Download PDF
Laryngorhinootologie 2020; 99(08): 545-551
DOI: 10.1055/a-1160-5979
Originalarbeit

Einfluss gutartiger Tumoren der Glandula parotis auf die Gesamtspeichelflussrate

Impact of benign parotid gland tumors on whole salivary flow rate
Marc Burghartz
1   Klinik für Hals-, Nasen-, Ohrenkrankheiten, plastische Operationen. Klinikum Stuttgart, Stuttgart, Germany
,
Christian Sittel
1   Klinik für Hals-, Nasen-, Ohrenkrankheiten, plastische Operationen. Klinikum Stuttgart, Stuttgart, Germany
,
Ivana Fiz
1   Klinik für Hals-, Nasen-, Ohrenkrankheiten, plastische Operationen. Klinikum Stuttgart, Stuttgart, Germany
,
Delf Taxis
1   Klinik für Hals-, Nasen-, Ohrenkrankheiten, plastische Operationen. Klinikum Stuttgart, Stuttgart, Germany
,
Thomas Plecko
2   Zentralinstitut für Klinische Chemie und Laboratoriumsmedizin mit Laborpraxis, Klinikum Stuttgart, Stuttgart, Germany
,
Carina Anna Kolkmeyer
3   Zoologie, Friedrich-Schiller-Universität Jena Institut für Zoologie und Evolutionsforschung mit Phyletischem Museum, Jena, Germany
,
Rudolf Hagen
4   Klinik und Poliklinik für Hals-, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Germany
,
Stephan Hackenberg
4   Klinik und Poliklinik für Hals-, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Germany
› Author Affiliations
› Further Information
Also available at
    Permissions and Reprints

Zusammenfassung

Hintergrund Der Einfluss von gutartigen Tumoren der Gl. parotis auf den Gesamtspeichelfluss oder die Zusammensetzung des Speichels ist weitestgehend unklar.

Material und Methoden 22 Patienten mit einem gutartigen Tumor der Gl. parotis und 18 Probanden einer gesunden Kontrollgruppe wurden im Hinblick auf den unstimulierten und stimulierten Gesamtspeichelfluss sowie die Speichelzusammensetzung (Natrium, Kalium, Kalzium, Amylase und pH) miteinander verglichen. Zudem wurden die Studienteilnehmer mittels visueller Analogskala (VAS) bzw. Lebensqualitätsfragebogen (QoL) zu einer möglichen Mundtrockenheit (Xerostomie) befragt.

Ergebnisse Der stimulierte Gesamtspeichelfluss in der Patientengruppe war im Vergleich zur Kontrollgruppe signifikant geringer (2,76 ± 0,96 ml/min vs. 3,85 ± 0,72 ml/min; p = 0,009). Jedoch ergab der Vergleich des unstimulierten Gesamtspeichelflusses, der Speichelzusammensetzung und der subjektiven Parameter (VAS, QoL) keinen signifikanten Unterschied zwischen der Patienten- und der Kontrollgruppe (0,73 ± 0,41 ml/min vs. 0,68 ± 0,39 ml/min; p = 1).

Schlussfolgerungen Die Ergebnisse der vorliegenden Studie könnten einen Hinweis darauf geben, dass gutartige Tumoren der Gl. parotis den stimulierten Gesamtspeichelfluss reduzieren, während sie den unstimulierten Gesamtspeichelfluss sowie die Speichelzusammensetzung unbeeinflusst lassen. Dennoch scheinen die Patienten unter keiner signifikanten Mundtrockenheit zu leiden.

Abstract

Objective The impact of benign tumors of the parotid gland on whole salivary flow or sialochemistry is unclear.

Material and Methods A total of 22 patients with benign parotid tumors and 18 healthy controls underwent measurements of unstimulated and stimulated whole saliva flow and sialochemistry (Na+, K+, Ca++, Amylase, and pH). Assessment of xerostomia was performed by means of a visual analogue scale (VAS) and a questionnaire (QoL).

Results Stimulated whole salivary flow was significantly lower in patients with benign parotid tumors in comparison to the control group (2.76 ± 0.96 ml/min vs. 3.85 ± 0.72 ml/min; p = 0.009). However, assessment of unstimulated whole salivary flow, sialochemistry, and subjective parameters (VAS, QoL) showed no significant differences between the patient and control groups (0.73 ± 0.41 ml/min vs. 0.68 ± 0.39 ml/min; p = 1).

Conclusions Benign salivary gland tumors appear to reduce whole stimulated salivary flow and leave unstimulated whole salivary flow and sialochemistry unchanged. The patients’ subjective feelings of dry mouth do not seem to be influenced by the reduction in salivary flow.

