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Long-term Outcomes of Submandibular Gland Transfer for Prevention of Postradiation Xerostomia
Hadi Seikaly, MD;
Naresh Jha, MBBS;
Jeffrey R. Harris, MD;
Pam Barnaby, RN;
Richard Liu, MD;
David Williams, MD;
Timothy McGaw, DDS, MD;
Jana Rieger, PhD;
John Wolfaardt, DDS, PhD;
John Hanson, MSc
Arch Otolaryngol Head Neck Surg. 2004;130:956-961.
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.
Design 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.
From the Divisions of Otolaryngology–Head and Neck Surgery (Drs Seikaly, Harris, and Liu) and General Surgery (Dr Williams), Department of Dentistry (Drs McGaw and Wolfaardt), and Faculty of Rehabilitation Medicine (Dr Rieger), University of Alberta; Division of Surgical Oncology (Dr Seikaly and Ms Barnaby) and Departments of Radiation Oncology (Dr Jha) and Epidemiology (Mr Hanson), Cross Cancer Institute; and Craniofacial Osseointegration and Maxillofacial Prosthetic Rehabilitation Unit (Drs Seikaly, Rieger, and Wolfaardt); Edmonton, Alberta. The authors have no relevant financial interest in this article.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Submandibular Gland Transfer for Prevention of Xerostomia After Radiation Therapy: Swallowing Outcomes
Rieger et al.
Arch Otolaryngol Head Neck Surg 2005;131:140-145.
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