Maxillofac Plast Reconstr Surg.  2015 Feb;37(2):5. 10.1186/s40902-015-0006-4.

Microvascular autologous submandibular gland transplantation in severe cases of keratoconjunctivitis sicca

• Su JZ
• Cai ZG
• Yu GY

• KMID: 2381877
• DOI: http://doi.org/10.1186/s40902-015-0006-4

Abstract

Dry eye syndrome is a relatively common disease of the tears and ocular surfaces that results in discomfort, visual disturbance, and tear film instability with possible damage to the ocular surfaces. Microvascular submandibular gland (SMG) transfer offers a surgical alternative for a permanent autologous substitution of tears using the basal secretion of a transplanted SMG. Long-term follow-up reveals that this technique is a lasting and effective solution for patients with severe dry eye syndrome. The uncomfortable symptoms were relieved, and the frequency of use of pharmaceutical tear substitutes was reduced. Objective examination showed significant improvement in tear film and some features of ocular surface such as breakup time of tear film and corneal staining. Patients may suffer from obstruction of Wharton's duct or epiphora after surgery. Activation of secretion-related receptors could improve the early hypofunction of the denervated SMG and prevent the duct obstruction. Reduction surgery, partial SMG transplantation, uses of atropine gel or Botulinum toxin A could be the choices of treatment for epiphora.

Keyword

Obstructive sialadenitis; Keratoconjunctivitis sicca; Submandibular gland transplantation

MeSH Terms

Atropine
Botulinum Toxins
Dry Eye Syndromes
Follow-Up Studies
Humans
Keratoconjunctivitis Sicca*
Lacrimal Apparatus Diseases
Salivary Ducts
Submandibular Gland*
Tears
Atropine
Botulinum Toxins