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Sonographic Assessment of Parotid and Submandibular Glands in Patients Undergoing 3D Conformal Radiotherapy

Authors: Johari M, Javad Rashid R, Ghasemi Jangjoo A, Esmaeili F, Razavi Dizaji H, Reyhani Z, Mohamad Khani A and Moghadam M A

Int J Med Res Health Sci.127-135 | pdf PDF Full Text

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(13males and 7females) 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.

Key words: Ultrasonography, Conformal radiotherapy, Parotid glands, Submandibular glands, Xerostomia.

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