gms | German Medical Science

76th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

04.05. - 08.05.2005, Erfurt

The surgical transfer of the submandibular gland out of the radiation field before radiotherapy of head and neck cancers: an anatomical study

Meeting Abstract

  • corresponding author Robert Schoenberg - Univ. HNO-Klinik Hamburg, Hamburg
  • Stephan Tesche - Univ. HNO-Klinik Hamburg, Hamburg
  • Boris Tolsdorff - Univ. HNO-Klinik Hamburg, Hamburg
  • Christoph Sagowski - Univ. HNO-Klinik Hamburg, Hamburg

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 76. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V.. Erfurt, 04.-08.05.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05hno394

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/hno2005/05hno220.shtml

Published: September 22, 2005

© 2005 Schoenberg et al.
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Outline

Text

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.