内镜辅助经口下颌下腺切除术：手术、功能及生活质量结局的前瞻性评估
Endoscopic-assisted transoral submandibular sialadenectomy: a prospective evaluation of surgical, functional, and quality-of-life outcomes.
文献信息
| PMID | 42966796 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Mohamed Ebrahim Abou-Elfotoh |
| 作者单位 | Department of Otolaryngology - Head and Neck Surgery, Faculty of Medicine, Mansoura University, Mansoura, 35511, Egypt. |
| 期刊 | European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery |
| SCI 分区 | Q1 |
| IF | 2.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景： 经颈下颌下腺切除术仍是下颌下腺切除的标准术式，但存在边缘下颌神经损伤和颈部瘢痕的风险。内镜辅助经口下颌下腺切除术已成为一种微创替代方案，可能改善术野显露并降低并发症发生率。
目的： 评估内镜辅助经口下颌下腺切除术的可行性和安全性，并在慢性下颌下腺炎患者的单臂队列中评估术后功能和生活质量结局。
方法： 本前瞻性研究纳入20例于2020年1月至2022年12月期间接受内镜辅助经口下颌下腺切除术的慢性下颌下腺炎成年患者。记录术中及术后并发症。功能结局采用进食评估工具-10（EAT-10）、言语障碍指数（SHI）、疼痛视觉模拟量表（VAS）以及味觉障碍、舌感觉异常和舌偏斜的临床评估进行评价。口腔健康相关生活质量采用改良口腔健康影响程度量表-14（OHIP-14）问卷进行评估。
结果： 所有手术均成功完成，未中转经颈入路。未发生重大术中并发症或永久性神经血管损伤。2例患者出现轻度伤口裂开，1例出现口腔念珠菌病，均经保守治疗痊愈。术后观察到一过性味觉异常、舌感觉异常、舌偏斜、吞咽困难和言语障碍，但均在随访期间完全恢复。口腔健康相关生活质量显著改善，所有患者在术后3个月时OHIP-14评分均显示为最小影响（p = 0.002；效应量 r = 0.89）。
结论： 在这项前瞻性单臂可行性研究中，内镜辅助经口下颌下腺切除术在所有患者中均成功实施，并与低并发症发生率、良好的功能恢复及口腔健康相关生活质量的改善相关。
英文摘要
BACKGROUND: Transcervical submandibular sialadenectomy remains the standard approach for submandibular gland excision but carries the risk of marginal mandibular nerve injury and cervical scarring. Endoscopic-assisted transoral submandibular sialadenectomy has emerged as a minimally invasive alternative that may improve visualization and reduce morbidity.
OBJECTIVES: To evaluate the feasibility and safety of endoscopic-assisted transoral submandibular sialadenectomy and assess postoperative functional and quality-of-life outcomes in a single-arm cohort of patients with chronic submandibular sialadenitis.
METHODS: This prospective study included 20 adult patients with chronic submandibular sialadenitis who underwent endoscopic-assisted transoral submandibular sialadenectomy between January 2020 and December 2022. Intraoperative and postoperative complications were recorded. Functional outcomes were assessed using the Eating Assessment Tool-10 (EAT-10), Speech Handicap Index (SHI), visual analogue scale (VAS) for pain, and clinical evaluation of taste disturbance, tongue paresthesia, and tongue deviation. Oral health-related quality of life was assessed using the modified Oral Health Impact Profile-14 (OHIP-14) questionnaire.
RESULTS: All procedures were completed successfully without conversion to a transcervical approach. No major intraoperative complications or permanent neurovascular injuries occurred. Minor wound dehiscence developed in two patients and oral candidiasis in one patient, all of which resolved with conservative treatment. Transient postoperative taste abnormalities, tongue paresthesia, tongue deviation, dysphagia, and speech impairment were observed but resolved completely during follow-up. Oral health-related quality of life improved significantly, with all patients demonstrating minimal-impact OHIP-14 scores at 3 months postoperatively (p = 0.002; effect size r = 0.89).
CONCLUSION: In this prospective single-arm feasibility study, endoscopic-assisted transoral submandibular sialadenectomy was successfully performed in all patients and was associated with low morbidity, favorable functional recovery, and improved oral health-related quality of life.