title: Novel technique to control hypersecretion from a transplanted autologous submandibular salivary gland for keratoconjunctivitis sicca.
abstract: OBJECTIVE
  To present a novel technique to control hypersecretion from a transplanted autologous submandibular gland (SMG) in a patient with keratoconjunctivitis sicca.
  
  
  METHODS
  A 65-year-old man presented with corneal epithelial edema and suspicious ocular surface dysplasia secondary to hypersecretion from a transplanted autologous SMG. The location and function of the gland were evaluated perioperatively using technetium-99m-pertechnetate scintigraphy. The course of the duct was marked with a radiation probe, surgically exposed, and partially ligated with titanium clips.
  
  
  RESULTS
  Marked reduction in salivary flow and resolution of corneal edema and ocular surface changes were noted. Conjunctival biopsy showed no evidence of malignancy. Symptoms were stable during a 1-year follow-up period.
  
  
  CONCLUSIONS
  Partial ligation of the transplanted SMG duct may be a simple and reversible technique to control hypersecreting glands with secondary corneal edema and ocular surface changes.
authors.affiliation: Oculoplastic and Orbital Unit, Department of Ophthalmology and Visual Sciences, University of Adelaide, South Australia, Australia. leiboigal5@yahoo.com.au
authors.forename: Igal
authors.initials: I
authors.lastname: Leibovitch
authors.forename: Erika
authors.initials: E
authors.lastname: Hoyama
authors.forename: Vanessa
authors.initials: V
authors.lastname: Limawararut
authors.forename: John
authors.initials: J
authors.lastname: Crompton
authors.forename: Dinesh
authors.initials: D
authors.lastname: Selva
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical; D006801:Humans; D007638:Keratoconjunctivitis Sicca / Q000601:surgery*; D008026:Ligation / Q000379:methods*; D008297:Male; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D018987:Salivary Ducts / Q000601:surgery*; D012798:Sialorrhea / Q000601:surgery*; D013670:Sodium Pertechnetate Tc 99m; D013363:Submandibular Gland / Q000000981:diagnostic imaging / Q000378:metabolism / Q000637:transplantation*; D013699:Temporal Arteries / Q000601:surgery; D013703:Temporal Muscle / Q000098:blood supply; D014182:Transplantation, Autologous
chemical_list: D019275:Radiopharmaceuticals; D013670:Sodium Pertechnetate Tc 99m