Schlüsselwörter

Glandula parotis - gutartiger Tumor - Speichelzusammensetzung - Mundtrockenheit - Speichelflussrate (unstimuliert/stimuliert)

Key words

parotid gland - benign tumor - sialochemistry - xerostomia - salivary flow rate (unstimulated/stimulated)


Publication History

Received: 22 January 2020

Accepted: 15 April 2020

Article published online:
11 May 2020

© Georg Thieme Verlag KG
Stuttgart · New York

 

  • Literatur

  • 1 Schneyer LH, Levin LK. Rate of secretion by individual salivary gland pairs of men under conditions of reduced exogenous stimulation. J Appl Physiol 1955; 7: 508-512
    CrossrefPubMedGoogle Scholar
  • 2 Sreebny LM. Salivary flow in health and disease. Compend Suppl 1989; 13: 461-469
    PubMedGoogle Scholar
  • 3 Turner MD. Hyposalivation and Xerostomia: Etiology, complications, and medical management. Dent Clin North Am 2016; 60: 435-443
    CrossrefPubMedGoogle Scholar
  • 4 Tian Z, Li L, Wang L. et al. Salivary gland neoplasms in oral and maxillofacial regions: a 23-year retrospective study of 6982 cases in an eastern Chinese population. Int J Oral Maxillofac Surg 2010; 39: 235-242
    CrossrefPubMedGoogle Scholar
  • 5 Nagler RM, Laufer D. Tumors of the major and minor salivary glands: review of 25 years of experience. Anticancer Res 1997; 17: 701-707
    PubMedGoogle Scholar
  • 6 Satko I, Stanko P, Longauerová I. Salivary gland tumours treated in the stomatological clinics in Bratislava. J Craniomaxillofac Surg 2000; 28: 56-61
    CrossrefPubMedGoogle Scholar
  • 7 Bradley PJ, McGurk M. Incidence of salivary gland neoplasms in a defined UK population. Br J Oral Maxillofac Surg 2013; 51: 399-403
    CrossrefPubMedGoogle Scholar
  • 8 Luers JC, Guntinas-Lichius O, Klussmann JP. et al. The incidence of Warthin tumors and pleomorphic adenomas in the parotid gland over a 25-year period. Clin Otolaryngol 2016; 41: 793-797
    CrossrefPubMedGoogle Scholar
  • 9 Bradley PT, Paleri V, Homer JJ. Consensus statement by otolaryngologists on the diagnosis and management of benign parotid gland disease. Clin Otolaryngol 2012; 37: 300-304
    CrossrefPubMedGoogle Scholar
  • 10 Jechova A, Kuchar M, Novak S. et al. The role of fine-needle aspiration biopsy (FNAB) in Warthin tumour diagnosis and management. Eur Arch of Otorrhinolaryngol 2019; 276: 2941-2946
    PubMedGoogle Scholar
  • 11 Wolff A, Joshi RK, Ekström J. et al. Guide to medications inducing salivary gland dysfunction, xerostomia, and subjective sialorrhea: a systematic review sponsored by the world workshop on oral medicine VI. Drugs R D 2017; 17: 1-28
    CrossrefPubMedGoogle Scholar
  • 12 Bucher JA, Fleming TJ, Fuller LM. et al. Preliminary observations on the effect of mantle field radiotherapy on salivary flow rates in patients with Hodgkin’s disease. J Dent Res 1988; 67: 518-521
    PubMedGoogle Scholar
  • 13 Singer S, Arraras J, Chie WC. et al. Performance of the EORTC questionnaire for the assessment of quality of life in head and neck cancer patients EORTC QLQ-H&N35. A methodological review. Qual Life Res 2013; 22: 1927-1941
    CrossrefPubMedGoogle Scholar
  • 14 Proctor GB. The physiology of salivary secretion. Periodontol 2000 2016; 70: 11-25
    CrossrefPubMedGoogle Scholar
  • 15 Gröschl M. The physiological role of hormones in saliva. Bioessays 2009; 31: 843-852
    CrossrefPubMedGoogle Scholar
  • 16 Sreebny LM. Saliva in health and disease: an appraisal and update. Int Dent J 2000; 50: 140-161
    CrossrefPubMedGoogle Scholar
  • 17 Marunick MT, Mahmassani O, Klein B. et al. The effect of surgical intervention for head and neck cancer on whole salivary flow: a pilot study. J Prosthet Dent 1993; 70: 154-157
    CrossrefPubMedGoogle Scholar
