Ultrastructural Characteristics of the Testicular Interstitial Endocrinocytes of Adult Rats Subjected to Total Sialoadenectomy.

The major salivary glands of rats release into the saliva and blood a wide spectrum of bioactive substances, essential for many organs, including the testes. Sialoadenectomy leads to the development of degenerative changes in the cells of the twisted testicular tubules. However, the effects of bioactive factors released by the major salivary glands on the morphology and function of Leydig cells remain little studied. Sialoadenectomy in adult rats led (in 1-4 weeks) to a decrease in the nuclear and cytoplasmatic areas of Leydig cells, violation of the plasmalemma integrity, dilatation of perinuclear space and agranular endoplasmatic reticulum vesicles, and to destruction of the mitochondria. Ultrastructural changes caused by sialoadenectomy completely resolved by week 6 of the experiment at the expense of compensatory activation of the synthesis of the major salivary gland factors by other sources in the organism of rats.

Long-term influence of sialoadenectomy on the liver of male albino rat.

Epidermal growth factor is an endocrine product of the submandibular gland; the liver is an important target of its action and is affected by sialoadenectomy. Thirty rats were used in this study and divided into group I (sham-operated animals), group II (sialoadenectomy after 4 weeks), and group III (sialoadenectomy after 10 weeks). Liver samples were processed for light and electron microscope examination. Sialoadenectomy induced mild-to-moderate liver damage which persists up to 10 weeks after the operation. This damage is manifested morphologically rather than functionally, affecting the general structure, hepatocytes, hepatic stellate cells, and hepatic sinusoids.

Huge sialolith of the submandibular gland: a case report and review of literature.

The formation of stone in the ductal system of the salivary gland is termed sialolithiasis, with the submandibular gland being the most commonly affected. The precise aetiology is unknown but certain factors peculiar to the submandibular gland accounts for its likelihood of developing a calculous disease. Stones are classified based on their dimension, and may be silent or present with symptoms attributable to the size, location and complications. Here, a 50-year-old female who presented with a painless swelling in the left submandibular region that had grown slowly over the previous year, is reported. Following clinical and radiologic evaluation, left submandibular stone disease was preoperatively diagnosed. The patient underwent sialoadenectomy with transient palsy of the marginal mandibular branch of the facial nerve. Histopathology confirmed sialolith (2.7 cm) with severe squamous metaplasia of the duct. This presentation demonstrates some peculiar features attributable to the size, vertical orientation and location of the stone, in addition to the compression of the gland, thick fibrous capsule and significant squamous metaplasia of the duct. These findings require further evaluation for optimal treatment in view of the emerging trends for managing sialolithiasis.

Feline sialocoele: clinical presentation, treatment and outcome in 19 cases.

OBJECTIVES: The aim of this retrospective observational study was to describe the clinical presentation, treatment and outcome of cats with sialocoele. METHODS: Clinical records from seven referral hospitals were retrospectively searched to identify cats with sialocoele between 2007 and 2021. RESULTS: Nineteen cats were identified. The most common clinical signs were ptyalism, dysphagia and anorexia. Localisation of the sialocoele was cervical (n = 6), sublingual (n = 6), cervical/sublingual (n = 3), facial (n = 2), cervical/pharyngeal (n = 1) and zygomatic (n = 1). The affected salivary glands were mandibular-sublingual (n = 15), mandibular-sublingual/parotid (n = 1), zygomatic/parotid (n = 1) and parotid (n = 2). The aetiology of the sialocoele was traumatic in two cases, neoplastic in one cat and unknown in 16 cats. Sialoadenectomy was performed in 11 cats. Other treatments included ranula marsupialisation (n = 3), needle drainage (n = 2), single stab incision (n = 2) and parotid duct ligation (n = 1). The median follow-up time was 399 days (range 15-1460). Postoperative seroma was the only complication observed in one cat. No recurrence was reported. CONCLUSIONS AND RELEVANCE: Feline salivary sialocoele are relatively rare and have a good prognosis. They can be managed successfully with sialoadenectomy; however, a more conservative approach can be used with appropriate case selection.

