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Hadi Seikaly - One of the best experts on this subject based on the ideXlab platform.
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Modification of the submandibular gland transfer procedure.
The Laryngoscope, 2016Co-Authors: Hani Z. Marzouki, Naresh Jha, Jeffrey R Harris, Youness Elkhalidy, Rufus Scrimger, B.j. Debenham, Daniel A. O’connell, Hadi SeikalyAbstract:Objectives/Hypothesis The treatment for most advanced head and neck cancers (stage III and IV) usually includes radiation, and the most common side effect of this treatment modality is a permanent decrease in salivary production. Xerostomia is a devastating complication that significantly affects patients' quality of life by interfering with functions of taste, mastication, deglutition, and speech production. Treatment of xerostomia is varied, but one of the strategies developed by our group was to preserve one submandibular gland by surgically transferring it to the Submental Space and shielding it from the full dose of radiation. This procedure is proven to reduce the rate of radiation-induced xerostomia, but its main disadvantage is that it is contraindicated in oral cavity cancer. This study describes and evaluates a modification of the submandibular gland transfer (SGT) procedure, where the submandibular gland contralateral to the disease process is relocated to the parotid region. This modification has the potential of expanding the benefits of submandibular gland transfer procedures to patients with oral cavity cancers. Study Design Prospective feasibility study. Methods This study involved nine patients with a new diagnosis of advanced head and neck cancer undergoing major head and neck cancer resection with postoperative adjuvant radiation therapy. The new modified salivary gland transfer procedure was performed on all nine patients, and the glands total dose received with radiation therapy was assessed. Results All the modified SGT procedures were successful with no post-operative complications. The radiation oncology team has been able to successfully localize the transferred submandibular glands and shield them from the radiation beam postoperatively. Conclusions We have successfully demonstrated that surgical transfer of a submandibular salivary gland to the parotid region is feasible, surgically viable, oncologically sound, and does not interfere with radiation therapy. Level of Evidence 4 Laryngoscope, 2016
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long term outcomes of submandibular gland transfer for prevention of postradiation xerostomia
Archives of Otolaryngology-head & Neck Surgery, 2004Co-Authors: Hadi Seikaly, Timothy Mcgaw, Pam Barnaby, Jeffrey R Harris, David J Williams, Jana Rieger, John F Wolfaardt, John HansonAbstract:Background Xerostomia is a permanent and devastating sequela of head and neck irradiation, and its numerous consequences affect most aspects of the patient's life. A new method of preserving and protecting a single submandibular gland from radiation damage through the Seikaly-Jha procedure (SJP) has recently been described. Objective To report the long-term outcomes of the SJP. Design Inception cohort. Patients The trial was conducted between February 1, 1999, and February 1, 2002. All patients were followed up through the head and neck cancer clinic at the Cross Cancer Institute. All data were collected by a dedicated research nurse. Salivary function was evaluated at regular intervals with salivary flow studies and questionnaires. Results Ninety-six patients were enrolled in the study, and 38 had a minimum of 2 years' follow-up. The cohort of 38 patients was composed of 2 groups: 26 patients had preservation of one submandibular gland through the SJP, while the remaining 12 did not. Salivary flow was preserved in the SJP group, in which 83% of patients reported normal amounts of saliva 2 years after radiotherapy, compared with none in the SJP group. There were no disease recurrences on the side of the transferred gland or in the Submental Space. There were no surgical complications attributed to the transfer procedure. Conclusions The SJP prevented xerostomia in 83% of the study patients. The approach appears to be oncologically sound and safe.
