title: Obstructive sialadenitis of a transplanted submandibular gland: chronic inflammation secondary to ductal obstruction.
abstract: OBJECTIVE
  To determine the pathological basis and clinical features of obstructive sialadenitis in transplanted submandibular glands (SMGs).
  
  
  METHODS
  A total of 161 patients (174 eyes) with keratoconjunctivitis sicca underwent microvascular SMG transplantation. Patients were followed up at approximately 1 and 4 months and annually thereafter. Clinical data, including dry eye discomfort, symptoms of ductal obstruction, and Schirmer test, were recorded. Sialography was performed in six patients. In addition, SMG autotransplantation was performed in 22 rabbits. Salivary flow was recorded and the morphology of glands was examined at 6 months postoperatively by light microscopy.
  
  
  RESULTS
  Among the patients, 16 out of 172 glands during the latent period (0-3 months) and 2 out of 154 glands with long-term follow-up (>1 year) showed obstructive sialadenitis. Typical manifestations were continuous small volumes of viscous secretions, recurrent gland swelling, decreased Schirmer test values, and irregular dilation of the main duct on sialography. The transplanted SMGs eventually showed no secretion in five cases. Of the 22 rabbit SMGs, 4 had obstructive sialadenitis. Morphological examination showed chronic inflammatory infiltration with salivary deposits.
  
  
  CONCLUSIONS
  Obstructive sialadenitis of transplanted SMGs is a chronic inflammation secondary to ductal obstruction, which leads to insufficient ocular lubrication and potential treatment failure.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, PR China.
authors.forename: Jia-Zeng
authors.initials: JZ
authors.lastname: Su
authors.affiliation: Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, PR China.
authors.forename: Ning-Yan
authors.initials: NY
authors.lastname: Yang
authors.affiliation: Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, PR China.
authors.forename: Xiao-Jing
authors.initials: XJ
authors.lastname: Liu
authors.affiliation: Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, PR China.
authors.forename: Zhi-Gang
authors.initials: ZG
authors.lastname: Cai
authors.affiliation: Department of Ophthalmology, Affiliated Beijing Tong Ren Hospital, Capital University of Medical Science, Beijing, PR China.
authors.forename: Lan
authors.initials: L
authors.lastname: Lv
authors.affiliation: Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, PR China.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Physiology and Pathophysiology, Peking University Health Science Center and Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, Beijing, PR China.
authors.forename: Li-Ling
authors.initials: LL
authors.lastname: Wu
authors.affiliation: Department of Oral Radiology, Peking University School and Hospital of Stomatology, Beijing, PR China.
authors.forename: Deng-Gao
authors.initials: DG
authors.lastname: Liu
authors.affiliation: Department of Oral Radiology, Peking University School and Hospital of Stomatology, Beijing, PR China.
authors.forename: Wen-Ge
authors.initials: WG
authors.lastname: Ren
authors.affiliation: Department of Oral Pathology, Peking University School and Hospital of Stomatology, Beijing, PR China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, PR China.
authors.forename: Guang-Yan
authors.initials: GY
authors.lastname: Yu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D064592:Autografts; D002648:Child; D004195:Disease Models, Animal; D005260:Female; D006801:Humans; D007638:Keratoconjunctivitis Sicca / Q000601:surgery*; D007765:Lacrimal Apparatus / Q000502:physiology; D008297:Male; D008875:Middle Aged; D011817:Rabbits; D018987:Salivary Ducts / Q000503:physiopathology; D012466:Salivary Gland Diseases / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D012793:Sialadenitis / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D012796:Sialography; D013363:Submandibular Gland / Q000503:physiopathology / Q000637:transplantation*; D013666:Tears / Q000502:physiology
keywords: Inflammation; Lacrimal gland; Ocular surface; Tears