Submandibular claud transfer for prevention of radiation induced xerostomia in head and neck cancer patients

الملخص EN

Background: Xerostomia frequently follows radiation therapy to head and neck cancer, which has significant impact on the patient’s quality of life.

Transferring one submandibular gland to the submental area and shielding during radiotherapy is suggested to prevent xerostomia.

Purpose: evaluation of functional outcomes of submandibular gland transfer Study Design: prospective controlled study.

Patients and methods: The study included 35 patients with laryngeal, oropharyngeal and hypopharyngeal carcinomas.

All patients underwent surgical resection of the tumor followed by postoperative adjuvant radiation therapy.

Seventeen patients had preservation of one submandibular gland through surgical transfer to submental area and appropriate radiation shielding and 18 patients didn't have a gland transfer.

Assessment of radiation induced xerostomia was done by clinical grading and quality of life questionnaire.

Results: No surgical complications or recurrence related to the submandibular gland transfer.

Salivation was significantly better in the sumbmandibular gland transferred group at 3, 6 and 12 months, with continued functional loss in the control group.

Xerostomia was absent in 82.3% of patients in SGT group at 12 months compared with 44.4% of patients in the control group (p=0.04).The normal scores for patients benefit questionnaire worsened initially at 3 months in both groups, then significantly improved at 6 and 12 months in the gland transferred group compared with control group, regarding salivation and absence of pain; but, swallowing showed only a trend of improvement.

Conclusion: submandibular gland transfer may be included during surgery of selected head and neck cancers to prevent postradiotherapy xerostomia.

A combination of therapies may be necessary to improve quality of life of those patients.