Sonographic assessment of parotid and submandibular glands in patients undergoing 3D conformal radiotherapy Johari M1, Javad Rashid R2, Ghasemi Jangjoo A3, Esmaeili F1, Razavi Dizaji H2, Reyhani Z1,*, Khani A Mohamad4, Moghadam M A5 1Dental and Periodontal Research Center, Tabriz University of Medical Science, Tabriz, Iran 2Department of Radiology, School of Medicine, University of Medical Science, Tabriz, Iran 3Department of Radiation Oncology, School of Medicine, University of Medical Science, Tabriz, Iran 4Department of Otolaryngology, School of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran 5Department of Operative Dentistry, School of Dentistry, University of Medical Science, Zanjan, Iran *Corresponding Email: zreyhani@gmail.com
Online published on 29 September, 2018. Abstract The aim of this study was to evaluate sonographic changes in parotid and submandibular salivary glands in patients undergoing radiotherapy for head and neck malignancies. In addition, salivary changes subsequent to radiotherapy were evaluated objectively and subjectively. Twenty patients(13 males and 7 females) with head and neck malignancies, who had been referred to the Radiotherapy/Oncology Department of the Shahid Madani Hospital in Tabriz, Iran, were included in the study. Length, width, echotexture, echogenicity and margins of parotid and submandibular glands were evaluated before and after radiotherapy using sonography. Peak-systolic velocity(PSV),end-diastolic velocity(EDV) and resistive index(RI) were also assessed by Doppler sonography. Xerostomia subsequent to radiotherapy was evaluated with the use of two techniques: patients’ self-reported scoring and objective measurement of resting saliva. There was a significant decrease in the width of the parotid gland after radiotherapy compared to baseline(P=0.005). Although the length of the parotid gland and the dimensions of submandibular gland decrease, the differences were not significant. In addition, the echogenicity, echotexture and the margin of the glands change to hypoechoic, heterogenic and irregular, respectively, subsequent to radiotherapy. The Doppler technique showed decrease in PSV and RI and an increase in EDV; however, only the decrease in RI in the submandibular gland was statistically significant(P=0.002). The results showed a significant decrease in salivary flow after radiotherapy(P<0.001). In addition, based on the patients reports, the severity of xerostomia increased significantly after radiotherapy(P<0.001). Songraphic changes of parotid and submandibular glands after radiotherapy should be considered in ultrasound examinations. The damages to the parotid and submandibular glands had significant influence in patient post 3D-CRT. Top Keywords Ultrasonography, Conformal radiotherapy, Parotid glands, Submandibular glands, Xerostomia. Top |