Al-Qahtani Khalid, Hier Michael P, Sultanum Khalil, Black Martin J
Otolaryngology and Head & Neck Surgery, McGill University, Montreal, Quebec, Canada.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 Jun;101(6):753-6. doi: 10.1016/j.tripleo.2005.12.017. Epub 2006 Apr 21.
Xerostomia is a significant morbidity of radiation therapy in the management of head and neck cancers. The hypothesis is that the surgical transfer of 1 submandibular salivary gland to the submental space outside of the proposed radiation field, before starting radiation treatment would prevent xerostomia.
To evaluate the potential role of submandibular salivary gland transfer in reducing or preventing xerostomia in head and neck patients receiving chemoradiotherapy.
We conducted a prospective clinical trial in which the submandibular gland was transferred to the submental space as an independent surgical procedure, followed by chemoradiotherapy. The patients were followed clinically, with salivary flow studies, nuclear medicine salivary gland scans, and the University of Washington quality of life questionnaire.
We report the results of 8 patients who have undergone this procedure. All of the transferred salivary glands were positioned outside of the proposed radiation fields; were partially shielded from radiation and were functional. All of the patients completed their treatment. Four patients did not have xerostomia-related complaints, and 3 patients had only minor symptoms on subjective assessment. There were no surgical complications.
Surgical transfer of a submandibular salivary gland to the submental space (outside the radiation field) preserves its function and minimizes the development of radiation-induced xerostomia.
口干症是头颈部癌症放疗过程中的一种严重并发症。我们的假设是，在开始放疗前，将一侧下颌下唾液腺手术转移至计划放疗区域外的颏下间隙，可预防口干症。
评估下颌下唾液腺转移术在接受放化疗的头颈部患者中减少或预防口干症的潜在作用。
我们开展了一项前瞻性临床试验，其中将下颌下腺作为一项独立的外科手术转移至颏下间隙，随后进行放化疗。对患者进行临床随访，并进行唾液流量研究、核医学唾液腺扫描以及华盛顿大学生活质量问卷调查。
我们报告了8例接受该手术患者的结果。所有转移的唾液腺均位于计划放疗区域之外；部分受到辐射屏蔽且功能正常。所有患者均完成了治疗。4例患者无口干症相关主诉，3例患者主观评估仅有轻微症状。无手术并发症。
将下颌下唾液腺手术转移至颏下间隙（放疗区域外）可保留其功能，并将放射性口干症的发生降至最低。
