Removal Of Submandibular Gland Research Articles

Submandibular Gland Preservation in Oral Cavity Squamous Cell Carcinomas: Our Analysis at A Tertiary Care Hospital.

Surgical excision forms the principal treatment of oral cavity squamous cell carcinomas. The comprehensive surgical management consists of Wide Local Excision of the tumor and Neck Dissection with removal ofSubmandibular gland. The submandibular gland accounts for 70-90 % of unstimulated salivary volume. Its excision as a part of neck dissection has been found to cause high Incidence (21% vs 7%) of postoperative xerostomia. Recent studies have highlighted that the preservation of the SMG is possible and oncologically safe in early-grade OCSCC with N0 neck as the involvement of SMG in such cases is low and its preservation decreases the chances of xerostomia. 80 subjects were included in the study to estimate the prevalence of metastatic submandibular gland involvement in oral cavity squamous cell carcinomas. The presence of metastasis into the salivary gland was studied and the mechanism/route of involvement was analysed. The comparison was made between the early and advanced tumors for SMG metastasis irrespective of the primary subsite involvement. In the current study low prevalence (6.2 %) of metastasis to SMG was seen. It was seen in high-grade tumors only. None of the early-grade tumors showed any evidence of SMG metastasis. The most common pattern (80%) of glandular involvement was a direct extension from the primary tumor. Our study concludes that SMG preservation neck dissections can be carried out in early-grade OCSCC irrespective of primary tumor site involvement. The advantages of preserving the SMG are multiple. Furthermore, the morbidity is markedly decreased with its preservation without any compromise on oncological safety.

Recurrent pleomorphic adenoma of submandibular gland — a rare entity

BackgroundAmong benign salivary gland tumors, pleomorphic adenoma is one of the most common tumor involving submandibular gland, but it is rare to encounter recurrent pleomorphic adenoma in submandibular gland after submandibular gland excision.Case presentationWe present a case of 22-year-old female patient who presented to us with recurrent pleomorphic adenoma of submandibular gland region after 10 years of removal of submandibular gland, diagnosis was established with the help of ultrasound and fine-needle aspiration cytology, and thereafter, patient was taken up for surgical excision under general anesthesia. Histopathology confirmed the diagnosis.ConclusionsThis case report highlights the importance of special caution in removal of submandibular gland along with its capsule especially in pediatric population where due to small facial structures, chances of capsular breech are high, which can result in tumor seedling and future recurrence of tumor.

Gland-sparing neck dissection: oncological and functional outcomes in oral cancer patients

This study was performed to evaluate the subjective and objective functional outcomes of patients who had undergone submandibular gland-sparing neck dissection. All data were obtained from patients treated in a single hospital. Seventy-seven patients who had undergone complete submandibular gland sparing (CSGS) were included in the study. Cancer prognosis items were recorded. The subjective outcomes included patient self-evaluation of mouth dryness and the evaluation of the presence of saliva secretion following the application of digital pressure. Saliva scintigraphy served as the objective test. Self-reported xerostomia was compared between the CSGS patients and a control group of patients who had undergone unilateral submandibular gland removal (USGR; n = 74). In the CSGS group, local recurrence occurred in 3.8% of the 80 cancer sites, and neck recurrence occurred in 5.9% of neck dissection sites. Regarding the subjective measurements, 7.0% of the CSGS patients reported xerostomia and 91.9% demonstrated saliva secretion by digital pressure. Scintigraphy revealed actively secreting glands, with 42.9% of them showing normal gland function; none of the patients had severe xerostomia. The relative risk of dry mouth was significantly higher in the USGR patients than in the CSGS patients (P < 0.001). Submandibular gland sparing during neck dissection was found to result in satisfactory saliva secretion, with a relatively small risk of local or neck recurrence.

