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Stenosen und andere nicht steinbedingte Obstruktionen der Speicheldrüsenausführungsgänge

Moderne Therapiekonzepte

Stenosis and other non-sialolithiasis-related obstructions of the major salivary gland ducts

Modern treatment concepts

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Zusammenfassung

Die Versorgung von Stenosen und nicht steinbedingten Obstruktionen der Speicheldrüsenausführungsgänge hat seit der Entwicklung von minimal-invasiven Verfahren, insbesondere der Speichelgangendoskopie, eine signifikante Veränderung erfahren. Eine exakte Diagnostik ist meist nur mit der Sialendoskopie, nicht jedoch mit konventionellen bildgebenden Verfahren möglich. Sie gilt aber als Voraussetzung einer adäquaten Therapie. Während der letzten 10 Jahre wurde ein Spektrum von minimal-invasiven Therapiemaßnahmen mit dem Ziel entwickelt, die Drüsenfunktion zu erhalten. Neben sialographisch kontrollierten Methoden spielt v. a. die interventionelle Sialendoskopie eine entscheidende Rolle. Sie ist die Therapie der Wahl mit einer Erfolgsrate von etwa 85–90%. Durch die Kombination mit anderen minimal-invasiven operativen Verfahren am Gangsystem kann die Erfolgsrate auf mehr als 95% gesteigert werden. Die Sialendoskopie spielt damit eine zentrale Rolle bei der Therapie von nicht steinbedingten obstruktiven Speicheldrüsenerkankungen. Die operative Entfernung der Speicheldrüse sollte als letzter Schritt erwogen werden.

Abstract

The treatment of stenoses and non-stone-related obstructive diseases of the major salivary glands has undergone significant changes due to the development of minimally invasive treatment modalities. Correct diagnosis can often not be established in detail with all diagnostic tools except sialendoscopy, which is necessary for gland-preserving therapy. Over the last 10 years a range of minimally invasive treatment approaches aimed at preserving gland function have been developed. In addition to sialography-controlled therapy, interventional sialendoscopy plays a central role, representing the treatment of first choice in all stenoses and non-stone-related obstructions of the salivary duct system and with a success rate of about 85%–90%. By combining sialendoscopy with other minimally invasive surgical procedures, the function of the gland can be preserved in more than 95%. Thus sialendoscopy plays a crucial role in the treatment of non-stone-related obstructive diseases of the major salivary glands. In stenoses of the salivary gland ducts extirpation of the gland should be considered only as a last step.

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Authors and Affiliations

  1. Hals-Nasen-Ohren-Klinik, Kopf- und Halschirurgie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Waldstraße 1, 91054, Erlangen, Deutschland

    M. Koch, H. Iro & J. Zenk

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  1. M. Koch
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  3. J. Zenk
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Correspondence to M. Koch.

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Koch, M., Iro, H. & Zenk, J. Stenosen und andere nicht steinbedingte Obstruktionen der Speicheldrüsenausführungsgänge. HNO 58, 218–224 (2010). https://doi.org/10.1007/s00106-009-2076-z

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