirúrgicos Bucais/métodos , Cuidados Pós-Operatórios , Complicações Pós-Operatórias , StentsAssuntos
Histiocitoma Fibroso Benigno/patologia , Mandíbula/cirurgia , Neoplasias Mandibulares/patologia , Reconstrução Mandibular/métodos , Adulto , Transplante Ósseo , Histiocitoma Fibroso Benigno/diagnóstico por imagem , Histiocitoma Fibroso Benigno/cirurgia , Humanos , Masculino , Neoplasias Mandibulares/diagnóstico por imagem , Neoplasias Mandibulares/cirurgia , Reconstrução Mandibular/instrumentação , Antígeno Nuclear de Célula em Proliferação/análise , Radiografia PanorâmicaRESUMO
OBJECTIVE: To investigate the clinical application of free forearm flap in the functional hemitongue reconstruction. METHODS: From July 2002 to November 2006, 40 patients with tongue cancer underwent hemiglossectomy and primary hemitongue reconstruction with free forearm flaps. In some cases, the lateral antebrachial cutaneous nerves of the flaps were anastomosed with the lingual nerve to restore the flap sensation. RESULTS: All patients recovered uneventfully after surgery with no morbidity in the donor site. All free flaps survived. The average follow-up period was 2 years and 6 months. The aesthetic and functional results were both satisfactory. The swallowing and speech function were almost normal. The flap sensation was partially restored. CONCLUSIONS: Good functional hemitongue reconstruction can be achieved with free forearm flaps.