Prevalence of submandibular gland involvement in neck dissection specimens of patients with oral cavity carcinoma

IntroductionThe submandibular gland is commonly removed during neck dissection in patients with head and neck cancer. The patient experiences various complications due to the removal of the submandibular gland. Therefore, the necessity of submandibular gland removal should be evaluated. This study aimed to was to determine the frequency of submandibular gland (SMG) involvement in patients with oral cavity squamous cell carcinoma (SCC). MethodsIn this retrospective study, medical records of patients with oral cavity cancer who were referred to Amir Alam Hospital between 2015 and 2020 were reviewed. Patient data includes surgical report, histopathology report (tumor size, number of lymph nodes involved, and SMG tumor involvement), Tumor Location, History of Smoking, History of Opium, and Alcohol consumption was extracted from patients' medical records and statistically analyzed using SPSS software version 20. ResultsOf the total 60 patients, 24 (40%) were female and 36 (60%) were male. Smoking was reported in 55% of patients with a mean of 4.11 pack-year. Alcohol and opium use was observed in 18.3% and 26% of patients. The majority of patients (78.3%) had tongue cancer. More than half of the patients (53.3%) reported tumors of 2 cm or smaller, and 16.7% of patients had tumors larger than 4 cm. The majority of patients (80.3%) did not have cervical lymph node metastasis, 13.1% had 1–2 involved lymph nodes and 4.9% had 3 to 6 involved lymph nodes and there were no cases of metastasis to more than 6 lymph nodes. Finally, no individual had submandibular gland involvement, ie 100% of patients had no submandibular gland metastasis. ConclusionThe results confirmed that SMG involvement is very rare in patients with oral SCC and therefore it is not necessary to remove the gland as part of treatment. Preservation of the submandibular gland prevents complications related to the removal of this gland and reduces morbidity and increases the quality of life of patients after surgery.

Outpatient Submaxillectomy Using Active Drains. Safety of the Procedure and Patient Satisfaction.

Surgical interventions on an outpatient basis are defined as those procedures in which the patient is discharged the same day of the surgery after monitoring the subject during the immediate postoperative period. Submaxillectomies have conventionally been performed on an inpatient basis, and hospital stay was determined by the drain removal. This study aims to establish both safety and patient satisfaction following outpatient submaxillectomies using active drains. Fifteen patients between March 2016 and March 2020 underwent submaxillectomies using active drains in an outpatient basis. No patient had to be readmitted, and there were no complications that could be associated with the outpatient basis of this procedure, showing the safety of this surgical regimen. Patient satisfaction degree was high, with 86.7% of the patients declaring low or no pain as well as appropriate hospital stay. Most of the patients stated that they would accept the surgery in an outpatient basis once again. The performance of an outpatient submandibular gland removal is a safe and well-accepted procedure by the patient.

Predictive Factors for Submandibular Gland Involvement in Oral Cavity Squamous Cell Carcinoma-a Prospective Study from a Tertiary Cancer Center.

The oncological necessity of submandibular gland removal during neck dissection for oral cavity squamous cell carcinoma surgery has remained controversial. This study was aimed to determine the rate of SMG involvement and assess the feasibility of submandibular gland (SMG) preservation. We present a prospective study conducted at a tertiary cancer center from June 2017 to May 2019. All patients of oral squamous cell carcinoma who underwent primary surgery with neck dissection were included and analyzed for incidence and predictive factors for incidence of level IB nodal and SMG involvement as per CAP guidelines. A total of 60 patients were inducted in the study, wherein 63 neck dissections were performed including bilateral dissection in three cases. There was involvement of SMG in 6 patients with two cases each in floor of mouth cancer, gingivo-buccal, and alveolar lesions. The SMG was involved by direct contiguous spread from the primary lesion in two cases, extra-capsular extension from level IB lymph nodes in one and by both mode of spread in three glands. Perineural invasion was seen in 83.33% (n = 5) patients with SMG involvement (p- < 0.001), while 66.67% (4/6) patients had lympho vascular invasion (p-0.006) and all the cases with SMG involvement had extra-capsular extension (p < 0.001), suggesting PNI, LVI, and ECE as the strongest predictors of SMG involvement. This study demonstrates that oral cavity squamous cell carcinoma has low potential to metastasize to the SMG; however, high-risk factors include primary tumor site in floor of mouth or tongue, heavy level IB nodal burden, presence of LVI, PNI, and ECE. In the absence of these high-risk factors, SMG preservation with complete nodal clearance in level IB is a promising technique for reducing future complications.