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prevention of radiation induced xerostomia by surgical transfer of submandibular salivary gland into the Submental Space
Radiotherapy and Oncology, 2003Co-Authors: Hadi Seikaly, Timothy Mcgaw, Henry Hofmann, Don Robinson, John Hanson, David Williams, J W Harris, Pam BarnabyAbstract:BACKGROUND AND PURPOSE: Xerostomia is a significant morbidity of radiation treatment in the management of head and neck cancers. We hypothesized that the surgical transfer of one submandibular salivary gland to the Submental Space, where it can be shielded from radiation treatment (XRT), would prevent xerostomia. MATERIALS AND METHODS: We conducted a prospective Phase II clinical trial and the patients were followed clinically with salivary flow studies and the University of Washington Quality of Life questionnaire. RESULTS: We report the results on 76 evaluable patients. The salivary gland transfer was done in 60 patients. Nine patients (of 60) did not have postoperative XRT and in eight patients (of 60) the transferred gland was not shielded from XRT due to proximity of disease. The median follow up is 14 months. Of the 43 patients with the salivary gland transfer and post-operative XRT with protection of the transferred gland, 81% have none or minimal xerostomia, and 19% developed moderate to severe xerostomia. Three patients (6.9%) developed local recurrence, five patients (11.6%) developed distant metastases and five patients (11.6%) have died. There were no complications attributed to the surgical procedure. CONCLUSION: Surgical transfer of a submandibular salivary gland to the Submental Space preserves its function and prevents the development of radiation induced xerostomia.
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submandibular gland transfer a new method of preventing radiation induced xerostomia
Laryngoscope, 2001Co-Authors: Hadi Seikaly, Timothy Mcgaw, Linda Coulter, Derald OldringAbstract:Objective Radiation-induced xerostomia is a significant morbidity of radiation therapy in the management of patients with head and neck cancers. We have recently reported a method of transfer of one submandibular gland to the Submental Space in a small pilot series of eligible surgical patients. The Submental Space was shielded during postoperative radiation therapy. The transferred gland continued to function after the completion of radiation therapy and none of the patients developed xerostomia. The purpose of this article is to present the technique of submandibular gland transfer in detail and to evaluate the postoperative survival and function of the transferred submandibular glands. Design Prospective clinical trial. Methods The submandibular gland was transferred on eligible patients as part of their surgical intervention. The patients were followed clinically, with salivary flow and radioisotope studies. Results We performed the surgical transfer of the submandibular salivary gland in 24 of 25 patients placed on the protocol. All the glands survived transfer and functioned well postoperatively as demonstrated on the salivary flow and the radioisotope studies. The surgical transfer was relatively simple and added 45 minutes to the surgical procedure. There were no complications attributed to the submandibular gland transfer. Conclusions We have successfully demonstrated that the submandibular gland can be surgically transferred to the Submental Space with its function preserved. The gland seems to continue functioning even after radiation therapy with the appropriate shielding. This surgical transfer procedure has the potential to change the way we currently manage patients with head and neck cancer.
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submandibular salivary gland transfer prevents radiation induced xerostomia
International Journal of Radiation Oncology Biology Physics, 2000Co-Authors: Hadi Seikaly, Timothy Mcgaw, Linda CoulterAbstract:Background: Xerostomia is a significant morbidity of radiation therapy in the management of head and neck cancers. We hypothesized that the surgical transfer of one submandibular salivary gland to Submental Space, outside the proposed radiation field, prior to starting radiation treatment, would prevent xerostomia. Methods: We are conducting a prospective clinical trial where the submandibular gland is transferred as part of the surgical intervention. The patients are followed clinically, with salivary flow studies and University of Washington quality of life questionnaire. Results: We report early results of 16 patients who have undergone this procedure. Seven patients have finished and 2 patients are currently undergoing radiation treatment. In 2 patients, no postoperative radiation treatment was indicated. Two patients are waiting to start radiation treatment and 2 patients refused treatment after surgery. The surgical transfer was abandoned in 1 patient. All of the transferred salivary glands were positioned outside the proposed radiation fields and were functional. The patients did not complain of any xerostomia and developed only minimal oral mucositis. There were no surgical complications. Conclusions: Surgical transfer of a submandibular salivary gland to the Submental Space (outside the radiation field) preserves its function and prevents the development of radiation-induced xerostomia. © 2000 Elsevier Science Inc. Xerostomia, Radiation treatment, Prevention.
