Burch Emma, Lubeley Lacey, Murakami James
Department of Radiology, Nationwide Children's Hospital, Columbus, OhioUSA.
J Oral Maxillofac Res. 2017 Dec 31;8(4):e3. doi: 10.5037/jomr.2017.8403. eCollection 2017 Oct-Dec.
Sialorrhea is a common health and psychosocial problem for children with neuromuscular dysfunction secondary to a variety of disorders such as cerebral palsy. Current accepted treatments include the injection of botulinum toxin into the submandibular glands for temporary symptom relief. The purpose of this study is to demonstrate the feasibility of percutaneous ethanol injection for longer lasting salivary gland ablation in an animal model.
Twenty rats were used in this study. In each rat, 98% ethanol was injected into the right submandibular gland under ultrasound guidance. No intervention was performed on the left gland, which served as the control. Ten rats were sacrificed and glands evaluated at three weeks, with the remaining 10 rats sacrificed and evaluated at three months. Unpaired, 1-tailed T-tests were used to analyse the data.
Ethanol injections induced a significant and sustained reduction in salivary gland size. Treated glands were 41% smaller by mass than untreated controls in the 10 rats sacrificed at three weeks (P < 0.001). Treated glands were 43% smaller by mass than untreated controls in the 10 rats sacrificed at three months (P < 0.001). Qualitative histologic analysis demonstrated extensive parenchymal damage, inflammation, and fibrosis at both three week and three month time points.
Using a rat model, we demonstrated dramatic and sustained submandibular gland damage after percutaneous injection of ethanol.
流涎是继发于多种疾病（如脑瘫）的神经肌肉功能障碍儿童常见的健康和心理社会问题。目前公认的治疗方法包括向颌下腺注射肉毒杆菌毒素以暂时缓解症状。本研究的目的是在动物模型中证明经皮注射乙醇进行更持久的唾液腺消融的可行性。
本研究使用了20只大鼠。在每只大鼠中，在超声引导下将98%乙醇注入右侧颌下腺。左侧腺体未进行干预，作为对照。10只大鼠在3周时处死并评估腺体，其余10只大鼠在3个月时处死并评估。使用不成对单尾T检验分析数据。
乙醇注射导致唾液腺大小显著且持续减小。在3周时处死的10只大鼠中，治疗组腺体的质量比未治疗的对照组小41%（P < 0.001）。在3个月时处死的10只大鼠中，治疗组腺体的质量比未治疗的对照组小43%（P < 0.001）。定性组织学分析显示，在3周和3个月时间点均有广泛的实质损伤、炎症和纤维化。
通过大鼠模型，我们证明了经皮注射乙醇后颌下腺会出现显著且持续的损伤。
