Modification of the submandibular gland transfer procedure

Area of Science:

• Head and Neck Surgery
• Radiation Oncology
• Salivary Gland Physiology

Background:

• Advanced head and neck cancers (Stage III-IV) often require radiation therapy, leading to xerostomia (dry mouth) due to decreased salivary production.
• Xerostomia significantly impairs quality of life, affecting taste, chewing, swallowing, and speech.
• Traditional submandibular gland transfer (SGT) to the submental space is contraindicated for oral cavity cancers.

Purpose of the Study:

• To describe and evaluate a modified submandibular gland transfer (SGT) procedure.
• To assess the feasibility of relocating the submandibular gland to the parotid region.
• To expand SGT benefits to patients with oral cavity cancers.

Main Methods:

• Prospective feasibility study involving nine patients with advanced head and neck cancer.
• Patients underwent major resection with adjuvant radiation therapy.
• A modified SGT procedure relocated the submandibular gland to the parotid region; radiation dose to the gland was assessed.

Main Results:

• All modified SGT procedures were technically successful with no postoperative complications.
• The transferred submandibular glands were successfully localized and shielded from radiation.
• The procedure demonstrated feasibility and surgical viability.

Conclusions:

• Modified SGT to the parotid region is a feasible and oncologically sound procedure.
• This technique preserves submandibular gland function and does not interfere with radiation therapy.
• The modified SGT expands treatment options for patients with oral cavity cancers requiring radiation.