Almansoori Akram A, Khentii Namuun, Hei Wei-Hong, Seo Nari, Lee Sung-Ho, Kim Soung Min, Lee Jong Ho
Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea.
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Sana'a University, Sana'a, Yemen.
J Korean Assoc Oral Maxillofac Surg. 2017 Oct;43(5):299-304. doi: 10.5125/jkaoms.2017.43.5.299. Epub 2017 Oct 26.
To test the feasibility of submandibular salivary gland (SMG) replantation techniques and the survival of the replanted glands. Such a study can provide a rationale for later allotransplantation procedures, along with implementation of conventional and advanced immunosuppression therapy.
Six SMG replantations were performed in New Zealand white rabbits. One week postoperatively, Tc scintigraphy was performed and the uptake ratio and salivary excretion fraction were calculated. Two to four weeks later, submandibular glands were excised, fixed, and stained with H&E for histomorphometric evaluation.
Intraoperatively, all glands showed patent blood perfusion except gland 5. Positive tracer uptake and saliva excretion were documented by scintigraphy. On excision, all of the glands except glands 4 and 5 looked viable, with a red color and patent pedicles. Gland 4 was infected and filled with creamy pus, while gland 5 looked pale and necrotic. Histologically, glands 1, 2, 3, and 6 had preserved normal glandular tissue with slight variations from the contralateral normal glands, as their parenchyma was composed of mildly atrophic acini.
Four out of six replanted SMGs successfully survived. The glands maintained good viability and function. Such success depends on safe harvesting, short anastomosis time, and strict control of infection.
测试下颌下唾液腺(SMG)再植技术的可行性以及再植腺体的存活情况。这样的研究可为后续的同种异体移植手术提供理论依据,并为实施传统和先进的免疫抑制治疗提供依据。
在新西兰白兔身上进行了6例SMG再植手术。术后1周,进行锝扫描,并计算摄取率和唾液排泄分数。2至4周后,切除下颌下腺,固定并用苏木精-伊红染色进行组织形态计量学评估。
术中,除腺体5外,所有腺体的血液灌注均通畅。锝扫描记录到示踪剂摄取阳性和唾液排泄。切除时,除腺体4和5外,所有腺体看起来都有活力,呈红色且蒂部通畅。腺体4被感染,充满乳状脓液,而腺体5看起来苍白且坏死。组织学上,腺体1、2、3和6保留了正常的腺组织,与对侧正常腺体略有差异,因为其实质由轻度萎缩的腺泡组成。
6例再植的SMG中有4例成功存活。腺体保持了良好的活力和功能。这种成功取决于安全采集、短吻合时间和严格控制感染。