  • 18 Jacob RF, Weber RS, King GE. Whole salivary flow rates following submandibular gland resection. Head Neck 1996; 18: 242-247
    CrossrefPubMedGoogle Scholar
  • 19 Cunning DM, Lipke N, Wax MK. Significance of unilateral submandibular gland excision on salivary flow in noncancer patients. Laryngoscope 1998; 108: 812-815
    CrossrefPubMedGoogle Scholar
  • 20 Jaguar GC, Lima EN, Kowalski LP. et al. Impact of submandibular gland excision on salivary gland function in head and neck cancer patients. Oral Oncol 2010; 46: 349-354
    CrossrefPubMedGoogle Scholar
  • 21 Chaushu G, Dori S, Sela BA. et al. Salivary flow dynamics after parotid surgery: a preliminary report. Otolaryngol Head Neck Surg 2001; 124: 270-273
    CrossrefPubMedGoogle Scholar
  • 22 Roh JL, Kim HS, Park CI. Randomized clinical trial comparing partial parotidectomy versus superficial or total parotidectomy. Br J Surgery 2007; 94: 1081-1087
    CrossrefPubMedGoogle Scholar
  • 23 Min R, Zun Z, Siyi L. et al. Gland-preserving surgery can effectively preserve gland function without increased recurrence in treatment of benign submandibular gland tumour. J Oral Maxillofac Surg 2013; 51: 615-619
    PubMedGoogle Scholar
  • 24 Ge N, Peng X, Zhang L. et al. Partial sialoadenectomy for the treatment of benign tumours in the submandibular gland. Int J Oral Maxillofac Surg 2016; 45: 750-755
    CrossrefPubMedGoogle Scholar
  • 25 Jezewska E, Scinska A, Kukwa W. et al. Effects of benign parotid tumors on unstimulated saliva secretion from the parotid gland. Auris Nasus Larynx 2009; 36: 586-589
    CrossrefPubMedGoogle Scholar
  • 26 Navazesh M. Methods for collecting saliva. Ann N Y Acad Sci 1993; 694: 72-77
    CrossrefPubMedGoogle Scholar
  • 27 Froehlich DA, Pagborn RM, Whitaker JR. The effect of oral stimulation on human parotid salivary flow rate and alpha-amylase secretion. Physiol Behav 1987; 41: 209-217
    CrossrefPubMedGoogle Scholar
  • 28 Young JA. Salivary secretion of inorganic electrolytes. Int Rev Physiol 1979; 19: 1-58
    PubMedGoogle Scholar
  • 29 Schwartz SS, Hay DI, Schluckebier SK. Inhibition of calcium-phosphate precipitation by human salivary statherin: structure-activity relationships. Calcif Tissue Int 1992; 50: 511-517
    CrossrefPubMedGoogle Scholar
  • 30 Rad M, Kakoie S, Brojeni FN. et al. Effect of long-term smoking on whole-mouth salivary flow rate and oral health. J Dent Res Dent Clin Dent Prospects 2010; 4: 110-114
    PubMedGoogle Scholar
  • 31 Dyasanoor S, Saddu SC. Association of xerostomia and assessment of salivary flow using modified Schirmer test among smokers and healthy individuals: a preliminutesary study. Clin Diagn Res 2014; 8: 211-213
    PubMedGoogle Scholar
  • 32 Nagler RM. Altered salivary profile in heavy smokers and its possible connection to oral cancer. Int J Biol Markers 2007; 22: 274-280
    CrossrefPubMedGoogle Scholar
  • 33 Parvinen T. Stimulated salivary flow rate, pH and lactobacillus and yeast concentrations in non-smokers and smokers. Scand J Dent Res 1984; 92: 315-318
    PubMedGoogle Scholar
  • 34 Billings RJ, Proskin HM, Moss ME. Xerostomia and associated factors in a community-dwelling adult population. Community Dent Oral Epidemiol 1996; 24: 312-316
    CrossrefPubMedGoogle Scholar
  • 35 Sevón L, Laine MA, Karjalainen S. et al. Effect of age on flow-rate, protein and electrolyte composition of stimulated whole saliva in healthy, non-smoking women. Open Dent J 2008; 2: 89-92
    CrossrefPubMedGoogle Scholar
  • 36 Jones RE, Ship JA. Major salivary gland flow rates in young and old generally healthy Africans and whites. J Natl Med Assoc 1995; 87: 131-135
    PubMedGoogle Scholar
  • 37 Dawes C. Circadian rhythms in human salivary flow rate and composition. J Physiol 1972; 220: 529-545
    CrossrefPubMedGoogle Scholar