Timothy Mcgaw - One of the best experts on this subject based on the ideXlab platform.
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long term outcomes of submandibular gland transfer for prevention of postradiation xerostomia
Archives of Otolaryngology-head & Neck Surgery, 2004Co-Authors: Hadi Seikaly, Timothy Mcgaw, Pam Barnaby, Jeffrey R Harris, David J Williams, Jana Rieger, John F Wolfaardt, John HansonAbstract:Background Xerostomia is a permanent and devastating sequela of head and neck irradiation, and its numerous consequences affect most aspects of the patient's life. A new method of preserving and protecting a single submandibular gland from radiation damage through the Seikaly-Jha procedure (SJP) has recently been described. Objective To report the long-term outcomes of the SJP. Design Inception cohort. Patients The trial was conducted between February 1, 1999, and February 1, 2002. All patients were followed up through the head and neck cancer clinic at the Cross Cancer Institute. All data were collected by a dedicated research nurse. Salivary function was evaluated at regular intervals with salivary flow studies and questionnaires. Results Ninety-six patients were enrolled in the study, and 38 had a minimum of 2 years' follow-up. The cohort of 38 patients was composed of 2 groups: 26 patients had preservation of one submandibular gland through the SJP, while the remaining 12 did not. Salivary flow was preserved in the SJP group, in which 83% of patients reported normal amounts of saliva 2 years after radiotherapy, compared with none in the SJP group. There were no disease recurrences on the side of the transferred gland or in the Submental Space. There were no surgical complications attributed to the transfer procedure. Conclusions The SJP prevented xerostomia in 83% of the study patients. The approach appears to be oncologically sound and safe.
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prevention of radiation induced xerostomia by surgical transfer of submandibular salivary gland into the Submental Space
Radiotherapy and Oncology, 2003Co-Authors: Hadi Seikaly, Timothy Mcgaw, Henry Hofmann, Don Robinson, John Hanson, David Williams, J W Harris, Pam BarnabyAbstract:BACKGROUND AND PURPOSE: Xerostomia is a significant morbidity of radiation treatment in the management of head and neck cancers. We hypothesized that the surgical transfer of one submandibular salivary gland to the Submental Space, where it can be shielded from radiation treatment (XRT), would prevent xerostomia. MATERIALS AND METHODS: We conducted a prospective Phase II clinical trial and the patients were followed clinically with salivary flow studies and the University of Washington Quality of Life questionnaire. RESULTS: We report the results on 76 evaluable patients. The salivary gland transfer was done in 60 patients. Nine patients (of 60) did not have postoperative XRT and in eight patients (of 60) the transferred gland was not shielded from XRT due to proximity of disease. The median follow up is 14 months. Of the 43 patients with the salivary gland transfer and post-operative XRT with protection of the transferred gland, 81% have none or minimal xerostomia, and 19% developed moderate to severe xerostomia. Three patients (6.9%) developed local recurrence, five patients (11.6%) developed distant metastases and five patients (11.6%) have died. There were no complications attributed to the surgical procedure. CONCLUSION: Surgical transfer of a submandibular salivary gland to the Submental Space preserves its function and prevents the development of radiation induced xerostomia.