Surgery for Submandibular Gland Diseases: 14-years of Experience of a Single Tertiary Center

Objective: Surgical removal is a valid option in the treatment of submandibular gland diseases but there are still operative and diagnostic pitfalls. We aimed to review and investigate the long-term clinical, surgical, and pathologic outcomes of our cases that had undergone submandibular gland removal. Materials and Methods: Retrospective analysis was conducted on patients who underwent submandibular gland excision via the transcervical approach with minimal skin incision between January 2007 and April 2020. Demographic data, preoperative FNA cytology results, clinical findings, surgical procedure, postoperative histopathological diagnosis, and postoperative morbidity were reviewed and analyzed. Results: 66 patients (41.7%) had sialolithiasis, 47 patients (29.7%) had chronic sialadenitis. Pleomorphic adenoma was found in 30 of the 44 patients that been operated on for submandibular mass. Gland derived carcinoma was found in 9 patients. The sensitivity of FNA biopsy in our case series was 83.3% (10/12), specificity was 78.1% (25/32), positive predictive value was 71.4% (10/14), and the negative predictive value was 96.1% (25/26). Permanent facial nerve marginal mandibular branch palsy was found in two patients (1.2%). Conclusion: The transcervical approach to the submandibular gland offers safe and reliable removal of the submandibular gland with a minimal risk of complications. FNA cytology was found to be useful in the preoperative evaluation of the submandibular masses.

Flow Cytometric Analysis of Peripheral T Cell Subsets in the Sialoadenectomized and Salivariadenectomized Male Mice ( Mus musculus Linn.)

The extraordinary sequential process of T cell development and maturation is hallmark of well-functioning of thymus gland. An earlier study clarifies the relationship between salivary glands and other organs including thymus. In order to define the precise role of salivary gland secreted growth factors on the development, differentiation and maturation of thymocytes, especially CD4 and CD8, we sialoadenectomized (removal of submandibular gland) and salivariadenectomized (removal of submandibular and sublingual glands) the male albino mice. The mice were operated at the age of 20 days and maintained under normal conditions in the animal house along with control, up to the age of ten weeks. Subsequently, blood samples were collected and peripheral T cell subsets was analysed using FACSCalibur flow cytometer with BD Tritest CD4FITC/ CD8PE/CD3 PerCP reagent. It was observed that in the absence of salivary gland-secreted growth factors, especially EGF, the mature naA¯ve T cells output gets disturbed, and there was significant reduction in CD4 absolute and % count and CD4:CD8 ratio, signifying the importance of salivary gland-secreted growth factors in maturation of immune cells in the thymus. It is suggested that the importance of interplay of hormones and neuropeptides on one hand and salivary secretory regulatory peptides on the other, on the T cell differentiation and maturation in the thymus is investigated.

Management of malignant submandibular gland tumour: 20‐year experience in a single institution

