舌下腺囊肿摘除引起舌神经舌下神经舌下静脉损伤的教训

舌下腺囊肿摘除术是口腔颌面外科中的一种小手术。但如果思想上不重视 ,操作中不严格按照操作常规 ,或对局部解剖不熟悉 ,则可能引起严重的后果 ,给病人带来不必要的痛苦。我科在这个问题上有过惨痛的教训 ,为了做好工作 ,把这个病例报告给大家。患者男性 ,2 0岁 ,河南人。主诉 :因左舌下肿物半年 ,生长缓慢。检查 :主舌下有一 2 cm× 2 cm大小肿物 ,椭圆形 ,呈淡蓝色 ,包膜菲薄 ,质软 ,无压痛 ,有明显波动 ,诊断为左舌下腺囊肿。入院后经过一般常规检查后 ,在局麻下行左舌下腺及囊肿摘除术。术后半小时述伤口疼痛 ,未处理 ,2小时发现病人颏…     

舌下腺囊肿的手术治疗

舌下腺囊肿为口腔颌面外科之常见病,好发于青年,多系因舌下腺导管受阻、囊液潴留所致。囊肿常位于前口底,呈浅兰色半透明,有明显的波动感,穿刺可吸出淡黄色粘液。部分病例囊肿穿过下颌舌骨肌向下发展,可无前口     

舌下腺囊肿的非手术治疗

舌下腺囊肿是一种常见的唾液腺囊肿,有多种治疗方法。尽管舌下腺及囊肿摘除术是目前临床上常用的方法,但为了避免手术的并发症,舌下腺囊肿的非手术治疗受到越来越多学者的关注。文章就舌下腺囊肿的硬化治疗、激光治疗及口服药物治疗等做一综述。     

舌下腺囊肿的临床研究：附354例分析

舌下腺囊肿是颌面外科最常见的疾病之一。早在60年代作者曾提出只需全部摘除舌下腺即可达到根治。目前不少学者仍然强调在摘除舌下腺的同时需要摘除囊壁。有的则采取折衷手术方案,即摘除舌下腺的同时,并摘除邻近腺体的囊壁。本文将重庆市     

85例舌下腺囊肿治疗体会

目的　分析舌下腺囊肿手术治疗成败的原因。方法　总结 85例舌下腺囊肿病例 ,其中行舌下腺囊肿袋形切开术 5例 ,单纯囊肿切除术 2 2例 ,全部舌下腺囊肿加舌下腺摘除术 5 2例 ,患侧舌下腺加部分舌下腺囊肿壁切除术 6例。结果　术后复发 6例 ,其中行囊肿袋形切开者 2例 ,口外颌下型行单纯囊肿切除者 4例。术后复发的患者行患侧舌下腺摘除术 ,后均获痊愈。结论　舌下腺囊肿患者从口内切除舌下腺和部分囊壁 ,就能达到很好的根治效果     

安钠咖注射治疗舌下腺囊肿

安钠咖注射治疗舌下腺囊肿董云友钱国珍舌下腺囊肿：为舌下腺导管阻塞，唾液潴留而形成，祖国医学称之为“痰泡”，系狭湿所致。因囊肿似哈蟆之咽囊，故有哈蟆囊之称。此病根据病史及临床表现，即可明确诊断。此病以前主要采用手术方法治疗。①摘除囊肿②囊肿开窗以利于潴...     

180例舌下腺囊肿根治性治疗分析

舌下腺囊肿是由于导管破裂、粘液渗入组织间隙所形成的粘液性囊肿,根治方法是摘除患侧舌下腺,由于手术部位的特殊性而易产生一些并发症,本文收集了１８０例手术治疗所产生的并发症,就其所产生的原因进行分析,提出减少并发症的措施并介绍采用腰麻用的麻醉导管,于术前插入颌下腺导管内作为手术标志的方法。临床资料１－性别及年龄：男性１１０例,女性７０例,年龄６～３３岁。２－部位：口底舌下型１０８例,占６０％;哑铃型５５例,占３０．６％;颌下型１７例,占９．４％。３－病程最长９个月,最短的１４天,平均６周。４－手术方…     

126例舌下腺囊肿治疗体会

１２６例舌下腺囊肿治疗体会湖北省黄石市第三医院（４３５０００）刘勇刚广东省口腔医院艾伟健舌下腺囊肿是口腔颌面外科常见病之一，表现为舌下肿胀的舌下腺囊肿易确诊。若舌下区不肿，仅有颌下肿胀的舌下腺囊肿容易误诊。现将黄石市第三医院和广东省口腔医院１９８８一...     

