Long-term results of autologous submandibular gland transfer for the surgical treatment of severe keratoconjunctivitis sicca
Long-term results of autologous submandibular gland transfer for the surgical treatment of severe keratoconjunctivitis sicca
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DOI：
10.1016/j.jcms.2007.08.010
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发表时间：
2008-06-01
影响因子：
3.1
通讯作者：
Sieg, Peter
中科院分区：
文献类型：
--
作者：
Jacobsen, Hans-Christian;Hakim, Samer G.;Sieg, Peter
目的：本研究的目的是评估自体颌下腺移植手术矫正严重干燥性角结膜炎的长期结果。患者和方法：对 32 名接受颌下腺移植的患者（42 个腺体）进行了调查，并对 11 名患者（15 个腺体）进行了 5-10 年的随访。评估了主观益处以及眼表的临床发现。分析了分泌的“唾液泪液”的生化一致性，并与匹配对照组的天然下颌下唾液进行了比较。通过唾液闪烁显像测试移植物的活力和功能。对在移植物复位过程中获得的颌下组织样本进行免疫组织化学研究，以纠正分泌过多。结果：患者评估和临床评估显示，2/3 的患者获得了持久的主观益处，并且所有病例的眼表都稳定了。分泌物仍为高度浓缩的颌下唾液。闪烁图像显示腺体活力和功能。免疫组织化学研究显示，移植后没有进行性萎缩，细胞分裂能力保持完整，并且即使在移植后数年，所有移植物中仍然存在神经元组织。由于所有移植物对拟副交感神经药物反应良好，这可能表明腺体重新受神经支配。 (C) 2008 年欧洲颅颌面外科协会。
Aim: The aim of this study was to assess the long-term results of autologous submandibular gland transfer for surgical correction of severe keratoconjunctivitis sicca. Patients and methods: A survey was undertaken of 32 patients who had undergone submandibullar gland transfer (42 glands) and by following up 11 patients (15 glands) for 5-10 years. Subjective benefit was evaluated as well as clinical findings at the ocular surface. The biochemical consistency of the secreted "saliva-tear" was analysed and compared with natural submandibular saliva of a matched control-group. The vitality and function of the transplants was tested by means of sialoscintigraphy. Immunohistochemical investigations were carried out in specimens of submandibular tissue, gained during reduction procedures of the transplants to correct secretory excess. Results: Patient evaluation and clinical assessment revealed a long-lasting subjective benefit in 2/3 of the patients and a stabilisation at the ocular surface in all cases. The secretion remained as highly concentrated submandibular saliva. Glandular vitality and function was shown scintgraphically. Immunohistochemical investigations revealed no progressive atrophy after transplantation, the ability of cell division remained intact and there was still neuronal tissue in all transplants, even several years after transfer. As all transplants responded well to parasympathomimetic drugs, this might be an indication of re-innervation of the gland. (C) 2008 European Association for Cranio-Maxillofacial Surgery.