Novel technique to control hypersecretion from a transplanted autologous submandibular salivary gland for keratoconjunctivitis sicca.
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.
Leibovitch
Igal
I
Oculoplastic and Orbital Unit, Department of Ophthalmology and Visual Sciences, University of Adelaide, South Australia, Australia. leiboigal5@yahoo.com.au
Hoyama
Erika
E
Limawararut
Vanessa
V
Crompton
John
J
Selva
Dinesh
D
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
D019275:Radiopharmaceuticals; D013670:Sodium Pertechnetate Tc 99m