Major Salivary Gland

About: Major Salivary Gland is a research topic. Over the lifetime, 1996 publications have been published within this topic receiving 47803 citations.

Xerostomia and its predictors following parotid-sparing irradiation of head-and-neck cancer

Abstract: Purpose: To assess long-term xerostomia in patients receiving parotid-sparing radiation therapy (RT) for head-and-neck cancer, and to find the patient and therapy-related factors that affect its severity. Patients and Methods: From March 1994 through January 2000, 84 patients received comprehensive bilateral neck RT using conformal and multisegmental intensity-modulated RT (IMRT) aiming to spare the major salivary glands. Before RT and periodically through 2 years after the completion of RT, salivary flow rates from each of the major salivary glands were selectively measured. At the same time intervals, each patient completed an 8-item self-reported xerostomia-specific questionnaire (XQ). To gain a relative measure of the effect of RT on the minor salivary glands, whose output could not be measured, the surfaces of the oral cavity (extending to include the surface of the base of tongue) were outlined in the planning CT scans. The mean doses to the new organ (“oral cavity”) were recorded. Forty-eight patients receiving unilateral neck RT were similarly studied and served as a benchmark for comparison. Factors predicting the XQ scores were analyzed using a random-effects model. Results: The XQ was found to be reliable and valid in measuring patient-reported xerostomia. The spared salivary glands which had received moderate doses in the bilateral RT group recovered to their baseline salivary flow rates during the second year after RT, and the spared glands in the unilateral RT group, which had received very low doses, demonstrated increased salivary production beyond their pre-RT levels. The increase in the salivary flow rates during the second year after RT paralleled an improvement in xerostomia in both patient groups. The improvement in xerostomia was faster in the unilateral compared with the bilateral RT group, but the difference narrowed at 2 years. The major salivary gland flow rates had only a weak correlation with the xerostomia scores. Factors found to be independently associated with the xerostomia scores were the pre-RT baseline scores, the time since RT, and the mean doses to the major salivary glands (notably to the submandibular glands) and to the oral cavity. Conclusion: An improvement over time in xerostomia, occurring in tandem with rising salivary production from the spared major salivary glands, suggests a long-term clinical benefit from their sparing. The oral cavity mean dose, representing RT effect on the minor salivary glands, was found to be a significant, independent predictor of xerostomia. Thus, in addition to the major salivary glands, sparing the noninvolved oral cavity should be considered as a planning objective to further reduce xerostomia.

Salivary gland tumours. A review of 2410 cases with particular reference to histological types, site, age and sex distribution

Abstract: To date the British Salivary Gland Tumour Panel has accumulated 2569 salivary gland tumours. Of these, 2410 were primary epithelial salivary gland tumours and these formed the basis of the present study. The diagnosis of individual tumours was based on the World Health Organisation classification. Tumours were analysed according to histological type, site, age and sex. The principal site was the parotid and the combined minor (oropharyngeal) glands formed the second largest group. Pleomorphic adenomas formed the largest group of tumours in most sites, but were particularly common in the parotid. The frequency of malignant tumours increased with age after the third decade and was maximal in the eighth decade. Malignant tumours were more common in the submandibular and the minor glands than in the parotid. In the sublingual gland six out of seven tumours were malignant.

Labial salivary gland biopsy in sjögren's syndrome

Abstract: Xerostomia is an unsatisfactory diagnostic criterion for the salivary component of Sjogren's syndrome (SS). To determine the diagnostic usefulness of the presence of focal sialadenitis in labial salivary gland (LSG) biopsy specimens, 362 patients suspected of having SS prospectively underwent a unique LSG biopsy procedure. The pattern and severity of LSG inflammation were compared with measurements of parotid flow rate, and the presence or absence of symptomatic xerostomia, major salivary gland enlargement, keratoconjunctivitis sicca (KCS), and other connective tissue diseases (CTD). LSG biopsy focus scores of >1 correlated more closely with the diagnoses of KCS alone and with KCS plus a CTD than did either reduced parotid flow rate or symptoms of xerostomia (P < 0.0005 and P < 0.05, respectively). Focal sialadenitis in an adequate LSG specimen is an objective criterion and a more disease-specific feature of SS than xerostomia or any other feature of salivary disease. The salivary component of SS should be redefined as the presence of LSG focal sialadenitis.

Subjective reports of xerostomia and objective measures of salivary gland performance

Abstract: This study involves collecting saliva under unstimulated and stimulated conditions and asking standardized questions of 100 patients with xerostomia The study examines which questions are useful in identifying and predicting current major salivary gland output deficiency or dysfunction