Stomatology Department - Hospital AC Camargo, São Paulo, Brazil.
Oral Oncol. 2010 May;46(5):349-54. doi: 10.1016/j.oraloncology.2009.11.018. Epub 2010 Mar 15.
Head and neck cancer surgery is often associated with neck dissection and usually includes the submandibular glands. Literature data related to remaining salivary gland function after surgery is scarce and controversial. A reduction in salivary output and increase in complaints of xerostomia have been suggested. However, a compensatory salivary mechanism has also been reported. The aim of this prospective study was to evaluate the effect of neck dissection (with submandibular excision) on salivary gland function measured by salivary flow rate and salivary gland scintigraphy. A total of 80 patients with head and neck tumors were evaluated. The surgery group was composed of 37 patients, who underwent submandibular gland resection, and the non-surgery group of 43 patients evaluated prior to radiation and/or chemotherapy treatment. Whole unstimulated and stimulated saliva collection and salivary gland scintigraphy were performed in all patients. Twenty-one percent of patients in the surgery group reported xerostomia, whereas 7% in the non-surgery group. The mean unstimulated salivary flow was 0.60 and 0.94 m/min for the surgery and non-surgery groups, respectively (p=0.008). Nevertheless, no statistical difference in the stimulated salivary flow was observed between the groups (p=0.26). In addition, the mean uptake and excretion rates for parotid and remaining submandibular glands also showed no statistical difference. The data of the present study support the contention that submandibular gland resection causes a decrease in unstimulated salivary volume. However, the residual submandibular glands in the surgery group showed similar function to that of submandibular glands in the non-surgery group. Consequently, the compensatory salivary mechanism seems not to be a possibility.
头颈部癌症手术通常与颈部解剖术相关，并且通常包括下颌下腺。有关手术后残留唾液腺功能的文献数据稀缺且存在争议。有人提出唾液分泌减少和口干抱怨增加。然而，也有报道称存在代偿性唾液机制。本前瞻性研究旨在评估颈部解剖术（伴下颌下腺切除）对唾液流量和唾液腺闪烁扫描测量的唾液腺功能的影响。共评估了 80 例头颈部肿瘤患者。手术组由 37 例接受下颌下腺切除术的患者组成，非手术组由 43 例在放射和/或化疗治疗前评估的患者组成。所有患者均进行了全唾液非刺激和刺激采集以及唾液腺闪烁扫描。手术组 21%的患者报告口干，而非手术组为 7%。手术组和非手术组的平均非刺激唾液流量分别为 0.60 和 0.94ml/min（p=0.008）。然而，两组之间的刺激唾液流量无统计学差异（p=0.26）。此外，腮腺和残留下颌下腺的摄取和排泄率平均值也无统计学差异。本研究的数据支持下颌下腺切除导致非刺激唾液量减少的观点。然而，手术组的残留下颌下腺与非手术组的下颌下腺具有相似的功能。因此，代偿性唾液机制似乎不太可能。
