Long-term outcomes of submandibular gland transfer for prevention of postradiation xerostomia.
BACKGROUND
Xerostomia is a permanent and devastating sequela of head and neck irradiation, and its numerous consequences affect most aspects of the patient's life. A new method of preserving and protecting a single submandibular gland from radiation damage through the Seikaly-Jha procedure (SJP) has recently been described.


OBJECTIVE
To report the long-term outcomes of the SJP.


METHODS
Inception cohort. Patients The trial was conducted between February 1, 1999, and February 1, 2002. All patients were followed up through the head and neck cancer clinic at the Cross Cancer Institute. All data were collected by a dedicated research nurse. Salivary function was evaluated at regular intervals with salivary flow studies and questionnaires.


RESULTS
Ninety-six patients were enrolled in the study, and 38 had a minimum of 2 years' follow-up. The cohort of 38 patients was composed of 2 groups: 26 patients had preservation of one submandibular gland through the SJP, while the remaining 12 did not. Salivary flow was preserved in the SJP group, in which 83% of patients reported normal amounts of saliva 2 years after radiotherapy, compared with none in the SJP group. There were no disease recurrences on the side of the transferred gland or in the submental space. There were no surgical complications attributed to the transfer procedure.


CONCLUSIONS
The SJP prevented xerostomia in 83% of the study patients. The approach appears to be oncologically sound and safe.
Seikaly
Hadi
H
Division of Otolaryngology--Head and Neck Surgery, University of Alberta, Edmonton, Alberta, Canada. hseikaly@shaw.ca
Jha
Naresh
N
Harris
Jeffrey R
JR
Barnaby
Pam
P
Liu
Richard
R
Williams
David
D
McGaw
Timothy
T
Rieger
Jana
J
Wolfaardt
John
J
Hanson
John
J
D000416:Alberta; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000532:radiotherapy; D015331:Cohort Studies; D004307:Dose-Response Relationship, Radiation; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000453:epidemiology / Q000532:radiotherapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011878:Radiotherapy / Q000009:adverse effects*; D013363:Submandibular Gland / Q000528:radiation effects* / Q000601:surgery*; D013514:Surgical Procedures, Operative; D011795:Surveys and Questionnaires; D013995:Time; D016896:Treatment Outcome; D014987:Xerostomia / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*