Surgical prevention and management of radiation-induced xerostomia in head-and-neck cancer patients

Abstract

Head-and-neck cancer is the sixth most commonly diagnosed cancer in the world and amounts to nearly 3% of all malignancies. Therapeutic irradiation is a common mode of treatment either alone or in conjunction with surgery for treatment of head-and-neck cancers which leads to irradiation-induced xerostomia which may in turn lead to disturbances in taste, speech, and prosthesis wear, etc. Xerostomia may also lead to infections in the oral cavity and rampant carious lesion in teeth. Salivary gland transfer is a surgical procedure done to prevent the gland from radiation exposure during radiotherapy of the head-and-neck region. Management of xerostomia is usually done with systemic or topical pilocarpine or cevimeline, artificial saliva compounds, herbal compounds, acupuncture and acupuncture-like transcutaneous nerve stimulation, low-level laser therapy, etc. with varying effectiveness.