악하선 타석증의 임상적 특성과 수술적 치료 결과

Background and Objectives: Submandibular sialolithiasis is one of common otolaryngologic diseases. Stones located in the distal portion of Wharton’s duct can be easily removed by intraoral approach. Hilar stone was removed traditionally by excision of submandibular gland. However, intraoral removal of hilar stone or stone of proximal portion of Wharton’s duct has increased recently. In this study, we evaluated clinical characteristics and surgical outcomes of submandibular sialolithiasis according to surgical approach and the location of stone. Materials and Methods: We retrospectively reviewed the data of patients with submandibular sialolithiasis who had undergone surgical treatment from January 2006 to April 2016. We classified stones into 5 groups according to the location (distal, middle, proximal, hilar, and intraparenchymal). We investigated patient demographics, size of stone, number of stone, complications, surgical approach (intraoral vs. external approach), and recurrence. Results: Patients with submandibular sialolithiasis presented with submandibular swelling (65.7%) or pain (11.9%). Sialoliths were located mainly at the distal portion (44.7%) and hilar portion of Wharton’s duct (36.9%). Most hilar stones were removed intraorally(82.4%). Complication rate was not different between the intraoral approach group (4.7%) and the external approach group (4.5%) in hilar and proximal stones. Recurrence occurred in 7 cases (1.8%), and recurrence was significantly correlated with multiplicity of stone (p=0.04). Conclusions? Submandibular sialoliths were mainly located at distal and hilar portion of Wharton’s duct. Recurrence after surgical removal is relatively low, and multiple stone is associated with recurrence. (J Clinical Otolaryngol 2017;28:199–204)