Surgery of the major salivary glands and its impact on salivary flow—A review

Abstract

Objective The aim of this study was to bring attention to a rather unnoted side effect of salivary gland surgery–reduced salivary flow. Methods A systematic PubMed, Cochrane Library, LIVIVO, and Embase databases search was performed to identify relevant articles. Results Eight studies matched the inclusion criteria. All studies described an association between salivary gland surgery and reduced salivary flow. In five of the eight studies, patients reported on xerostomia after salivary gland surgery. Conclusions Head and neck surgeons should inform their patients more accurately about reduced salivary flow and possible xerostomia after salivary gland surgery, and focus more on conservative strategies and minimally invasive techniques. Laryngoscope, 129:2053–2058, 2019

A prospective study of patient‐reported xerostomia‐related outcomes after parotidectomy

“…There may be compensation from other remaining salivary glands, as has been suggested by other studies 2 . Also, the parotid glands, which together secrete approximately a quarter of unstimulated saliva production, or one eighth of saliva from one gland, may have limited noticeable contribution to the patient perception of normal salivation 1 . Additionally, because over a third of the sample reported some degree of preoperative xerostomia, any changes brought by loss of partial unilateral parotid gland may have been disguised by ongoing baseline xerostomia.…”

“…The parotid glands together account for approximately 26% of unstimulated saliva production. When stimulated, the parotid glands together produce about 50% of total saliva 1 . Previous studies have investigated salivary flow rates after parotidectomy, finding both a decrease in salivary production as well as a compensatory increase in production from the contralateral side 2,3 .…”

“…Objective salivary flow rates do not correlate well with subjective xerostomia symptoms 1,4‐7 . Beyond evidence of objective changes in salivary flow, there are limited studies evaluating the specific functional or QOL implications of xerostomia following parotidectomy.…”

Qualität der Therapie von Speicheldrüsenerkrankungen

“…parotis oder der Gl. submandibularis konnte überhaupt nur acht prospektive Studien (1993 bis 2016) identifizieren [21]. Sechs Studien untersuchten Patienten nach Operation an der Gl.…”

“…Drei Studien, die eine Speicheldrüsen-Szintigrafie zur objektiven Bewertung der Speicheldrüsenfunktion verwendeten, wurden aus methodischen Mängeln nicht in die systematischen Reviews aufgenommen [23][24][25]. Die Autoren der systematischen Reviews vertreten in der Diskussion die Ansicht, dass eine Speicheldrüsen-Szintigrafie zur Funktionsuntersuchung nicht empfohlen werden könne, da die Strahlenbelastung dem entgegenstehe [21].…”