AbstractAimOur primary objective is to establish the epidemiology of submandibular gland malignant tumour in Hong Kong. Our second objective is to investigate the correlation of positive surgical margin and survival in patients with primary malignant submandibular gland tumour. Our third objective is to review the accuracy of fine needle aspiration in histological diagnosis.Patients and MethodsA retrospective study was conducted. Patients who underwent surgery and were discharged from Queen Mary Hospital and Tung Wah Hospital from December 31, 1997‐December 31, 2017 were included. Data was analysed by Microsoft Excel and IBM SPSS Statistics 25.ResultThere were 239 patients with submandibular gland removal between 1997‐2017 in the Queen Mary and Tung Wah Hospitals. Among this group, 32 patients were diagnosed with malignant submandibular gland. Data of these 32 patients were reviewed and analysed. The male‐to‐female ratio was 3:1. The median age at diagnosis was 55.5. Mean follow up time was 44.8 months. Patients presented with various histological subtypes of submandibular gland tumour, the most common being lymphoepithelioma‐like carcinoma and adenocystic carcinoma (28.1% each), followed by carcinoma ex pleomorphic adenoma (12.5%), mucoepidermoid carcinoma (9.4%), salivary duct carcinoma (9.4%), undifferentiated carcinoma (6.3%) and squamous cell carcinoma (6.3%). The tumour histological subtype was unknown in 40.6% of patients at the time of surgery. The positive surgical margin rate was 50%. The overall 5‐year locoregional control rate, disease‐free survival and overall survival were 81.83%, 75.14% and 76.57% respectively.ConclusionLack of preoperative histological diagnosis is identified as the only predictor of positive surgical margin, OR 7.22, P &lt; 0.0163. It is concluded that TNM staging and lymphovascular invasion are the two significant prognostic factors in management of malignant submandibular gland tumour. However, we cannot draw a statistically significant conclusion on whether positive surgical margin would affect the overall survival or locoregional control or disease‐free survival. (P &lt; 0.997, P &lt; 0.74, P &lt; 0.950 respectively).

A Case of Removal of Multiple Submandibular Gland and Duct Stones by Cervical Incision Approach

A calcified structure blocking the flow of saliva into the mouth is a major cause of salivary dysfunction. If a stone is detected, the goal of treatment would be to remove it. Furthermore, the fundamental treatment for preventing recurrence, although depending on the location and size of the stone, is salivary gland resection. The submandibular gland duct and hilum stone is usually removed by transoral approach. If there are multiple stones in the submandibular gland and the duct, it would be necessary to carry out resection of submandibular gland, using the intra-oral approach. We recently experienced a case of multiple stone in the submandibular gland and the duct in a 73-year-old man, who presented with the right submandibular area swelling after meals. We removed the submandibular gland and duct stone without intra-oral approach and present this case with a review of the literature. Key words: Sialolithiasis ㆍ Submandibular gland ㆍ Whartons duct

Advantages of submandibular gland preservation surgery over submandibular gland resection for proximal submandibular stones

This study sought to compare surgical outcomes after the removal of submandibular gland (SMG) stones via 2 different surgical methods. From June 2015 to July 2016, a total of 40 patients with SMG stones were selected from the Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University (Shenyang, China), and were randomly assigned to 2 groups. Twenty patients underwent sialendoscopy-assisted stone removal via extraoral incision with preservation of the SMG, and 20 patients underwent traditional SMG resection. The outcomes of the 2 surgical procedures were assessed. The operation time and hospital stay were shorter in the SMG preservation group than the SMG resection group. There were no significant differences in stone size or location between the groups. The mean visual analog scale (VAS) score was lower in the SMG preservation group than the SMG resection group. All patients in the SMG resection group exhibited varying degrees of scarring and concave deformity on the face and neck, whereas all patients in the SMG preservation group retained intact facial morphology. Sialendoscopy-assisted stone removal with preservation of the SMG exhibited many advantages relative to traditional SMG resection.

Multiple sialolithiasis of submandibular gland: a case report

Objective: Sialolithiasis is a common disease of the salivary glands. Sialolithiasis occurs mainly in the submandibular gland (80–90%) and to a lesser extent in the parotid gland (5–20%). Sialoliths may be single or multiple. Multiple sialolith in the submandibular gland are rare. Seventy to 80% of cases feature solitary stones; only about 5% of patients have three or more stones. Patients commonly experience pain and/or swelling.Methods: A 51-year-old male came to Department of Oral and Maxillofacial Surgery with a swelling and pain at the right submandibular. The panoramic radiograph showed a radiopacity mass with well-defined in right submandibular. The Ultrasonographic interpretation showed hypoechoic inhomogeneous mass with multiple calcification.The submandibular gland removal was performed by extraoral approach.Result:Multiple sialolith in the submandibular gland are rare. A surgical approach for removal of sialolith in the submandibular gland could be intraoral or extraoral. In this case report, we described five stones in the submandibular gland. which were removed by extraoral approach.Conclusion: There are various methods available for the management of salivary stones. In this case report, removal of the submandibular gland with the stone should still be preferred as the gold standard of treatment and could avoid recurrence of this medical condition.

