China ; Humans ; Xerostomia ; classification

PURPOSE: Parotid gland can be considered as a risk organ in whole brain radiotherapy (WBRT). The purpose of this study is to evaluate the parotid gland sparing effect of computed tomography (CT)-based WBRT compared to 2-dimensional plan with conventional field margin. MATERIALS AND METHODS: From January 2008 to April 2011, 53 patients underwent WBRT using CT-based simulation. Bilateral two-field arrangement was used and the prescribed dose was 30 Gy in 10 fractions. We compared the parotid dose between 2 radiotherapy plans using different lower field margins: conventional field to the lower level of the atlas (CF) and modified field fitted to the brain tissue (MF). RESULTS: Averages of mean parotid dose of the 2 protocols with CF and MF were 17.4 Gy and 8.7 Gy, respectively (p < 0.001). Mean parotid dose of both glands > or =20 Gy were observed in 15 (28.3%) for CF and in 0 (0.0%) for MF. The whole brain percentage volumes receiving >98% of prescribed dose were 99.7% for CF and 99.5% for MF. CONCLUSION: Compared to WBRT with CF, CT-based lower field margin modification is a simple and effective technique for sparing the parotid gland, while providing similar dose coverage of the whole brain.
Brain ; Humans ; Parotid Gland ; Xerostomia

Patients with Sjögren's syndrome usually suffer from teeth discoloration and attrition due to xerostomia. If the anterior teeth are badly worn, problems such as loss of anterior guidance, occlusal disharmony, and limited space for restoration may occur. However, ideal occlusion is obtained in both centric and eccentric relation by regaining the disocclusion of the posterior teeth through the anterior and lateral guidance using twin-stage method. In this case, rehabilitation was performed for a Sjögren's syndrome patient with maxillary and mandibular incisor's severe attrition and teeth discoloration by using twin-stage method.
Dental Occlusion ; Humans ; Methods* ; Rehabilitation* ; Tooth* ; Xerostomia

Patients with Sjögren's syndrome usually suffer from teeth discoloration and attrition due to xerostomia. If the anterior teeth are badly worn, problems such as loss of anterior guidance, occlusal disharmony, and limited space for restoration may occur. However, ideal occlusion is obtained in both centric and eccentric relation by regaining the disocclusion of the posterior teeth through the anterior and lateral guidance using twin-stage method. In this case, rehabilitation was performed for a Sjögren's syndrome patient with maxillary and mandibular incisor's severe attrition and teeth discoloration by using twin-stage method.
Dental Occlusion ; Humans ; Methods* ; Rehabilitation* ; Tooth* ; Xerostomia

PURPOSE: This study is to evaluate the xerostomia following 3-dimensional conformal radiation therapy (3D CRT) in nasopharynx cancer patients using the xerostomia questionnaire score (XQS). MATERIALS AND METHODS: Questionnaire study was done on 51 patients with nasopharynx cancer who received 3D CRT from Dec. 2000 to Aug. 2005. 3D CRT technique is based on "serial shrinking field" concept by 3 times of computed tomography (CT) simulation. Total target dose to the primary tumor was 72 Gy with 1.8 Gy daily fractions. Xerostomia was assessed with 4-questions XQS, and the associations between XQS and time elapsed after RT, age, sex, stage, concurrent chemotherapy, and parotid dose were analyzed. RESULTS: Concurrent chemotherapy was given to 40 patients and RT alone was given to 11 patients. The median time elapsed after 3D CRT was 20 (1~58) months and the mean XQS of all 51 patients was 8.4+/-1.9 (6~14). XQS continuously and significantly decreased over time after 3D CRT (x(2)=-0.484, p<0.05). There was no significant difference in XQS according to sex, age, and stag. However, XQS of concurrent chemotherapy patients was significantly higher than RT alone patients (p=0.001). XQS of patients receiving total mean parotid dose > or=35 Gy was significantly higher than <35 Gy (p=0.05). CONCLUSION: Decreasing tendency of XQS over time after 3D CRT was observed. Concurrent chemotherapy and total mean parotid dose > or=35 Gy were suggested to adversely affect radiation-induced xerostomia.
Drug Therapy ; Humans ; Nasopharyngeal Neoplasms* ; Surveys and Questionnaires ; Radiotherapy, Conformal* ; Xerostomia*

OBJECTIVES: The purpose of this study was to investigate oral discomfort factors in the elderly and to analyze the sociodemographic and health-related characteristics influencing their oral discomfort using multiple regression analysis. METHODS: Facilities were selected based on the 2014 Elderly Welfare Facilities Status. Data was collected through the interview of 176 participants aged ≥65 years. The oral discomfort factors (10 items) were investigated using a 5-point Likert scale. The total oral discomfort scores were added for each of the 10 items investigated using the 5-point Likert scale. SPSS 12.0 program was used to analyze the descriptive statistics and perform a t-test and a stepwise multiple regression analysis. RESULTS: The oral discomfort factor with the highest score was g oral discomfort factorThe total oral discomfort score for women was significantly higher than that for men. 'men. gnificantly higher thangenderg were, respectively, the health-related and sociodemographic characteristics that most significantly influenced the total oral discomfort scores. Perceived oral health accounted for 30.4% of the total oral discomfort score, while gender accounted for 2%. CONCLUSIONS: Health-related characteristics were more significantly associated with oral discomfort than sociodemographic characteristics. Since sociodemographic characteristics are not easily changed, government and healthcare providers should strive to improve the health of the elderly population.
Aged* ; Female ; Health Personnel ; Humans ; Male ; Oral Health ; Xerostomia

