Gland Surgery – Minimizing Radiation
Guest: Dr. Joshua Hornig - Otolaryngology
Host: Dr. Linda Austin – Psychiatry
Linda Austin: This is Dr. Linda
Austin. I’m talking with Dr. Joshua Hornig
who is Assistant Professor of Ear, Nose & Throat, Otolaryngology, here at
Hornig, I know you’ve been doing a procedure here, at the medical university,
which you learned in Canada,
which, actually, is unusual here in the United States. It helps prevent a very common side effect
after radiation for head and neck cancer.
Can you describe that procedure, please?
Joshua Hornig: Sure. The biggest side effect of people having
radiation is that you get a very dry mouth afterwards. Saliva is critically important in swallowing
ability and in hygiene for your teeth, and also for speech. If you’re not convinced of this, all you have
to do is eat a whole bunch of crackers and then try to talk and swallow and
whistle. It’s just impossible to do.
when you get the radiation, all the saliva glands become atrophied and no
longer function properly. So, the new
procedure that we’re doing is transferring one of the glands underneath the jaw
line to underneath the front part of the chin.
By moving it from that one area to the area of the chin, the radiation
therapist can actually target his radiation to avoid that gland. By doing so, surprisingly, but convincingly,
people will have near normal saliva after these treatments. The effect for the patient is that you
swallow better, talk better, and you’re often able to keep your own teeth. Often, after you’ve had radiation treatments,
over time, all your teeth have to be pulled because they get very bad cavities.
Linda Austin: That sounds really
important. Why is that procedure not
routinely done throughout the United
Joshua Hornig: Surgeons are creatures of
habit. They like to do it the way they
were taught. This is a very new
procedure and we were the leading site in the United States for the clinical
trial. This clinical trial just closed
this week. The evidence from the trial
will show that these people that had this procedure had much better saliva,
were able to keep their teeth, and swallow much more effectively than those
that did not. The initial studies
showing this came out of Canada. And this international trial, that we just
finished, was trying to show that we could replicate these results in other
Linda Austin: How long does this surgery
Joshua Hornig: The surgery takes about
45 minutes, and that’s in addition to any other surgery you have at that
time. It’s part of, almost, a normal
treatment of head and neck cancer, so there’s hardly any additional surgery
that you need to have for it.
Linda Austin: So it just gets rolled
into the procedure that a patient would expect to have, but then end up with a
much better outcome?
Joshua Hornig: That’s correct. That’s very well said.
Linda Austin: Are there any other areas
in the southeast that are currently doing this procedure?
Joshua Hornig: I think we are one of the
few centers in the entire United
States doing it. We, typically, in the last six months, have
had people come from California, Florida, Georgia
for this particular procedure.
Linda Austin: Now, we keep referring to
it as this surgery and this procedure. It has a name, I presume.
Joshua Hornig: We call it the submandibular gland transfer.
Linda Austin: Because the mandible is
Joshua Hornig: Yes.
Linda Austin: Right. And you’re transferring that gland?
Joshua Hornig: Right.
Dr. Linda Austin:
Dr. Hornig, thank you very much.
Joshua Hornig: You’re very welcome.
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