Drain-Less Submandibular Gland Excision With Preserved Facial Artery.

OBJECTIVES: To describe our experience in excision of the submandibular gland (SMG) without drain insertion and with preservation of the facial artery as a day case surgery as well as evaluation of the surgical outcomes of this procedure. METHODS: Prospective case series study of 42 cases of chronic calcular submandibular sialadenitis that underwent SMG excision by the same surgical team during the period from 2017 to 2021. The initial surgical plan in all cases was to excise the SMG with preservation of the facial artery and without drain insertion. RESULTS: SMG excision without drain insertion was successfully achieved in 28 patients who were discharged on the same day. In the remaining 14 patients, the surgical dissection was difficult and a suction drain was inserted at the end of the surgery; consequently, they were discharged on the next day. In all cases, facial vessels were preserved, and complete gland excision was achieved. Among the 28 patients who had no drain insertion, 1 patient had a postoperative seroma and no patient had wound related complications. Among the 14 patients who had drain insertion, 2 patients had postoperative seroma and 3 patients had wound related complications in the form of obvious scar formation. There were no other significant complications in all patients. CONCLUSIONS: Submandibular gland (SMG) excision with facial artery preservation and without drain insertion as a day case surgery could be safely done in cases of chronic calcular inflammation provided that meticulous surgical dissection and complete hemostasis were achieved.

Total Endoscopic Submandibular Sialoadenectomy Using a 3-Port Supraclavicular Approach: A New Technique.

OBJECTIVES: The objective of this pilot study was to report the feasibility and safety of a new 3-port supraclavicular approach in endoscopic submandibular sialoadenectomy. METHODS: We reported the safety, surgical feasibility, and aesthetic features of the total endoscopic submandibular sialoadenectomy (submandibular gland excision) using a 3-port supraclavicular approach in our institute from December 2018 to January 2020. RESULTS: Endoscopic submandibular sialoadenectomy using a 3-port supraclavicular approach was performed in 2 patients with intraglandular sialolithiasis. No major adverse events occurred in this study. The patient's satisfaction score was high (more than 8; range: 0-10). CONCLUSIONS: The 3-port supraclavicular approach submandibular sialoadenectomy is a feasible method that permits a relatively good surgical scarring and minimal adverse effects.

Submandibular gland degloving: A minimally invasive function-preserving surgical approach for benign diseases.

In the Video S1, a modified technique for submandibular gland resection in benign disease is shown. The main plane of dissection is below the fascia and immediately superficial to the fibrous capsule of the gland. The video shows the surgical steps and the structures that become evident along the procedure and illustrates some tips and tricks. Facial vessels are dissected, easily spared, and not ligated as it occurs in the classical technique. This technical variant is minimally invasive, respectful of anatomy, and through preservation of the fascial layer investing the gland aims at reducing the risk of injury to the marginalis mandibulae branch of the facial nerve, which lies within the fascia itself.

An Atypical Presentation of a Zygomatic Sialocele in a dog.

A sialocele is an accumulation of salivary fluid due to leakage into the interstitial space surrounding the affected salivary gland and/or its corresponding duct. Reported causes of salivary leakage include trauma, foreign bodies, sialoliths, and neoplasia, but in many cases the etiology is not identified. Clinical signs of sialoceles associated with the zygomatic salivary gland or corresponding duct usually include exophthalmos due to periorbital salivary accumulation, whereas sialoceles associated with the mandibular or sublingual glands or ducts usually manifest as cervical, pharyngeal and/or sublingual salivary accumulation. This case report describes an atypical cervical presentation of a zygomatic sialocele in a dog that resolved after zygomatic sialoadenectomy.

Epidermal growth factor attenuates lingual papillae lesions in a rat model of sialoadenectomy.