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submandibular gland transfer a new method of preventing radiation induced xerostomia
Laryngoscope, 2001Co-Authors: Hadi Seikaly, Timothy Mcgaw, Linda Coulter, Derald OldringAbstract:Objective Radiation-induced xerostomia is a significant morbidity of radiation therapy in the management of patients with head and neck cancers. We have recently reported a method of transfer of one submandibular gland to the Submental Space in a small pilot series of eligible surgical patients. The Submental Space was shielded during postoperative radiation therapy. The transferred gland continued to function after the completion of radiation therapy and none of the patients developed xerostomia. The purpose of this article is to present the technique of submandibular gland transfer in detail and to evaluate the postoperative survival and function of the transferred submandibular glands. Design Prospective clinical trial. Methods The submandibular gland was transferred on eligible patients as part of their surgical intervention. The patients were followed clinically, with salivary flow and radioisotope studies. Results We performed the surgical transfer of the submandibular salivary gland in 24 of 25 patients placed on the protocol. All the glands survived transfer and functioned well postoperatively as demonstrated on the salivary flow and the radioisotope studies. The surgical transfer was relatively simple and added 45 minutes to the surgical procedure. There were no complications attributed to the submandibular gland transfer. Conclusions We have successfully demonstrated that the submandibular gland can be surgically transferred to the Submental Space with its function preserved. The gland seems to continue functioning even after radiation therapy with the appropriate shielding. This surgical transfer procedure has the potential to change the way we currently manage patients with head and neck cancer.
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submandibular salivary gland transfer prevents radiation induced xerostomia
International Journal of Radiation Oncology Biology Physics, 2000Co-Authors: Hadi Seikaly, Timothy Mcgaw, Linda CoulterAbstract:Background: Xerostomia is a significant morbidity of radiation therapy in the management of head and neck cancers. We hypothesized that the surgical transfer of one submandibular salivary gland to Submental Space, outside the proposed radiation field, prior to starting radiation treatment, would prevent xerostomia. Methods: We are conducting a prospective clinical trial where the submandibular gland is transferred as part of the surgical intervention. The patients are followed clinically, with salivary flow studies and University of Washington quality of life questionnaire. Results: We report early results of 16 patients who have undergone this procedure. Seven patients have finished and 2 patients are currently undergoing radiation treatment. In 2 patients, no postoperative radiation treatment was indicated. Two patients are waiting to start radiation treatment and 2 patients refused treatment after surgery. The surgical transfer was abandoned in 1 patient. All of the transferred salivary glands were positioned outside the proposed radiation fields and were functional. The patients did not complain of any xerostomia and developed only minimal oral mucositis. There were no surgical complications. Conclusions: Surgical transfer of a submandibular salivary gland to the Submental Space (outside the radiation field) preserves its function and prevents the development of radiation-induced xerostomia. © 2000 Elsevier Science Inc. Xerostomia, Radiation treatment, Prevention.
Pam Barnaby - One of the best experts on this subject based on the ideXlab platform.
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long term outcomes of submandibular gland transfer for prevention of postradiation xerostomia
Archives of Otolaryngology-head & Neck Surgery, 2004Co-Authors: Hadi Seikaly, Timothy Mcgaw, Pam Barnaby, Jeffrey R Harris, David J Williams, Jana Rieger, John F Wolfaardt, John HansonAbstract:Background Xerostomia is a permanent and devastating sequela of head and neck irradiation, and its numerous consequences affect most aspects of the patient's life. A new method of preserving and protecting a single submandibular gland from radiation damage through the Seikaly-Jha procedure (SJP) has recently been described. Objective To report the long-term outcomes of the SJP. Design Inception cohort. Patients The trial was conducted between February 1, 1999, and February 1, 2002. All patients were followed up through the head and neck cancer clinic at the Cross Cancer Institute. All data were collected by a dedicated research nurse. Salivary function was evaluated at regular intervals with salivary flow studies and questionnaires. Results Ninety-six patients were enrolled in the study, and 38 had a minimum of 2 years' follow-up. The cohort of 38 patients was composed of 2 groups: 26 patients had preservation of one submandibular gland through the SJP, while the remaining 12 did not. Salivary flow was preserved in the SJP group, in which 83% of patients reported normal amounts of saliva 2 years after radiotherapy, compared with none in the SJP group. There were no disease recurrences on the side of the transferred gland or in the Submental Space. There were no surgical complications attributed to the transfer procedure. Conclusions The SJP prevented xerostomia in 83% of the study patients. The approach appears to be oncologically sound and safe.
