| 【Objective】 The diseases that cause recurrent parotid gland swelling are mainly chronic obstructive parotitis,chronic recurrent parotitis and Sj?gren’s syndrome and so on.The main performance of the parotid duct is the uneven expansion of the parotid duct,duct stenosis and other morphological changes.The traditional examination methods of parotid gland are B ultrasound,CT,MRI and Sialography.In this study,patients with obstructive parotid disease underwent CBCT sialography and three-dimensional reconstruction of parotid duct.The objective of the study is to assess the value of CBCT sialography in the diagnosis of obstructive parotid disease,to understand the morphology of parotid duct and the site of obstruction.At the same time,3D reconstruction and the measure diameter of parotid duct were performed by computer software to quantitative evaluation of the clinical efficacy of obstructive parotid disease.【Methods】 1.All patients were from the outpatient clinic of oral surgery department of Shanghai Jiaotong University affiliated No.9 Hospital from April 2016 to April 2017.All patients suffering the recurrent parotid gland swelling were included in the research.All patients underwent routine clinical examination,B ultrasound examination,and part of patients with immunological examination and labial gland biopsy.All patients ruled out parotid gland tumor disease.And then all patients underwent CBCT sialography andthree-dimensional reconstruction of parotid duct to understand the morphology of parotid duct and the site of obstruction.2.The patients with chronic obstructive parotitis were treated by 3-6 months of perfusion expansion therapy(0.25% chloramphenicol,once a week,each time 5-10 ml,further consultation after six months).These patients underwent CBCT sialography before and after treatment.3D reconstruction and the measure diameter of these patients parotid duct were performed by computer software before and after treatment,in order to quantitative evaluation of the clinical efficacy of obstructive parotid disease and observation the changes of morphology of parotid duct.【Results】 1.In total,61 patients underwent CBCT sialography and other examinations.Among the 60 patients in the study,33 patients were diagnosed as chronic obstructive parotitis,20 patients were chronic recurrent parotitis and 8 patients were Sj?gren’s syndrome.2.There was no significant difference in the incidence of chronic obstructive parotitis between gender and age of onset.(p>0.05)3.The CBCT sialography imaging of the main,first,second,and third branches of the parotid gland is 100%,89.6%,77.1%,62.5%.4.Parotid duct stenosis(the smallest diameter)occurred in the anterior segment of the duct in 16 cases,accounting for 33.3%;occurred in the middle segment of the duct in 27 cases,accounting for 56.3%;occurred in the posterior segment of the duct in 5cases,accounting for 10.4%.The expansion of the parotid duct(the maximum diameter)ccurred in the anterior segment of the duct in 10 cases,accounting for 20.8%;occurred in the middle segment of the duct in 13 cases,accounting for 27.1%;occurred in the posterior segment of the duct in 25 cases,accounting for 52.1%.5.The patients with chronic obstructive parotitis were treated by 3-6 months of perfusion expansion therapy.There were 7 patients completed the course of treatment,re examination of CBCT sialography.6.The results showed that before and after treatment,there were significant difference in the stricture and the diameter difference(the maximum diameter-the smallest diameter)of the duct.(p<0.05)【Conclusions】 1.CBCT sialography can clearly show the main duct and branch duct of parotid duct,and can be combined with computer software for three-dimensional reconstruction and measurement of the diameter of the parotid duct.2.Parotid gland duct dilatation segment prone to the posterior of the parotid duct.Parotid gland duct stenosis site prone to the anterior segment of the parotid duct,and secondly occurred in the middle segment of the duct.3.Perfusion expansion therapy in clinical treatment of chronic obstructive parotitis has obvious clinical efficacy. |
