gms | German Medical Science

Introduction: Xerostomia is the most common side effect of the treatment with radiotherapy of head and neck cancer. The submandibular gland (G.S.) is the most important salivary gland. It produces about 70% of saliva. Because of its location in the main field of radiation the radiotherapy of head and neck cancer regularly causes a loss of 85 – 90% of its function.

A surgical transfer of the gland out of the focus could result in a better function and less xerostomia. This method has been introduced and published by Sheihaly et al. 2003. Critics mention that there is no way to save the parasympathetic innervation of the gland. The aim of this study was to investigate if a transfer of the gland is possible without interrupting the efferent nerve supply and how far towards the submental region one can move it.

Methods: The operations have been done on 6 cadavers. The gland was transferred under the anterior venter of the digastric muscle. The distance of the possible transfer without destroying the efferent nerves of the submandibulary ganglion was measured.

Results: In the average the length of transfer was 2.9cm ± 0.4 cm. We were able to preserve the submandibular ganglion in 100 %. Conclusion: A surgical transfer of the submandibular gland out of the radiation field is possible without destroying the parasympathic nerve supply. This should result in the reduction of the radiation dose for the G.S. from 60 to about 5 Gy. We postulate an improvement of the xerostomia induced by radiation and better quality of life after treatment.