• 12/2/2004
  • Pathak KA et al.
  • Nature Clinical Practice Oncology (2004) 1, 60-61

Damage to the submandibular salivary glands is an important side effect of head and neck radiation therapy. The resulting xerostomia causes problems with chewing, swallowing and changes to the oral microbial flora, adversely affecting the patient’s quality of life. Pathak and colleagues have described a technique for protecting the contralateral submandibular salivary gland from radiation by transferring it to the submental space prior to treatment. This approach has been used previously in patients undergoing neck dissection as part of primary treatment. The new study, however, deals with those patients not requiring neck dissection.

A total of 22 patients with oropharyngeal or hypopharyngeal tumors underwent contralateral submandibular salivary gland transfer (SMSGT) as an upfront, day care procedure. The incision was small, extending from the tip of the greater horn of hyoid to the midpoint of the submental space. The operating time was approximately 20 minutes. All patients went on to receive radical radiotherapy within 2 weeks of the procedure. Unstimulated pre-radiation and post-radiation salivary output was measured by cannulating the submandibular ducts.

The mean salivary output of the transferred gland was 73% after radiotherapy, compared with only 27% for the untransferred, ipsilateral gland. The authors conclude that SMSGT maintained adequate salivary gland function in these patients and that the procedure was simple, safe and cost effective