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prevention of radiation induced xerostomia by surgical transfer of submandibular salivary gland into the Submental Space
Radiotherapy and Oncology, 2003Co-Authors: Hadi Seikaly, Timothy Mcgaw, Henry Hofmann, Don Robinson, John Hanson, David Williams, J W Harris, Pam BarnabyAbstract:BACKGROUND AND PURPOSE: Xerostomia is a significant morbidity of radiation treatment in the management of head and neck cancers. We hypothesized that the surgical transfer of one submandibular salivary gland to the Submental Space, where it can be shielded from radiation treatment (XRT), would prevent xerostomia. MATERIALS AND METHODS: We conducted a prospective Phase II clinical trial and the patients were followed clinically with salivary flow studies and the University of Washington Quality of Life questionnaire. RESULTS: We report the results on 76 evaluable patients. The salivary gland transfer was done in 60 patients. Nine patients (of 60) did not have postoperative XRT and in eight patients (of 60) the transferred gland was not shielded from XRT due to proximity of disease. The median follow up is 14 months. Of the 43 patients with the salivary gland transfer and post-operative XRT with protection of the transferred gland, 81% have none or minimal xerostomia, and 19% developed moderate to severe xerostomia. Three patients (6.9%) developed local recurrence, five patients (11.6%) developed distant metastases and five patients (11.6%) have died. There were no complications attributed to the surgical procedure. CONCLUSION: Surgical transfer of a submandibular salivary gland to the Submental Space preserves its function and prevents the development of radiation induced xerostomia.
Linda Coulter - One of the best experts on this subject based on the ideXlab platform.
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submandibular gland transfer a new method of preventing radiation induced xerostomia
Laryngoscope, 2001Co-Authors: Hadi Seikaly, Timothy Mcgaw, Linda Coulter, Derald OldringAbstract:Objective Radiation-induced xerostomia is a significant morbidity of radiation therapy in the management of patients with head and neck cancers. We have recently reported a method of transfer of one submandibular gland to the Submental Space in a small pilot series of eligible surgical patients. The Submental Space was shielded during postoperative radiation therapy. The transferred gland continued to function after the completion of radiation therapy and none of the patients developed xerostomia. The purpose of this article is to present the technique of submandibular gland transfer in detail and to evaluate the postoperative survival and function of the transferred submandibular glands. Design Prospective clinical trial. Methods The submandibular gland was transferred on eligible patients as part of their surgical intervention. The patients were followed clinically, with salivary flow and radioisotope studies. Results We performed the surgical transfer of the submandibular salivary gland in 24 of 25 patients placed on the protocol. All the glands survived transfer and functioned well postoperatively as demonstrated on the salivary flow and the radioisotope studies. The surgical transfer was relatively simple and added 45 minutes to the surgical procedure. There were no complications attributed to the submandibular gland transfer. Conclusions We have successfully demonstrated that the submandibular gland can be surgically transferred to the Submental Space with its function preserved. The gland seems to continue functioning even after radiation therapy with the appropriate shielding. This surgical transfer procedure has the potential to change the way we currently manage patients with head and neck cancer.
