title: Submandibular salivary gland transfer prevents radiation-induced xerostomia.
abstract: BACKGROUND
  Xerostomia is a significant morbidity of radiation therapy in the management of head and neck cancers. We hypothesized that the surgical transfer of one submandibular salivary gland to submental space, outside the proposed radiation field, prior to starting radiation treatment, would prevent xerostomia.
  
  
  METHODS
  We are conducting a prospective clinical trial where the submandibular gland is transferred as part of the surgical intervention. The patients are followed clinically, with salivary flow studies and University of Washington quality of life questionnaire.
  
  
  RESULTS
  We report early results of 16 patients who have undergone this procedure. Seven patients have finished and 2 patients are currently undergoing radiation treatment. In 2 patients, no postoperative radiation treatment was indicated. Two patients are waiting to start radiation treatment and 2 patients refused treatment after surgery. The surgical transfer was abandoned in 1 patient. All of the transferred salivary glands were positioned outside the proposed radiation fields and were functional. The patients did not complain of any xerostomia and developed only minimal oral mucositis. There were no surgical complications.
  
  
  CONCLUSIONS
  Surgical transfer of a submandibular salivary gland to the submental space (outside the radiation field) preserves its function and prevents the development of radiation-induced xerostomia.
authors.affiliation: Department of Radiation Oncology, University of Alberta, Edmonton, Canada. nareshj@cancerboard.ab.ca
authors.forename: N
authors.initials: N
authors.lastname: Jha
authors.forename: H
authors.initials: H
authors.lastname: Seikaly
authors.forename: T
authors.initials: T
authors.lastname: McGaw
authors.forename: L
authors.initials: L
authors.lastname: Coulter
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy; D006258:Head and Neck Neoplasms / Q000532:radiotherapy; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D011832:Radiation Injuries / Q000209:etiology / Q000517:prevention & control*; D011835:Radiation Protection / Q000379:methods*; D013363:Submandibular Gland / Q000528:radiation effects / Q000601:surgery*; D016896:Treatment Outcome; D014987:Xerostomia / Q000209:etiology / Q000517:prevention & control*