Carotid artery and lower cranial nerve exposure with increasing surgical complexity to the parapharyngeal space.

To investigate the extent of carotid artery exposure attained, including the identification of the external carotid branches and lower cranial nerves in five sequential external approaches to the parapharyngeal space, and to provide an anatomical algorithm. Anatomical study. Six latex-injected adult cadaver heads were dissected in five consecutive approaches: transcervical approach with submandibular gland removal, posterior extension of the transcervical approach, transcervical approach with parotidectomy, parotidectomy with lateral mandibulotomy, and parotidectomy with mandibulectomy. The degree of carotid artery exposure attained, external carotid branches, and lower cranial nerves visualized was documented. The transcervical approach exposed 1.5 cm (Standard Deviation (SD) 0.5) of internal carotid artery (ICA) and 1.25 cm (SD 0.25) of external carotid artery (ECA). The superior thyroid and facial arteries and cranial nerve XII and XI were identified. The posterior extension exposed 2.9 cm (SD 0.7) of ICA and 2.7 cm (SD 1.0) of ECA. Occipital and ascending pharyngeal arteries were visualized. The transparotid approach exposed 4.0 cm (SD 1.1) of ICA and 3.98 cm (SD 1.8) of ECA. Lateral mandibulotomy exposed the internal maxillary artery, cranial nerve X, the sympathetic trunk, and 4.6 cm (SD 2.4) of ICA. Mandibulectomy allowed for complete ECA exposure, cranial nerve IX, lingual nerve, and 6.9 cm (SD 1.3) of ICA. Approaches for the parapharyngeal space must be based on anatomic and biological patient factors. This study provides a guide for the skull base surgeon for an extended approach based on the desired anatomic exposure. N/A. Laryngoscope, 127:585-591, 2017.

Development of a virtual reality training system for endoscope-assisted submandibular gland removal.

Endoscope-assisted surgery has widely been adopted as a basic surgical procedure, with various training systems using virtual reality developed for this procedure. In the present study, a basic training system comprising virtual reality for the removal of submandibular glands under endoscope assistance was developed. The efficacy of the training system was verified in novice oral surgeons. A virtual reality training system was developed using existing haptic devices. Virtual reality models were constructed from computed tomography data to ensure anatomical accuracy. Novice oral surgeons were trained using the developed virtual reality training system. The developed virtual reality training system included models of the submandibular gland and surrounding connective tissues and blood vessels entering the submandibular gland. Cutting or abrasion of the connective tissue and manipulations, such as elevation of blood vessels, were reproduced by the virtual reality system. A training program using the developed system was devised. Novice oral surgeons were trained in accordance with the devised training program. Our virtual reality training system for endoscope-assisted removal of the submandibular gland is effective in the training of novice oral surgeons in endoscope-assisted surgery.

Minimally invasive surgery of sialolithiasis using sialendoscopy.

The introduction of minimally invasive surgical procedures using sialendoscopy has significantly reduced the rate of major salivary gland removal due to sialolithiasis. The present study assessed the utility of sialendoscopy and identified potential factors influencing successful sialendoscopic salivary stone retrieval. Medical records of sialendoscopic procedures performed at the Department of Otolaryngology of the National Defense Medical College in Japan from November 2007 to January 2014 were retrospectively reviewed. We identified 78 patients diagnosed with sialolithiasis and treated with sialendoscopy (SE). Factors analyzed included stone location, size, symptom duration, surgical methods, and complications. The mean age at presentation was 41 years (range, 11-76 years) with a male-to-female gender ratio of 1:1.89. In total, 73 submandibular and 5 parotid endoscopies were performed. Stone size ranged from 2 to 20mm in diameter. Submandibular stones were removed either by SE alone (9.6%), by transoral stone removal (19.2%), or a combined approach (57.5%). Only 13.7% (10/73) of the cases required submandibular gland removal. Stone size and shape were significant predictors for successful endoscopic stone removal, and stone size and location were significant predictors for submandibular gland removal. Sialendoscopy is a reasonable, minimally invasive treatment option for sialolithiasis that avoids salivary gland removal. The present results indicate that sialendoscopy is the first treatment of choice for submandibular gland sialolithiasis. Complete surgical excision is becoming uncommon as a first-line treatment, but it remains indispensable in certain cases.

