Objective: To analyze whether variation of anatomic morphology of salivary ductal system was associated with the occurrence of obstructive salivary diseases. Methods: 372 cases of submandibular gland obstructive disease with sialolithiasis were retrospectively reviewed. Variations of duct hilum observed by sialoendoscopy, and ductal systems acrylic resin replicated cast of 10 patients were used to analyze any association between anatomical variances in the ductal system and sialolith formation. Results: Sialolithiasis was detected in 87.6% (326/372) of these patients who presented with obstructive symptoms. Roughly 67% (285/426) of the stones were located in the distal third of the ducts or at the hilum of the submandibular gland. 87.4%(285/326) hilums were noted to be dilated, like a basin by sialoendoscopy. The anatomy of the duct from the replicated casts demonstrated a tree-like structure and the basin-like widening of the hilum was found in all the 10 replicated casts. Conclusion: A high number of patients presenting with sialolithiasis in the submandibular gland seem to have an anatomical variance in the hilar region.%目的:研究下颌下腺导管解剖形态的改变与涎石形成的关系.方法:回顾性分析372例下颌下腺导管结石患者,在接受内镜治疗过程中镜下观察到的导管解剖形态资料,并用自凝塑料复制10例离体下颌下腺导管解剖形态铸型,分析导管解剖形态的改变与涎石形成的关系.结果:372例涎腺镜术中有326例在镜下发现涎石,在所发现的426颗结石中约67％的涎石位于导管腺门端1/3或腺门区.在发现涎石的病例中,内镜探查导管系统发现87.4％的病例存在腺门区壶腹状扩张现象.10例下颌下腺导管铸型均直观地表现出导管系统树形结构及腺门区壶腹状扩张现象.结论:下颌下腺导管结石患者普遍存在腺门区壶腹状扩张现象.大部分下颌下腺导管结石位于近导管腺门端1/3或腺门区.
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