-
submandibular salivary gland transfer prevents radiation induced xerostomia
International Journal of Radiation Oncology Biology Physics, 2000Co-Authors: Hadi Seikaly, Timothy Mcgaw, Linda CoulterAbstract:Background: Xerostomia is a significant morbidity of radiation therapy in the management of head and neck cancers. We hypothesized that the surgical transfer of one submandibular salivary gland to Submental Space, outside the proposed radiation field, prior to starting radiation treatment, would prevent xerostomia. Methods: We are conducting a prospective clinical trial where the submandibular gland is transferred as part of the surgical intervention. The patients are followed clinically, with salivary flow studies and University of Washington quality of life questionnaire. Results: We report early results of 16 patients who have undergone this procedure. Seven patients have finished and 2 patients are currently undergoing radiation treatment. In 2 patients, no postoperative radiation treatment was indicated. Two patients are waiting to start radiation treatment and 2 patients refused treatment after surgery. The surgical transfer was abandoned in 1 patient. All of the transferred salivary glands were positioned outside the proposed radiation fields and were functional. The patients did not complain of any xerostomia and developed only minimal oral mucositis. There were no surgical complications. Conclusions: Surgical transfer of a submandibular salivary gland to the Submental Space (outside the radiation field) preserves its function and prevents the development of radiation-induced xerostomia. © 2000 Elsevier Science Inc. Xerostomia, Radiation treatment, Prevention.
John Hanson - One of the best experts on this subject based on the ideXlab platform.
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long term outcomes of submandibular gland transfer for prevention of postradiation xerostomia
Archives of Otolaryngology-head & Neck Surgery, 2004Co-Authors: Hadi Seikaly, Timothy Mcgaw, Pam Barnaby, Jeffrey R Harris, David J Williams, Jana Rieger, John F Wolfaardt, John HansonAbstract:Background Xerostomia is a permanent and devastating sequela of head and neck irradiation, and its numerous consequences affect most aspects of the patient's life. A new method of preserving and protecting a single submandibular gland from radiation damage through the Seikaly-Jha procedure (SJP) has recently been described. Objective To report the long-term outcomes of the SJP. Design Inception cohort. Patients The trial was conducted between February 1, 1999, and February 1, 2002. All patients were followed up through the head and neck cancer clinic at the Cross Cancer Institute. All data were collected by a dedicated research nurse. Salivary function was evaluated at regular intervals with salivary flow studies and questionnaires. Results Ninety-six patients were enrolled in the study, and 38 had a minimum of 2 years' follow-up. The cohort of 38 patients was composed of 2 groups: 26 patients had preservation of one submandibular gland through the SJP, while the remaining 12 did not. Salivary flow was preserved in the SJP group, in which 83% of patients reported normal amounts of saliva 2 years after radiotherapy, compared with none in the SJP group. There were no disease recurrences on the side of the transferred gland or in the Submental Space. There were no surgical complications attributed to the transfer procedure. Conclusions The SJP prevented xerostomia in 83% of the study patients. The approach appears to be oncologically sound and safe.
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prevention of radiation induced xerostomia by surgical transfer of submandibular salivary gland into the Submental Space
Radiotherapy and Oncology, 2003Co-Authors: Hadi Seikaly, Timothy Mcgaw, Henry Hofmann, Don Robinson, John Hanson, David Williams, J W Harris, Pam BarnabyAbstract:BACKGROUND AND PURPOSE: Xerostomia is a significant morbidity of radiation treatment in the management of head and neck cancers. We hypothesized that the surgical transfer of one submandibular salivary gland to the Submental Space, where it can be shielded from radiation treatment (XRT), would prevent xerostomia. MATERIALS AND METHODS: We conducted a prospective Phase II clinical trial and the patients were followed clinically with salivary flow studies and the University of Washington Quality of Life questionnaire. RESULTS: We report the results on 76 evaluable patients. The salivary gland transfer was done in 60 patients. Nine patients (of 60) did not have postoperative XRT and in eight patients (of 60) the transferred gland was not shielded from XRT due to proximity of disease. The median follow up is 14 months. Of the 43 patients with the salivary gland transfer and post-operative XRT with protection of the transferred gland, 81% have none or minimal xerostomia, and 19% developed moderate to severe xerostomia. Three patients (6.9%) developed local recurrence, five patients (11.6%) developed distant metastases and five patients (11.6%) have died. There were no complications attributed to the surgical procedure. CONCLUSION: Surgical transfer of a submandibular salivary gland to the Submental Space preserves its function and prevents the development of radiation induced xerostomia.
