Microvascular autologous transplantation of partial submandibular gland for severe keratoconjunctivitis sicca

Abstract

Microvascular transplantation of partial SMG is feasible and effective for severe KCS and does not decrease the survival rate of transplanted SMG. For ample SMGs with normal function, transplantation of partial SMG alleviates the symptoms of dry eye and significantly reduces the incidence of severe postoperative epiphora.

The timing of acid-induced increase in saliva secretion in transplanted submandibular glands

“…3,8 However, excessive secretion, or epiphora, occurs in more than 40% of patients at >6 months after surgery. 8 Patients with severe epiphora may experience mild discomfort at rest and at room temperature, but may experience worsened symptoms upon exercise or at increased temperatures. These patients may require reduction surgery of the transplanted SMG.…”

“…[1][2][3][4][5][6][7][8][9][10] In our experience of SMG transplantation in 180 patients (195 glands), all viable transplanted SMGs retain their secretion function in the long term and the symptoms of dry eye are greatly relieved. 3,8 However, excessive secretion, or epiphora, occurs in more than 40% of patients at >6 months after surgery. 8 Patients with severe epiphora may experience mild discomfort at rest and at room temperature, but may experience worsened symptoms upon exercise or at increased temperatures.…”

An Experimental Study on Botulinum Toxin Type A for the Treatment of Excessive Secretion after Submandibular Gland Transplantation in Rabbits

“…SMG transplantation has been considered as one of the most effective treatments for severe xerophthalmia [4, 11, 31, 32]. However, about 40% of patients suffered from epiphora after SMG transplantation [13, 14, 33], which reduced patients' life quality and increased their social embarrassments.…”

“…However, about 40% of patients suffered from epiphora after SMG transplantation [13, 14, 33], which reduced patients' life quality and increased their social embarrassments. Current therapeutic strategies of epiphora after SMG transplantation include surgery, a variety of drugs, and other therapies [15, 31, 34]. However, none of them are entirely satisfactory for various side effects.…”

Ophthalmic Procedures for Treatment of Advanced Ocular Surface Diseases

“…57 This procedure has been documented to cause extensive epiphora in approximately half of patients 6 months postoperatively. 58 The salivary gland secretions remain in a ''saliva-tear'' composition given the source gland properties, and epiphora can become worse with exercise and in hot environments. 57 Some cases require partial graft excision/revision with a second procedure to mediate symptoms of epiphora.…”