BACKGROUND: This study was carried out for the purpose of evaluating the efficacy of submandibular gland transfer to prevent radiation-induced xerostomia. METHODS: Thirty-eight patients with oropharyngeal carcinoma were recruited. Twenty-six submandibular glands were transferred into the submental space to elude radiotherapy in 24 patients (transfer group); the submandibular gland was not disturbed in the control group (n = 14). The salivary flow rate, xerostomia, and quality of life (QOL) were assessed preoperatively, postoperatively, and after radiotherapy. The swallowing function was then evaluated after radiotherapy. RESULTS: All the transferred glands survived and functioned after radiotherapy. The submandibular salivary flow rate recovered by 6 months after radiotherapy in the transfer group, whereas the flow rate declined drastically after radiotherapy and remained at a low level in the longer term in the control group. Two years after radiotherapy, 92.3% of patients in the transfer group had no or minimal xerostomia. QOL in the transfer group was better than that in the control group from 3 months after radiotherapy. Histologically, the majority of the transferred glands had normal glandular acini and ducts. There was no significant difference in dysphagia between the groups. CONCLUSIONS: The submandibular gland can be successfully transferred to the submental space, thus preserving salivary function and preventing radiation-induced xerostomia. The transfer of the submandibular gland can improve the QOL by alleviating xerostomia, although it did not relieve dysphagia in this study.
BACKGROUND: This study was carried out for the purpose of evaluating the efficacy of submandibular gland transfer to prevent radiation-induced xerostomia. METHODS: Thirty-eight patients with oropharyngeal carcinoma were recruited. Twenty-six submandibular glands were transferred into the submental space to elude radiotherapy in 24 patients (transfer group); the submandibular gland was not disturbed in the control group (n = 14). The salivary flow rate, xerostomia, and quality of life (QOL) were assessed preoperatively, postoperatively, and after radiotherapy. The swallowing function was then evaluated after radiotherapy. RESULTS: All the transferred glands survived and functioned after radiotherapy. The submandibular salivary flow rate recovered by 6 months after radiotherapy in the transfer group, whereas the flow rate declined drastically after radiotherapy and remained at a low level in the longer term in the control group. Two years after radiotherapy, 92.3% of patients in the transfer group had no or minimal xerostomia. QOL in the transfer group was better than that in the control group from 3 months after radiotherapy. Histologically, the majority of the transferred glands had normal glandular acini and ducts. There was no significant difference in dysphagia between the groups. CONCLUSIONS: The submandibular gland can be successfully transferred to the submental space, thus preserving salivary function and preventing radiation-induced xerostomia. The transfer of the submandibular gland can improve the QOL by alleviating xerostomia, although it did not relieve dysphagia in this study.
Authors: Marc Benderitter; Fabio Caviggioli; Alain Chapel; Robert P Coppes; Chandan Guha; Marco Klinger; Olivier Malard; Fiona Stewart; Radia Tamarat; Peter van Luijk; Charles L Limoli Journal: Antioxid Redox Signal Date: 2014-02-03 Impact factor: 8.401