Radiotherapy is the main way to treat the Nasopharyngeal Carcinoma. But there are a lot of serious complications, the most common one of then is radioactive xerostomia. It seriously affect the patients's quality of life, even make patients change or stop their radiotherapy. It is extremely important to prevent and treat xerostomia caused by radiotherapy.
Carcinoma ; Humans ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; complications ; radiotherapy ; Quality of Life ; Radiotherapy ; adverse effects ; Xerostomia ; etiology ; prevention & control

OBJECTIVE: To evaluate the long-term efficacy of submandibular gland transfer for prevention of xerostomia after radiotherapy for nasopharyngeal carcinoma. METHOD: Sixty-five cases of nasopharyngeal carcinoma patients were randomly divided into study group of 32 patients and control group of 33 patents. The submandibular gland was transferred to submental region on 32 cases with nasopharyngeal carcinoma before receiving conventional radiotherapy and a block was used to cover the submental region. Before radiotherapy, two groups of submandibular gland function was detected by imaging of the submandibular gland. At 60 months after radiotherapy, submandibular gland function was detected by 99mTc radionuclide scanning, the questionnaire about the degree of xerostomia was investigated respectively. Five-year survival rate was counted. RESULT: After following up for 60 months, submandibular gland uptake and secretion function in the study group was significantly higher than that in the control group, there was significant difference between the two groups (P < 0.01) respectively. The incidence of moderate or severe xerostomia in the study group was significantly lower than that in the control group (15.4% vs 76.9%, P < 0.01). Five-year survival rate of the study group and control group was 81.3% and 78.8% respectively, there was no significant difference between the two groups (P > 0.05). CONCLUSION The long-term efficacy of submandibular gland transfer for prevention of xerostomia after radiotherapy for nasopharyngeal carcinoma was well. It could improve the quality of life in nasopharyngeal carcinoma patients after radiotherapy, and did not affect the long-term efficacy of nasopharyngeal carcinoma.
Adult ; Carcinoma ; Female ; Humans ; Male ; Middle Aged ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; radiotherapy ; surgery ; Prospective Studies ; Radiotherapy ; adverse effects ; Submandibular Gland ; surgery ; Xerostomia ; etiology ; prevention & control

PURPOSE: This study was done to examine the effects of 4% hypertonic saline solution mouthwash and tooth brushing education on the oral health of elders living in long term care facilities. METHODS: In this quasi-experimental study, the participants were assigned to a 2% experimental group (n=20), a 4% experimental group (n=20), and a control group (n=20). Data were analyzed using ANOVA, repeated measures ANOVA, Fisher exact test, Chi-square test, Kruskal-Wallis test and multiple response analysis with the SAS program. RESULTS: Regular tooth brushing and use of 4% hypertonic saline solution mouthwash by elders provided better oral health by decreasing xerostomia, oral tongue plaque, halitosis, and the number of oral bacteria. CONCLUSION: The results indicate that regular tooth brushing with continuous 4% hypertonic saline solution mouth washing education promotes oral health for elders in long term care facilities, thus the dental care described in this study is recommended for elders in long term facilities.
Aged ; Aged, 80 and over ; Bacteria/drug effects/isolation & purification ; Dental Plaque/prevention & control ; Female ; Halitosis/prevention & control ; *Homes for the Aged ; Humans ; Male ; Mouthwashes/pharmacology/*therapeutic use ; *Oral Health ; Saline Solution, Hypertonic/pharmacology/*therapeutic use ; Toothbrushing ; Xerostomia/prevention & control

The saliva secreted from submandibular gland (SMG) accounts for 60%-65%. It plays an important role in maintaining the human function of swallow, digestion, testing, speech, protection of oral mucosa, and prevention from dental carries. The SMG is frequently resected during the treatment for various kinds of oral and maxillofacial diseases, resulting in xerostomia and decreased quality of life. During the past 15 years, Research Center of Salivary Gland Diseases in Peking University School and Hospital of Stomatology conducted a series of studies on new techniques for preservation of SMG and achieved remarkable results. The clinicopathologic and imaging characteristics of IgG4-related sialadenitis (IgG4-RS) were clarified based on systematic studies. The results of studies on the pathogenesis of IgG4-RS showed that unbalance of inflammatory factors mediated the abnormality of secretion of SMG. IL-4 participates in occurring and development of glandular fibrosis of SMG. Regulation of tumor necrosis factor α (TNF-α) and cleaning of senescent cells might be taken as the targets for treatment of IgG4-RS. The combination of glucocorticoid and steroid-sparing agents showed effective results for treating IgG4-RS, clinical remission was achieved in all the patients, serum IgG4 levels decreased, and salivary gland secretion significantly increased. Sialoendoscopy-assisted sialolithectomy was applied in the treatment of about 1 000 cases with submandibular hilar calculi with a success rate of more than 90%. Transfer of SMG was used for prevention from radiation-induced xerostomia in the patients with head and neck carcinoma. SMG was transferred to the submental region before radiotherapy and was kept away from the ra-diation field. The results of prospective clinical controlled study showed this technique could effectively preserve the function of SMG and prevent from xerostomia. Based on the micro-anatomical study on the blood vessels and ducts of SMG, partial sialoadenectomy was applied for treatment of benign tumors in the SMG. A clinical controlled study confirmed its safety for control of the tumors and its advantage of preservation of SMG function. The studies on the involvement of SMG in oral squamous cell carcinoma (OSCC) provided the anatomical and histopathological basis for preservation of SMG during neck dissection for early cases with OSCC. A innovated surgical modality "four preservations including SMG" was used during the neck dissection for the early cases with OSCC. A prospective randomized clinical controlled study confirmed its safety, feasibility, effectiveness for control of the carcinoma, and advantages of preservation of SMG function.
Humans ; Carcinoma, Squamous Cell/pathology* ; Glucocorticoids ; Immunoglobulin G ; Interleukin-4 ; Mouth Neoplasms/pathology* ; Prospective Studies ; Quality of Life ; Sialadenitis/surgery* ; Submandibular Gland/surgery* ; Tumor Necrosis Factor-alpha ; Xerostomia/prevention & control* ; Randomized Controlled Trials as Topic

Amifostine ; therapeutic use ; Animals ; Head and Neck Neoplasms ; radiotherapy ; Humans ; Oral Health ; Radiation Injuries ; etiology ; prevention & control ; therapy ; Radiation-Protective Agents ; therapeutic use ; Radiotherapy ; adverse effects ; Radiotherapy, Conformal ; Salivary Glands ; radiation effects ; Salivation ; radiation effects ; Submandibular Gland ; surgery ; transplantation ; Xerostomia ; etiology ; prevention & control ; therapy