Jacob R F, Weber R S, King G E
Department of Dental Oncology, Anderson Cancer Center, Houston, Texas.
Head Neck. 1996 May-Jun;18(3):242-7. doi: 10.1002/(SICI)1097-0347(199605/06)18:3<242::AID-HED6>3.0.CO;2-#.
Patients with head and neck neoplasms receive therapeutic neck dissections which may include the submandibular gland unilaterally or bilaterally. The clinical consequences of salivary gland resection could be reduced salivary output, altered cariogenic microflora, and increased incidence of dental caries.
This investigation evaluated whole salivary flow rates of patients who had received unilateral (n = 29) or bilateral (n = 8) submandibular gland resections and compared them with noncancer control subjects (n = 29).
Unstimulated and stimulated (paraffin) flow rates were significantly lower in both resection groups compared with those of the noncancer group, ranging from p < .002 to p < .02. Although flow rates were lower in the bilateral group than in the unilateral group, the differences between these two groups were statistically significant (p < .02) only for stimulated saliva. Xerostomia was reported by one third of the resection subjects.
In view of the significantly lower flow rates observed in the resection groups (especially for unstimulated saliva), topical fluoride therapy should be considered for those patients whose past caries activity would indicate an increased caries risk associated with partial loss of salivary function.
头颈部肿瘤患者接受治疗性颈部清扫术，该手术可能单侧或双侧切除下颌下腺。唾液腺切除的临床后果可能是唾液分泌量减少、致龋微生物群改变以及龋齿发病率增加。
本研究评估了接受单侧（n = 29）或双侧（n = 8）下颌下腺切除术的患者的全唾液流速，并将其与非癌症对照受试者（n = 29）进行比较。
与非癌症组相比，两个切除组的非刺激性和刺激性（石蜡）流速均显著降低，范围为p <.002至p <.02。虽然双侧组的流速低于单侧组，但仅在刺激性唾液方面，这两组之间的差异具有统计学意义（p <.02）。三分之一的切除受试者报告有口干症。
鉴于在切除组中观察到流速显著降低（尤其是非刺激性唾液），对于那些过去的龋齿活动表明与唾液功能部分丧失相关的龋齿风险增加的患者，应考虑局部用氟治疗。