缝线微袋形术与舌下囊肿摘除术治疗舌下腺囊肿的疗效对比

目的 分析比较缝线微袋形术与舌下囊肿摘除术治疗舌下腺囊肿的疗效,为临床治疗舌下腺囊肿提供参考.方法 回顾性分析我院2016年2月～2020年2月收治的75例舌下腺囊肿患者临床资料,分为舌下囊肿摘除术组40例、缝线微袋形术组35例.比较两组临床疗效、手术相关指标、并发症、复发情况.结果 舌下囊肿摘除术组临床总有效率97....     

舌下腺舌神经鞘瘤临床病例报告及分析

本文通过对经诊治的1例左侧舌下腺舌神经鞘瘤患者进行临床病例报告及分析。发现对于神经鞘瘤这种生长缓慢、包膜完整的良性肿瘤,沿包膜外完整切除,术后3个月复诊创口愈合良好,舌感觉及运动无异常,未见复发。所以在对于舌下腺肿瘤的临床诊断及治疗时,舌神经鞘瘤应予以鉴别诊断。     

Effect of substance P administration on vascular permeability in the rat oral mucosa and sublingual gland

Neuropeptides, including substance P (SP) may play a role in neurogenic inflammation. Although SP-immunoreactive (SP-IR) axons are known to be present within the oral mucosa (OM) and salivary glands, the functional significance of SP in oral mucosa and sublingual salivary gland (SLG) is not fully understood. The present experiments were carried out to study the effects of SP infused into the left common carotid artery on vascular permeability in the OM and in the SLG of male rats. Vascular permeability was assessed on the basis of Evans Blue extravasation. Separate groups of animals received histamine (H₁) receptor antagonist (chloropyramine, 10 mg kg^?1 i.v.) or prostaglandin synthesis inhibitor (indomethacin, 4 mg kg^?1 i.v.) prior to SP infusions. Infusion of SP in doses of 30 and 74 pmol min^?1 increased the vascular permeability of OM by 162.3±16.3% (n=8, p>0.05) and 482.7±46.7% (n=8, p>0.001), respectively. SP in a dose of 15 pmol min^?1 did not increase Evans Blue extravasation in OM (38.3±4.0 μ g^?1, n=8, compared to the control: 44.0±7.9 μg g^?1, n = 8, NS). Although SP increased plasma extravasation in OM, it failed to affect vascular permeability in SLG (15 pmol min^?1 SP: 46.9±6.9 μg g^–1, n = 6, NS; 30 pmol min^?1 SP: 54.1 ±6.2 μg g^?1, n= 11 NS; 74 pmol min^?1 SP: 49.7±2.3 μg g^?1, n = 7, NS; compared to the control: 48.9±5.8 μg g^?1, n = 8). After chloropyramine administration the SP effect on vascular permeability decreased in OM by 41.5±5.9% (n=10, p>0.05). Indomethacin pretreatment similarly diminished the effect of SP on the dye extravasation in OM by 43.9±6.1% (n = 8, p>0.01). Our results suggest that the effect of SP on plasma extravasation in the oral mucosa is partly elicited via the release of vasoactive agents (histamine, prostaglandins), and the microvasculature of SLG has lower sensitivity of SP than that of the oral mucosa.     

微波热凝结合造袋术治疗舌下腺囊肿的临床疗效观察

目的：探讨微波热凝结合造袋术治疗舌下腺囊肿的疗效。方法：81例经微波热凝结合造袋术治疗,术后1个月、3个月复查疗效,如复发可再行治疗,2次治疗未愈认为手术失败,同期采用63例舌下腺及囊肿摘除术治疗作为对照,2者的总有效率进行统计学分析。结果：81例微波热凝结合造袋术治疗后,囊肿壁组织即凝固坏死成痂皮状白斑,逐渐脱落,周围黏膜组织随即覆盖创面,统计学分析总有效率为97.5%,与手术方法差异无显著性。结论：微波热凝结合造袋术安全有效,避免了手术方式摘除舌下腺的缺点,减少了患者的痛苦、达到了微创目的。     

