The Tubarial salivary glands: A potential new organ at risk for radiotherapy.

Thumyat Noe ‘ 23

Figure 1: The salivary glands are essential for digestion, speech production, and maintenance of dental hygiene. Recently, researchers have discovered a structure in the center of the human head that resembles salivary glands. 

Production of saliva by the salivary gland system is important for speech production, chewing, swallowing, tasting, and maintaining dental hygiene. Previously, physicians and scientists were only aware of the existence of three paired major glands and 1000 minor glands in the salivary gland system. However, researchers from the Netherlands have recently discovered an unknown bilateral structure posterior in the nasopharynx with the help of PSMA PET/CT, an advanced tool that can be used to image or scan the internal human body. Researchers believe that the presence of this structure has been overlooked previously because advanced imaging tools such as PSMA PET/CT were not available. Upon closer examination of this structure, researchers have noticed that its functions are similar to that of a salivary gland, leading them to suspect that this new structure is indeed a salivary gland. This is an important discovery especially in facilitating optimal radiotherapy for head and neck cancer patients as radiotherapy aimed towards head and neck cancer can impair the function of any salivary gland. As a consequence, head and neck cancer patients who undergo radiotherapy often experience impaired food intake, digestion issues, and speech problems in addition to increased risk of dental caries and oral infections. The purpose of this research is to further study the anatomy and function of these previously unknown structures, as well as determine their clinical relevance in cancer treatment. 

The presence of these structures were first confirmed in a retrospective cohort study using PSMA PET/ CT scans. To assess the effects of radiotherapy on these glands, researchers studied the relationship between the mean radiotherapy dose to the gland area and physician-evaluated ratings of post-treatment xerostomia (dry mouth) and dysphagia (difficulty swallowing). Patients were also asked to fill out the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire. The results showed that the structure was observed in all participants from the retrospective cohort study. In head and neck cancer patients, the mean radiotherapy dose to the gland area was significantly associated with dry mouth and difficulty in swallowing, further supporting the notion that the structure is a salivary gland that should be considered when administering radiotherapy. 

Researchers have proposed the name “Tubarial glands” for these newly discovered salivary glands. Findings of this study suggest that physicians should consider the existence of tubarial glands in order to provide optimal cancer treatment and avoid inducing xerostomia and dysphagia in head and neck cancer patients. 

Work(s) cited:

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