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Sialendoscopy-Based Analysis of Submandibular Duct Papillae with a Proposal for Classification

Identifying a submandibular (Wharton’s) duct punctum often hinders sialendoscopy; however, there is a paucity of evidence on whether the appearance of Wharton’s duct papilla impacts the sialendoscopic procedure. A classification of Wharton’s duct papillae based on the macroscopic appearance, size of...

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Autores principales: Aničin, Aleksandar, Jerman, Anže, Urbančič, Jure, Pušnik, Luka
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9917658/
https://www.ncbi.nlm.nih.gov/pubmed/36769777
http://dx.doi.org/10.3390/jcm12031129
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author Aničin, Aleksandar
Jerman, Anže
Urbančič, Jure
Pušnik, Luka
author_facet Aničin, Aleksandar
Jerman, Anže
Urbančič, Jure
Pušnik, Luka
author_sort Aničin, Aleksandar
collection PubMed
description Identifying a submandibular (Wharton’s) duct punctum often hinders sialendoscopy; however, there is a paucity of evidence on whether the appearance of Wharton’s duct papilla impacts the sialendoscopic procedure. A classification of Wharton’s duct papillae based on the macroscopic appearance, size of dilatation probes, and sialendoscopic approach was proposed herein. The classification describing four main types of papillae, A, B, C, and D, was prospectively evaluated on 351 Wharton’s duct papillae in 315 patients. For each papillae type, the demographic/clinical data, intraoperative complications, and time required for sialendoscope introduction were analyzed. Estuary-like papilla (type A) was commonly seen after spontaneous stone extrusion, had no intraoperative complications noted, and had the shortest time required for the sialendoscope introduction. Normal papilla (type B) was the most frequently observed papilla (48.1%), reflecting diverse underlying pathology, while difficult papilla (type C) was often associated with unfavorable anatomical variations of the mandible or floor of the mouth. Substantially closed papilla (type D) had the highest rate of intraoperative complications, namely, perforation with a false passage, and required the longest time for the sialendoscope introduction. In seven patients (2.0%), the entrance into the duct was feasible only through the fistula, while the sialendoscope introduction failed in eight patients (2.3%). In conclusion, the appearance of Wharton’s duct papillae may be influenced by the underlying pathology. Based on the proposed classification, papilla typology affects the duration of sialendoscope introduction and may influence the frequency of intraoperative complications.
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spelling pubmed-99176582023-02-11 Sialendoscopy-Based Analysis of Submandibular Duct Papillae with a Proposal for Classification Aničin, Aleksandar Jerman, Anže Urbančič, Jure Pušnik, Luka J Clin Med Article Identifying a submandibular (Wharton’s) duct punctum often hinders sialendoscopy; however, there is a paucity of evidence on whether the appearance of Wharton’s duct papilla impacts the sialendoscopic procedure. A classification of Wharton’s duct papillae based on the macroscopic appearance, size of dilatation probes, and sialendoscopic approach was proposed herein. The classification describing four main types of papillae, A, B, C, and D, was prospectively evaluated on 351 Wharton’s duct papillae in 315 patients. For each papillae type, the demographic/clinical data, intraoperative complications, and time required for sialendoscope introduction were analyzed. Estuary-like papilla (type A) was commonly seen after spontaneous stone extrusion, had no intraoperative complications noted, and had the shortest time required for the sialendoscope introduction. Normal papilla (type B) was the most frequently observed papilla (48.1%), reflecting diverse underlying pathology, while difficult papilla (type C) was often associated with unfavorable anatomical variations of the mandible or floor of the mouth. Substantially closed papilla (type D) had the highest rate of intraoperative complications, namely, perforation with a false passage, and required the longest time for the sialendoscope introduction. In seven patients (2.0%), the entrance into the duct was feasible only through the fistula, while the sialendoscope introduction failed in eight patients (2.3%). In conclusion, the appearance of Wharton’s duct papillae may be influenced by the underlying pathology. Based on the proposed classification, papilla typology affects the duration of sialendoscope introduction and may influence the frequency of intraoperative complications. MDPI 2023-01-31 /pmc/articles/PMC9917658/ /pubmed/36769777 http://dx.doi.org/10.3390/jcm12031129 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Aničin, Aleksandar
Jerman, Anže
Urbančič, Jure
Pušnik, Luka
Sialendoscopy-Based Analysis of Submandibular Duct Papillae with a Proposal for Classification
title Sialendoscopy-Based Analysis of Submandibular Duct Papillae with a Proposal for Classification
title_full Sialendoscopy-Based Analysis of Submandibular Duct Papillae with a Proposal for Classification
title_fullStr Sialendoscopy-Based Analysis of Submandibular Duct Papillae with a Proposal for Classification
title_full_unstemmed Sialendoscopy-Based Analysis of Submandibular Duct Papillae with a Proposal for Classification
title_short Sialendoscopy-Based Analysis of Submandibular Duct Papillae with a Proposal for Classification
title_sort sialendoscopy-based analysis of submandibular duct papillae with a proposal for classification
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9917658/
https://www.ncbi.nlm.nih.gov/pubmed/36769777
http://dx.doi.org/10.3390/jcm12031129
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