Submandibular Gland Preservation during Concurrent Neck Dissection and Transoral Surgery for Oropharyngeal Squamous Cell Carcinoma

Analyze the effect of ipsilateral submandibular gland preservation on patients undergoing concurrent neck dissection and transoral surgery for oropharyngeal squamous cell carcinoma. Evaluate for (1) intraoperative and postoperative communications between the oropharynx and neck and (2) oncologic outcomes. Retrospective chart review of prospectively collected data. Tertiary academic referral center. Retrospective chart review of patients undergoing transoral laser resection of oropharyngeal squamous cell carcinoma with simultaneous neck dissection(s) for primary, persistent, recurrent, and second primary disease between January 1999 and February 2013. Data analyzed for operative technique, pathologic diagnosis, postoperative course, complications, and oncologic outcomes. Overall 253 patients were identified. Of these, 96 patients underwent ipsilateral submandibular gland preservation and 157 underwent ipsilateral submandibular gland removal at the time of neck dissection. The prevalence of intraoperative communication between the neck and oropharynx was significantly lower in cases with submandibular gland preservation (2/96, 2.08%) compared to those with submandibular gland removal (22/157, 14.13%). No postoperative leaks occurred in the gland preservation group (0/96, 0%) compared to a leak prevalence of 8.92% (14/157) when the gland was removed (P = .0041). There was no difference in local, regional, or distant disease recurrence between submandibular gland preservation and gland removal. Similarly, Kaplan-Meier analysis showed no difference in disease free survival, disease specific survival, or overall survival. Submandibular gland preservation during neck dissection in patients undergoing transoral surgery for oropharyngeal squamous cell carcinoma significantly reduces the risk of intraoperative and postoperative salivary leaks without compromising oncologic outcomes.

Submandibular Gland Preservation during Concurrent Neck Dissection and Transoral Surgery for Oropharyngeal Squamous Cell Carcinoma

Objectives: Analyze the effect of ipsilateral submandibular gland preservation on patients undergoing concurrent neck dissection and transoral surgery for oropharyngeal squamous cell carcinoma. Evaluate for 1) intraoperative communications between the oropharynx and neck, 2) postoperative salivary leaks, and 3) oncologic outcomes. Methods: Retrospective chart review of oropharyngeal squamous cell carcinoma patients undergoing transoral surgery with simultaneous neck dissection(s) at a tertiary referral center between 1999 and 2013 with analysis of operative technique, pathologic diagnosis, postoperative course, complications, and oncologic outcomes. Results: Overall 253 patients were identified. Of these, 96 patients underwent ipsilateral submandibular gland preservation and 157 underwent ipsilateral submandibular gland removal at the time of neck dissection. The prevalence of intraoperative communication between the neck and oropharynx was significantly lower ( P = 0.0017) in cases with submandibular gland preservation (2.08%, n = 2) compared to those with submandibular gland removal (14.13%, n = 22). Similarly, there were fewer postoperative salivary leaks with gland preservation. No postoperative leaks occurred in the gland preservation group (0%, n = 0) compared to a leak prevalence of 8.92% (n = 14) when the gland was removed ( P = 0.0041). There was no difference in local ( P = 0.2208), regional ( P =0.9624), or distant disease ( P = 0.7523) recurrence between the groups. Conclusions: Submandibular gland preservation during neck dissection in patients undergoing transoral surgery for oropharyngeal squamous cell carcinoma reduces the risk of intraoperative and postoperative salivary leaks without compromising oncologic outcomes.