Salivary epidermal growth factor (EGF) plays an important role in the maintenance of the oral and gastro-esophageal mucosa. Sialoadenectomy delays healing of oral wounds and affects lingual papillae. In this work, we aimed to determine the effect of EGF deficiency induced by sialoadenectomy and evaluate the effect of exogenous EGF administration on the lingual papillae and taste buds in rats. Thirty male adult Wistar albino rats were equally divided into 3 groups; sham-operated control group, sialoadenectomy group and group of sialoadenectomy + EGF. EGF was given 8 weeks after sialoadenectomy in a dose of 1 µg /ml/day in drinking water for 2 weeks. The anterior two-thirds of the tongue was dissected and cut longitudinally into two halves; one half for light microscope and the other for electron microscope examinations. Saliva and blood were collected to determine salivary and plasma EGF. Our results revealed that sialoadenectomy significantly reduced plasma and saliva levels of EGF which resulted in severe disruption of the architecture of lingual papillae. These changes were effectively improved by the exogenous EGF administration. In conclusion, EGF supplementation reversed the effects of sialoadenectomy and restored almost normal architecture of lingual papillae and taste buds.

Primary squamous cell carcinoma of major salivary gland: "Sapienza Head and Neck Unit" clinical recommendations.

Primary squamous cell carcinoma of salivary gland (SCG) is an extremely rare type of malignant salivary gland tumor, which in turn results in scarcity of data available regarding both its treatment and associated genetic alterations. A retrospective analysis of 12 patients with primary SCG was conducted, along with analysis of the association between treatment, clinical/pathological characteristics, and outcomes. Most patients (8) were staged IVa, with the majority of them (10) having G3 fast growing cancer. Local and systemic recurrence were reported in only three out of nine parotid cases (0 out of 2 submandibular SCGs). In two out of eight patients local relapse occurred after integrated treatment, while recurrence occurred in two out of three patients undergoing exclusive surgery. Five patients eventually died. Treatment of resectable disease must be aggressive and multimodal, with achievement of loco-regional control in order to reduce rate of recurrence and improve outcomes. Metastatic disease would require a therapeutic strategy tailored to the molecular profile in order to improve the currently disappointing results.

Lipomatosis of the parotid salivary gland: 2 case reports and review of the literature on fat-containing salivary gland lesions.

Two cases of lipomatosis of the parotid salivary gland in two dogs are reported. Both dogs were presented with a slow growing unilateral non-painful mass in the parotid region. The mass measured 12 and 15 cm on the longest axis for case 1 and 2 respectively. Initial incisional biopsies were suggestive of infiltrative lipoma or salivary gland adenocarcinoma. Case 2 underwent head radiographs that showed a soft tissue opacity on the area of the right parotid gland followed by a computed tomography that showed a multi-lobulated infiltrative mass occupying the right parotid gland. Both cases underwent total parotidectomy with an excisional biopsy intent. Surgery on case 1 included total ear canal ablation (TECA). Histology revealed lipomatosis of the parotid gland with a similar admixture of adipocytes and well-differentiated salivary acini on both cases. No recurrence was reported by 4 years for case 1 and by 3 years for case 2. Case 1 developed long-term right-sided facial paralysis and palpebral reflex deficit due to damage of the facial and trigeminal nerve during surgery. The cases are described and the veterinary literature is reviewed in view of the most updated information available in human medicine on fat-containing salivary gland lesions. Considering this literature review, authors recommended these two cases to be classified as lipomatosis of the salivary gland. In conclusion, fat-containing salivary gland lesions should be considered in the list of differential diagnoses in dogs with an enlarged salivary gland and seem to be associated with an excellent prognosis after surgical excision.

Partial sialoadenectomy for the treatment of benign tumours in the submandibular gland.

