Does Submandibular Gland Sacrificing Neck Dissection Decrease Salivary Output and Quality of Life?

Area of Science:

• Oncology
• Surgical Oncology
• Otorhinolaryngology

Background:

• Head and neck cancer (HNC) treatment often involves neck dissection (ND).
• Submandibular gland (SMG) preservation during Level I ND is debated regarding salivary function.
• Xerostomia significantly impacts quality of life in HNC survivors.

Purpose of the Study:

• To quantify the effect of SMG resection during Level I ND on stimulated salivary output (SSO).
• To assess the impact of SMG resection on xerostomia-related quality of life in HNC patients.

Main Methods:

• Retrospective cohort study comparing patients with and without SMG resection during Level I ND.
• Stimulated salivary output measured using the Saxon test.
• Quality of life assessed using the University of Washington Quality of Life (UW-QoL) survey.

Main Results:

• No significant difference in mean SSO between SMG resection and control groups.
• SMG resection combined with adjuvant radiotherapy resulted in SSO below the xerostomia threshold.
• The SMG-resected, radiotherapy-positive group reported the lowest UW-QoL saliva domain scores.

Conclusions:

• Unilateral or bilateral SMG resection does not significantly reduce SSO.
• Adjuvant radiotherapy and SMG resection are additive risk factors for xerostomia and reduced quality of life.
• SMG sparing may be beneficial for HNC patients likely to receive adjuvant radiation.