Division of Oral and Maxillofacial Surgery, Columbia University College of Dental Medicine, New York City, NY 10032, USA.
J Am Dent Assoc. 2012 Jan;143(1):39-42. doi: 10.14219/jada.archive.2012.0016.
Treatment for otosclerosis involves patients' undergoing stapedectomy. Inadvertent damage to the chorda tympani nerve's (CTN's) secretory fibers during stapedectomy can result in inadequate secretory stimulation of the submandibular salivary glands (SMSGs) and sublingual salivary glands (SLSGs). Because most saliva originates from these glands, hyposalivation and subjective xerostomia manifest during resting periods when parotid gland secretions are minimal. Stimulation with food increases parotid gland salivation enough to overcome the subjective sense of dryness.
The author examined a 52-year-old man who had undergone bilateral stapedectomy because of hearing loss; his rheumatologist referred him to the Salivary Gland Center (New York City) because of a complaint of dry mouth. After the author examined the patient, he concluded that the patient had decreased SMSG and SLSG secretion and recommended that the patient use sugarless chewing gum or sour candy frequently to stimulate his parotid glands and use oral lubricants and sip water as needed.
Stimulation of parotid gland secretion is independent of SMSG and SLSG activation. Therefore, the dental practitioner must become aware of the innervation of the salivary glands and each gland's secretory production during periods of oral stimulation and of rest.
耳硬化症的治疗需要患者接受镫骨切除术。镫骨切除术过程中，如果不小心损伤了鼓索神经的分泌纤维，可能会导致下颌下腺（SMSG）和舌下腺（SLSG）的分泌受到抑制，无法充分刺激分泌。由于大部分唾液来自这两个腺体，如果腮腺分泌较少，患者在休息期间就会出现唾液分泌不足和主观口干的情况。咀嚼食物可以刺激腮腺分泌足够的唾液，从而缓解口干的主观感觉。
作者检查了一位 52 岁的男性患者，他因听力下降接受了双侧镫骨切除术；由于口干的症状，他的风湿病医生将他转诊到唾液腺中心（纽约市）。作者检查完患者后，发现他的 SMSG 和 SLSG 分泌减少，建议患者经常咀嚼无糖口香糖或酸味糖果来刺激腮腺，并根据需要使用口腔润滑剂和小口饮水。
刺激腮腺分泌与 SMSG 和 SLSG 的激活无关。因此，牙医在口腔刺激和休息期间，必须了解唾液腺的神经支配以及每个腺体的分泌功能。
