A feasibility study of salivary gland autograft transplantation for xerostomia

Abstract

Background Radiation‐induced xerostomia is a frequent sequela in patients treated for cancer of the head and neck. One strategy to treat xerostomia would be to relocate portions of salivary tissue to adjacent submucosal sites that lie outside the radiation portals such as the anterior oral vestibule. It is not known whether salivary tissue transplanted as an autogenous free graft can survive, function adequately, and not produce mucoceles. Methods Salivary gland tissue from the parotid and submandibular glands of the Syrian hamster were transplanted into the submucosal layer of the cheek pouch. After 3 months of observation, looking at graft size, graft extrusion, ulceration, infection, and mucocele formation, the graft sites were harvested. The specimens then underwent pathologic analysis by hematoxylin and eosin staining, as well as immunohistochemical methods to determine positivity for cytokeratin, smooth muscle actin (SMA), and amylase. Results Histologic analysis of tissue harvested from Syrian hamsters grafted into the cheek pouch demonstrated intact, viable, organized salivary gland tissue. Eighty percent of the animals in the submandibular group and 63% of the animals in the parotid group had at least 1 graft with viable salivary tissue without undue complications. Conclusions Salivary gland tissue can be transplanted successfully as free autogenous grafts in the Syrian hamster model. Further studies are needed to determine whether the grafts will subsequently become functional and whether growth can be biologically stimulated. This approach may be a useful strategy to protect salivary gland tissue in patients undergoing radiotherapy for head and neck cancer. © 2000 John Wiley & Sons, Inc. Head Neck 22: 241–246, 2000.

Clinical and biochemical evaluation of the saliva of patients with xerostomia induced by radiotherapy

“…These results are in agreement with those of several papers found in the literature 6,15,16 . The statistical comparison between the total concentration of salivary protein before the radiation treatment of patients of the experimental group with data obtained after the treatment showed no significant differences (p > 0.05).…”

Different Saliva Substitutes for Treatment of Xerostomia Following Radiotherapy

“…Further, first studies exist about possibilities to relocate the salivary glands out of the radiation field by operation [8]. Dose reduction at the glands by modern treatment techniques such as three-dimensional treatment planning or intensitymodulated radiotherapy has a protective effect as well [6,12,21,37].…”

Treatment of xerostomia following radiotherapy: does age matter?

“…Further, it may be feasible to remove salivary glands from the radiation field temporarily by transplantation [8]. Reduction of the dose to the glands by modern treatment techniques (three-dimensional treatment planning, intensity-modulated irradiation) also has a protective effect [6,7,11,26].…”