BACKGROUND A sialendoscopy-assisted combined approach is well established in the surgery of sialolithiasis. In cases of proximal salivary stones, transcutaneous sialendoscopy-assisted extractions with parotid and submandibular gland preservation is the primary intention of treatment. We recently added computer tomography (CT) navigation to improve the results of this challenging surgery equally in both localizations. PATIENTS AND METHODS Al l the patients who submitted to sialendoscopy and sialendoscopy-assisted procedures at the tertiary institution between January 2012 and October 2020 were included in the present study. From November 2019, CT navigation was added in cases with sialolithiasis and a presumably poor sialendoscopic visibility. We evaluated the parameters of the disease, diagnostic procedures, sialendoscopic findings and outcomes, with or without optical surgical navigation. RESULTS We performed 178 successful salivary stone removals in 372 patients, of which 118 were combined sialendos-copy-assisted approaches, including 16 transcutaneous proximal, 10 submandibular and 6 parotid stone operations. Surgical navigation was used in six patients, four times for submandibular and twice for parotid sialolithiasis. These were all non-palpable, sialendoscopically invisible or partially visible stones, and we managed to preserve five of the six salivary glands. CONCLUSIONS The addition of CT navigation to sialendoscopy-assisted procedures for non-palpable, sialendoscopically invisible and fixed stones is a significant advantage in managing sialolithiasis. By consistently performing sialendoscopy and related preservation procedures, we significantly reduced the need for sialoadenectomies in patients with obstructive salivary gland disease.

中文翻译：

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涎石症手术中的唾液内镜检查和 CT 导航辅助。

背景技术在唾液腺结石手术中，唾液镜检查辅助的联合方法已得到广泛应用。在近端唾液腺结石的情况下，经皮唾液腺镜辅助取出腮腺和下颌下腺是治疗的主要目的。我们最近添加了计算机断层扫描 (CT) 导航，以在两个本地化中同样改善这一具有挑战性的手术的结果。患者和方法 2012 年 1 月至 2020 年 10 月期间在三级机构接受唾液内镜检查和唾液镜辅助手术的所有患者均被纳入本研究。从 2019 年 11 月起，在唾液腺结石和可能较差的唾液镜能见度的病例中增加了 CT 导航。我们评估了疾病的参数、诊断程序、唾液镜检查结果和结果，有或没有光学手术导航。结果 我们对 372 名患者进行了 178 次成功的唾液腺结石清除，其中 118 次是唾液腺复制联合辅助方法，包括 16 次经皮近端手术、10 次下颌下结石手术和 6 次腮腺结石手术。6 名患者使用了手术导航，4 次用于颌下腺结石，2 次用于腮腺涎石症。这些都是不可触及的、唾液内镜下不可见或部分可见的结石，我们设法保留了六个唾液腺中的五个。结论 将 CT 导航添加到唾液酸内镜辅助手术中，以治疗不可触及、唾液酸内镜下不可见和固定的结石，在治疗唾液酸结石方面具有显着优势。通过始终如一地进行唾液内窥镜检查和相关的保存程序，