BACKGROUND AND OBJECTIVES: The accurate measure of salivary flow rate requires a variety of clinical and experimental protocols. Several methods have traditionally been used to collect and measure the whole mouth saliva. The objective of this study was to verify usefulness of a newly developed oral Schirmer test for detecting salivary gland hypofunction. SUBJECTS AND METHOD: The control group consisted of 85 healthy patients, while another group consisted of 30 patients with salivary grand resection or post-head and neck irradiation and a third group of 30 patients who suffered from subjective xerostomia caused by other pathologies. Oral Schirmer test was carried out in all subjects. The main outcome was the wetted length after 5 minutes. RESULTS: The mean saliva flow was 59.3+/-16.99 mm/5 min in the control group, 47.0+/-13.50 mm/5 min in the 2nd group and 39.9+/-11.65 mm/ 5 min in the third group. The differences between the control group and the other two groups were statistically different (p<0.001). A cut-off value 40 mm/5 min showed sensitivity of 83.7% and specificity of 62.5%. CONCLUSION: The oral Schirmer test is valid and reliable for identifying subjects with xerostomia.
Humans ; Mouth ; Neck ; Saliva ; Salivary Glands ; Sensitivity and Specificity ; Xerostomia

Xerostomia is a subjective sensation of a dry mouth which is frequently encountered in otorhinolaryngologic practice. There are a variety of salivary and nonsalivary causes of xerostomia such as side effects of medication, systemic disorders, radiation and Sjögren's syndrome. The patients with xerostomia have difficulties in chewing, swallowing, speaking, tasting and mataining oral hygiene. Because of the ageing population, and the concomitant increase in medicated individuals, otorhinolaryngologists can expect to be presented with xerostomia in an increasing number of patients in the coming years and therefore should be familiar with its diagnosis and treatment. A systematic approach should be needed to determine the etiology of xerostomia and the management of xerostomia should be multidisciplinary and multimodal. This review summarizes the current literature on the diagnosis, and complications of xerostomia, and on the management of patients with xerostomia.
Deglutition ; Diagnosis* ; Humans ; Mastication ; Mouth ; Oral Hygiene ; Saliva ; Sensation ; Xerostomia*

OBJECTIVETo observe the general status, subjective syndromes, objective signs and salivary secretion of xerostomia patients for studying their correlations.

METHODSEighty patients' clinical data were collected and classified according to certain standards. The salivary secretion including the unstimulated whole saliva (UWS) and stimulated whole saliva (SWS) in five minutes was measured by spit method.

RESULTSDecreased UWS was the main presentation of xerostomia which accouted for seventy five percents. Significantly statistical correlation were found between the decreased UWS and the dry mouth signs but not the age, sex and the accompany syndromes.

CONCLUSIONXerostomia has a high prevalence in middle-aged women with a long course and obvious regularity. The decreased UWS is the main presentation which was not caused by physiological changes of salivary glands and has no correlation with many clinical manifestations.

BACKGROUND: The purpose of this study was to evaluate the efficacy and feasibility of non-coplanar whole brain radiotherapy (NC-WBRT) for parotid sparing.METHODS: Fifteen cases, previously treated with WBRT were selected. NC-WBRT plans were generated. The beam arrangement for the non-coplanar plans consisted of superior anterior, right, and left beams. After generation of the non-coplanar plans a field-in-field technique was applied to the bilateral parallel opposed beams in order to reduce maximum dose and increase dose homogeneity. The NC-WBRT plans were subsequently compared with the previously generated bilateral WBRT (B-WBRT) plans. A field-in-field technique was also used with the B-WBRT plans according to our departmental protocol. As per our institutional practice a total dose of 30 Gy in 10 fractions of WBRT was administered 5 days a week.RESULTS: The mean dose to the parotid gland for the two different plans were 16.2 Gy with B-WBRT and 13.7 Gy with NC-WBRT (p < 0.05). In the NC-WBRT plan, the V5Gy, V10Gy, V15Gy, V20Gy, and V25Gy of the parotid were significantly lower (p < 0.05) than those of the B-WBRT plan. The Dmax of the lens was also lower by 10% with NC-WBRT.CONCLUSION: The use of NC-WBRT plans could be a simple and effective method to reduce irradiated volumes and improve the dose-volume parameters of the parotid gland.
Brain ; Institutional Practice ; Methods ; Parotid Gland ; Radiotherapy ; Xerostomia