Document Detail

Microanatomic study of the vascular and duct system of the submandibular gland.
MedLine Citation:
PMID:  20619950     Owner:  NLM     Status:  In-Data-Review    
PURPOSE: Autologous microvascular submandibular gland (SMG) transfer is an effective treatment for severe keratoconjunctivitis sicca (KCS). However, epiphora (excessive tear secretion) may occur after the successful transfer of whole submandibular gland because tear secretion level is closely related to the size of the transferred gland. The aim of this study was to investigate the microanatomy of SMG to explore the possibility of partial SMG transfer to prevent postoperative epiphora.
MATERIALS AND METHODS: Sixty intact and histologically normal human SMGs from patients with benign tumor of the mandible who underwent vascularized mandibular reconstruction and removal of the SMG for anastomosis of the blood vessels were included in the study. SMGs were perfused with methacrylate to form resin casts of blood vessels and ducts. The length and diameter of the blood vessels and ducts in the casts were measured using a sliding caliper. The numbers of lobules, distribution of arteries, veins, and ducts, as well as the relationship among them, were analyzed.
RESULTS: The resin cast of the gland showed a treelike structure, with the vessels gradually dividing into multiple branches. The arteries, veins, and ducts run in parallel and were roughly divided into 3 levels: from the stem extending into the main branches (level I), into the narrower secondary branches (level II), and then the secondary branches subsequently divided into terminal branches (level III). The structures of the blood vessels and ducts were similar at each level in the lobules. In the vein casts, communicating vessels were found between the anterior facial vein and the concomitant vein of the facial artery.
CONCLUSION: The characteristic treelike structure of the SMG vascular and ductal system may provide useful information for partial gland transfers.
Heng Xu; Chi Mao; Jing-Ming Liu; Xin Peng; Zheng-Hong Zhu; Guang-Yan Yu
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons     Volume:  69     ISSN:  1531-5053     ISO Abbreviation:  J. Oral Maxillofac. Surg.     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8206428     Medline TA:  J Oral Maxillofac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1103-7     Citation Subset:  AIM; D; IM    
Copyright Information:
Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
Attending Doctor, Department of Stomatology, Affiliated Beijing, Tong Ren Hospital, Capital University of Medical Science, Beijing, China.
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