The conventional treatment for benign tumours arising in the submandibular gland (SMG) has always involved whole gland excision with the tumour. In light of developments in parotid gland functional surgery, this prospective study was performed to evaluate the effectiveness and safety of partial sialoadenectomy (PS) for benign tumours in comparison with conventional total sialoadenectomy (TS). Thirty-one consecutive patients with a preoperative diagnosis of benign tumour in the SMG were included in the study from December 2008 to December 2010. Eleven patients were treated with PS and 20 patients underwent conventional TS. Salivary gland function and surgery-related complications were assessed. No difference in resting saliva flow was found between the two groups before the operation, while this was significantly higher in the PS group than in the TS group at 1 year after surgery (P=0.009). With regard to complications, there was less deformity in facial appearance in the PS group. There was no recurrence in any of the 31 patients during the follow-up period (range 41-82 months). It is believed that this modification to SMG surgery is consistent with the idea of functional and minimal invasive salivary gland surgery. This technique represents a good choice for the management of benign tumours of the SMG for appropriately selected cases.

A large sialolith on the parenchyma of the submandibular gland: A case report.

A 45-year-old female was referred to the Department of Oral and Maxillofacial Surgery with the complaint of pain in the right submandibular region and a dry mouth, which had started one week previously. A clinical examination revealed a swelling and tenderness in the right submandibular region. Panoramic radiography and computed tomography identified a sialolith in the submandibular gland. Surgery on the sialolith was subsequently completed under general anesthesia extraorally. A brownish stone was present in the parenchyma of the submandibular gland, measuring 14×10 mm.

Localization of hsp27 in the rat submandibular gland following the application of various surgical treatments.

Salivary glands repair and regenerate following various types of injuries and surgical procedures. However, the tissue responses induced in the contralateral glands have yet to be elucidated in detail. Hsp27, a member of the heat-shock protein (Hsp) family, is strongly expressed in physiological environments, particularly during development. Hsp27 was previously shown to play a role in the regulation of acinar cell proliferation and differentiation in the rat submandibular gland. The present study performed the following surgical treatments on the right submandibular glands of adult rats: 1) duct ligation followed by unligation after one week; 2) partial sialoadenectomy; and 3) total sialoadenectomy. Immunohistochemistry for Hsp27 and Ki67 was performed in the experimental and normal contralateral glands, and localization was histologically and morphometrically analyzed. The results obtained revealed the localization of Hsp27 to the intercalated duct in the submandibular glands of non-treated rats. The expression of Hsp27 was strongly induced in both the uninjured contralateral control glands as well as treated glands of experimental rats regardless of the surgical procedure performed. The number of Hsp27-immunopositive cells increased rapidly following surgery, and subsequently returned to the same level as that in non-treated rats after 4 weeks. However, no marked changes were observed in the number of Ki67-immunopositive proliferating cells. Therefore, the change in the number of Hsp27-immunopositive cells may have contributed to compensatory hypertrophy. The results of the present study indicate that the expression of Hsp27 in the intercalated duct in the submandibular gland may play a role in the differentiation of acinar cells.

Submandibular glands and the regulation of gastric proliferation and TGFα distribution during rat postnatal development

Rodent gastric mucosa grows and differentiates during suckling-weaning transition. Among the molecules in rat milk, EGF and TGFβ are important peptides in the control of cell proliferation, and together with TGFα, they are also produced by submandibular glands. We aimed to determine the effect of saliva and milk on epithelial cell proliferation in the stomach of rat pups. We also examined the distribution of TGFα in the gastric mucosa after sialoadenectomy (SIALO) and fasting in order to determine whether this growth factor is affected by the deprivation of molecules derived from saliva and milk. SIALO was performed at 14 days and fasting was induced 3 days later. Cell proliferation was evaluated through metaphasic index and TGFα was detected by immunohistochemistry. We observed that whereas SIALO did not alter cell division, since the metaphasic index (MI) was unchanged, fasting stimulated cell proliferation (P < 0.05). After SIALO and fasting, MI was reduced when compared to the fasted group (P < 0.05). We found that TGFα is distributed along gastric gland and SIALO did not interfere in the localization and number of immunolabeled cells, but fasting increased their density when compared to the control (P < 0.05). The association of SIALO and fasting reduced TGFα immunostaining (P < 0.05). Therefore, during fasting, high MI was parallel to increased TGFα in gastric epithelium, but interestingly, this effect was found only in the presence of submandibular glands. We suggest that during suckling, peptides derived from saliva and milk are important to regulate gastric growth.