Academic
Publications
Application of 99mTc-Pertechnetate Scintigraphy to Microvascular Autologous Transplantation of the Submandibular Gland in Patients with Severe Keratoconjunctivitis Sicca

Application of 99mTc-Pertechnetate Scintigraphy to Microvascular Autologous Transplantation of the Submandibular Gland in Patients with Severe Keratoc

Application of 99mTc-Pertechnetate Scintigraphy to Microvascular Autologous Transplantation of the Submandibular Gland in Patients with Severe Keratoconjunctivitis Sicca  
BibTex | RIS | RefWorks Download
Our objective was to evaluate the role of 99mTc-pertechnetate scintigraphy on microvascular autologous transplantation of the submandibular gland in patients with severe keratoconjunctivitis sicca (KCS). Methods: 99mTc-Pertechnetate scintigraphy was performed on 106 patients with severe KCS. The patients were ex- amined before surgery and at 1 wk and 3 mo afterward using a standardized protocol that included static scintigrams, time- activity curves, and delayed scintigrams to check the function and secretion of the major salivary glands. The scintigraphic findings were assessed visually. When possible, the scintigraphic findings were compared with the clinical appearance of the transplanted gland. Results: The function of all 4 major salivary glands was al- most completely lost in 10 patients, indicating that these patients were not suitable for transplantation. The other 96 patients were treated by autologous transplantation of the submandibular gland. In 14 patients, the function of the major salivary glands was below normal. One patient's scintigram, obtained on the second day after surgery, showed no uptake of 99mTc-pertechnetate in the transplanted gland. Surgical exploration showed embolism of the artery of the transplanted gland. Scintigraphy was performed 1 wk after surgery in 90 patients. There was no uptake of 99mTc- pertechnetate in the temporal region in 8 patients, indicating that the glands were not revascularized. Scintigraphy showed ob- vious uptake of 99mTc-pertechnetate in the temporal region of the other 82 patients, indicating that the transplanted glands were vi- able. At more than 3 mo after surgery, scintigraphy was again per- formed on 30 patients. Scintigraphy after a 120-min delay showed that 99mTc-pertechnetate drained into the orbit through the duct of the transplanted gland in 26 patients. However, no secretion into the orbit was found in 4 patients, indicating obstruction of the duct. Conclusion: Scintigraphy plays an important role in microvascu- lar autologous transplantation of the submandibular gland in patients with severe KCS. Scintigraphy can be used to select pa- tients and donor glands, to evaluate the viability of the graft, and to check the patency of Wharton's duct of the transplanted gland.
Cumulative Annual
View Publication
The following links allow you to view full publications. These links are maintained by other sources not affiliated with Microsoft Academic Search.