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

  • H. Shih
    Affiliations
    Department of Dentistry, Division of Oral and Maxillofacial Surgery, China Medical University Hospital, Taichung, Taiwan
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  • J.-S. Huang
    Affiliations
    Division of Oral and Maxillofacial Surgery, Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Department of Dentistry, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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  • T.-T. Huang
    Affiliations
    Division of Oral and Maxillofacial Surgery, Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Department of Dentistry, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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  • T.-Y. Wong
    Affiliations
    Division of Oral and Maxillofacial Surgery, Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Department of Dentistry, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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  • M.-Y. Chen
    Affiliations
    Division of Oral and Maxillofacial Surgery, Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Department of Dentistry, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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  • K.-C. Chen
    Correspondence
    Correspondence to: Division of Oral and Maxillofacial Surgery, Department of Stomatology, Department of Dentistry, National Cheng Kung University Medical College and Hospital, No. 1, University Road, Tainan City 701401, Taiwan.
    Affiliations
    Division of Oral and Maxillofacial Surgery, Department of Stomatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Department of Dentistry, College of Medicine, National Cheng Kung University, Tainan, Taiwan
    Search for articles by this author
Published:December 12, 2022DOI:https://doi.org/10.1016/j.ijom.2022.11.013

      Abstract

      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.

      Keywords

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