Lymphoepithelial carcinoma in the sublingual gland

Lymphoepithelial carcinoma is rare in the salivary glands, with an incidence of 0.4%. The most commonly affected site is the parotid gland, followed by the submandibular gland. Lymphoepithelial carcinoma in the sublingual gland has been reported only four times in the existing English-language literature. Such tumours are characterized by the presence of a poorly differentiated carcinoma that is surrounded and infiltrated by lymphocytes, and they are strongly associated with Epstein–Barr virus infection, patient ethnicity, and prominent radiosensitivity. Wide surgical excision combined with adjuvant therapy has been suggested as the first-choice therapeutic regimen. This report describes the case of a 34-year-old Indonesian woman who was evaluated and treated in Taipei Medical University Hospital. She had a tumour that presented as a painless swelling on the floor of the mouth. The diagnosis was confirmed by conducting an incisional biopsy, and a wide surgical excision with bilateral supraomohyoid neck dissection and free flap reconstruction was performed. The patient also underwent adjuvant chemoradiotherapy. No evidence of local recurrence or distant metastasis was detected during the 6 months of follow-up. Subsequently, the patient returned to her home country, and further follow-ups were not conducted.     

Adenoid cystic carcinoma associated with salivary duct cyst in the sublingual gland

We described an extremely rare case of adenoid cystic carcinoma associated with salivary duct cyst in the sublingual gland of a 40-year-old Japanese woman. The tumor was growing from the cyst wall and almost occluded the cyst lumen. The epithelium lining the cyst lumen contained both keratin 19-positive cells and alpha-smooth muscle actin-positive cells, indicating the cyst being derived from the acinus/intercalated duct of the sublingual gland. Therefore, our case has presented for the first time a direct evidence that adenoid cystic carcinoma arises from acinus/intercalated duct.     

Immunohistochemical and ultrastructural study of a papillary cystadenocarcinoma arising from the sublingual gland

Immunohistochemical and ultrastructural findings in a rare case of papillary cystadenocarcinoma arising from the left sublingual gland of a 55-year-old Japanese man are reported. Histologically, the tumor tissue was found to be composed of various-sized cystic cavities in which papillary epithelial projections with thin fibrovascular cores were observed. The papillary projections consisted of a single layer to several layers of high columnar epithelial cells. Invasion to the surrounding fibrous tissue and into the lymphatics was observed, thus suggesting an aggressive potential in the present case. The possibility of the involvement of myoepithelial cells could be excluded based on the immunohistochemical and ultrastructural findings. The immunohistochemical and ultrastructural findings also suggested that this type of salivary gland tumor, at least the present case, may arise from striated or excretory ducts. There was positive immunostaining for tumor markers CA19-9 and CA125. However, the biological role of these carbohydrate antigens in salivary gland tumors is unclear at present. Further investigations are, therefore, called for to solve this issue.     

Mucinous adenocarcinoma of the sublingual gland

A case of mucinous (colloid) adenocarcinoma of the sublingual gland is reported. Adenocarcinomas associated with large pools of extracellular mucin are extremely rare in the major salivary glands. Analysis of the tumor for cytokeratin expression, estrogen and progesterone receptors was performed. Predominantly, the tumor expressed cytokeratins 7, 8, 18 and 19 that are commonly found in simple epithelia, and to a lesser degree cytokeratins 4 and 13 which are usually found in complex epithelia. Staining for estrogen and progesterone receptors was negative. No other cancer has been detected for three years after the first examination. The tumor is considered to be a primary mucinous adenocarcinoma of the sublingual gland.     

舌下腺切除术的并发症及处理的临床回顾分析

目的：分析舌下腺切除术治疗舌下腺囊肿的并发症及处理方法。方法：回顾分析682例舌下腺切除术治疗舌下腺囊肿病例,分析总结其并发症的种类、发生率、发生原因及处理结果,提示术中术后的注意点。结果：术后出血、舌神经损伤、感染发生较少,颌下腺导管损伤发生率最高,为1.91%;其次为术后复发,复发率为1.76%,其中有1例7次手术仍复发病例,5例复发者经OK-432囊内注射愈痊。结论：舌下腺切除术术中术后的规范处理可有效防止严重并发症的发生,可作为舌下腺囊肿的基础治疗方法,低复发率仍为其优点,与OK-432囊内注射结合,可有效防止术后的复发。     

口内入路摘除颌下腺的初步研究

目的：探讨口内入路摘除颌下腺的可行性及其优缺点。方法：对12例需和颌下腺摘除的患者从口内入路摘除颌下腺。结果：12例患者颌下腺均顺利摘除，均有舌麻木的表现，无面神经及舌下神经损伤，结论：从口内入路摘除颌下腺，具有不留手术瘢痕，不损伤面神经等优点，可代替传统的颌下腺摘除术。