Sialendoscopy Outcomes: A Study of over 100 North American Patients for Benign Salivary Gland Disorders

Objectives: Evaluate our institution’s experience with diagnostic and therapeutic sialendoscopy in the management of nonneoplastic salivary gland disorders. Methods: At a tertiary medical center, a retrospective chart review was conducted of 105 patients with recurrent sialadenitis between 2008-2012 with sialendoscopy performed on 130 glands. Outcomes measured included cause, stone size and location, surgical method, and any further need for intervention. Results: The mean age of presentation was 49 (range, 15-77), and 45% were male. Reasons for recurrent sialadenitis included sialolithiasis (75), history of radioactive iodine/radiation (10), Sjogrens Syndrome (2), stricture (6), and anatomical obstruction (7). Ten patients had a history of prior transoral intervention, and two had a history of gland removal on the affected side. In patients with sialolithiasis (n = 75), the mean stone size was 8.6 mm if originating from the submandibular gland (n = 44, range, 1-25mm), and 4.4 mm if originating from the parotid (n = 9, range, 2-7mm). Complete stone removal was accomplished in 92% of cases on first attempt with the stone visualized. In 33.8% of the patients, the stone was removed endoscopically, while a combined approach was required in 50.7%. 15.5% required submandibular or parotid gland removal. 17.8% of patients required further intervention (medical or surgical) following their procedure. Conclusions: Sialendoscopy demonstrates great potential in the management of recurrent sialadenitis and minimizes the need for gland excision in that setting. Further investigation and adoption of sialendoscopy is warranted.

Effect of Sialoadenectomy on the development of male reproductive organs in mice (Mus musculus).

Submandibular gland is rich source of epidermal growth factor (EGF). To investigate the role of salivary EGF on the development of male reproductive system we have performed the sialoadenectomy (removal of submandibular glands) of the 20 days old male mice and this sialoadenectomised mice was sacrificed on 45, 60 and 90th day. The testis, seminal vesicle, prostate gland, caput and cauda epididymis were dissected out for protein estimation and histological studies. It was found that the there was significant loss in the weight of these organs, protein content in the sialoadenectomised mice as compared to control. The histological structures of these organs were also changed in the sialoadenectomised mice. Keyword: Sialoadenectomy, Histology, weight, Protein

Sialoendoskopia w leczeniu kamicy ślinianek – doświadczenia własne na podstawie 95 przypadków

The introduction of minimally invasive surgical procedures has significantly reduced the rate of major salivary gland removal due to sialolithiasis. The aim of the analysis was to assess the effectiveness of sialoendoscopy and combined approach in most difficult cases. prospective study, tertiary university centre (Department of Otorhinolaryngology, Head and Neck Surgery, Poznan), between XII 2008 and V 2012, 207 sialendoscopies were performed in 197 patients. In this number 158 patients had obstructive pathology of salivary glands, 95 confirmed gland or duct sialolithiasis: parotid - 31 and submandibular - 64. In the group of submandibular lithaiasis in 40 cases (62.5%) stones were removed endoscopically. Double approach (sialendoscopy and incision of mucosa of the floor of the mouth with removal of the stone was performed in 21 cases (32.8%). Only in 3 cases removal of submandibular gland was necessary. In the group of parotid sialolithiasis in 17 cases (54%) endoscopy was the definite treatment, in 9 litothrypsy (ESWL) were necessary and in 5 combined approach. This five patients who failed SE were treated by combined transcutaneous (open surgery) and endoscopic procedure. We observed no incidence of salivary fistula after the incision of the duct; there was also no stenosis of the natural ostium due to the insertion of a stent. Sialoendoscopy is method of choice with high rate of success and gland preservation in small and moderate stones. The combined approach is indicated for large stones, complications and where there is a contraindication to established minimally invasive procedures.