title: Prevention of radiation-induced xerostomia by submandibular gland transfer.
abstract: BACKGROUND
  This study was carried out for the purpose of evaluating the efficacy of submandibular gland transfer to prevent radiation-induced xerostomia.
  
  
  METHODS
  Thirty-eight patients with oropharyngeal carcinoma were recruited. Twenty-six submandibular glands were transferred into the submental space to elude radiotherapy in 24 patients (transfer group); the submandibular gland was not disturbed in the control group (n = 14). The salivary flow rate, xerostomia, and quality of life (QOL) were assessed preoperatively, postoperatively, and after radiotherapy. The swallowing function was then evaluated after radiotherapy.
  
  
  RESULTS
  All the transferred glands survived and functioned after radiotherapy. The submandibular salivary flow rate recovered by 6 months after radiotherapy in the transfer group, whereas the flow rate declined drastically after radiotherapy and remained at a low level in the longer term in the control group. Two years after radiotherapy, 92.3% of patients in the transfer group had no or minimal xerostomia. QOL in the transfer group was better than that in the control group from 3 months after radiotherapy. Histologically, the majority of the transferred glands had normal glandular acini and ducts. There was no significant difference in dysphagia between the groups.
  
  
  CONCLUSIONS
  The submandibular gland can be successfully transferred to the submental space, thus preserving salivary function and preventing radiation-induced xerostomia. The transfer of the submandibular gland can improve the QOL by alleviating xerostomia, although it did not relieve dysphagia in this study.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.
authors.forename: Ye
authors.initials: Y
authors.lastname: Zhang
authors.forename: Chuan-Bin
authors.initials: CB
authors.lastname: Guo
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.forename: Yang
authors.initials: Y
authors.lastname: Wang
authors.forename: Xin
authors.initials: X
authors.lastname: Peng
authors.forename: Chi
authors.initials: C
authors.lastname: Mao
authors.forename: Guang-Yan
authors.initials: GY
authors.lastname: Yu
mesh_terms: D000328:Adult; D000368:Aged; D003679:Deglutition; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D011788:Quality of Life; D011832:Radiation Injuries / Q000517:prevention & control*; D011878:Radiotherapy / Q000009:adverse effects; D012463:Saliva; D013363:Submandibular Gland / Q000528:radiation effects* / Q000637:transplantation; D016896:Treatment Outcome; D014987:Xerostomia / Q000517:prevention & control*