Articles
August 11, 2022 // Sara Juliano, RDH
A Newly Discovered Salivary Gland: The Tubarial Gland
Our bodies are somewhat of a mystery, and we still do not know everything there is to know about the intricacies of our bodily functions. It is truly fascinating to me how the body repairs itself in times of distress. But the more we learn about these mysteries down to the cellular level, the better quality of life people will have, not to mention increased longevity and lifespan!
With modern medical advances and steadfast research, new discoveries are being made, leading to exciting discoveries about our precious human bodies.
In 2020 there was a game-changing medical discovery. Researchers from the Netherlands accidentally came across these “unknown bilateral macroscopic organs” in the head and neck region that had never been seen before. Strangely, they found these bilateral organs during a research study to find a cure for Prostate Cancer.
Profound how researchers found these new macroscopic glands in the nasal region while researching the prostate!
These new organs were discovered through a diagnostic imaging modality called Positron Emission Tomography-Computed Tomography (PET-CT) with radio-labeled ligands to the prostate-specific membrane antigen (PSMA1 PET/CT). Amazingly, the prostate-specific antigens used to detect prostate cancer also fluorescence all the major salivary glands that are present in the oral cavity.
This means that these prostate-specific antigens will light up wherever there are salivary glands in the body. The imaging led to discovering a pair of salivary glands in the posterior nasopharynx, now named Tubarial Glands.
To validate that these glands existed in all humans, researchers performed the PSMA1 PET-CT on over 100 patients, dissected two human cadavers, and all showed bilateral Tubarial glands!
You may be asking yourself why now. Why have doctors never seen these previously?
These glands have not been previously discovered due to their location. The anatomical location of these Tubarial glands is buried deep behind the nasopharynx at the base of the skull, making these glands virtually impossible to see until now. Thanks to modern medical technology and brilliant research scientists, the discovery was found!
With further research and dissection of cadavers, scientists concluded that the Tubarial glands are major bilateral salivary glands due to the presence of acinar cells. The primary physiological functions are to moisturize and lubricate the nasopharynx and oropharynx.
Prior to the discovery, there were only three major salivary glands and a plethora of minor salivary glands scattered within the oral cavity region.
The three major salivary glands are:
- Submandibular glands
- Sublingual glands
- Parotid glands
- (And newly found) Tubarial glands
Saliva’s function in the oral cavity:
- Saliva plays a significant role in maintaining optimal oral health and proper dental hygiene to prevent oral diseases such as gingivitis and periodontal disease.
- Saliva aids in chewing, digestion, speaking, swallowing, and talking. Not to mention, saliva is the first line of defense against foreign pathogens to prevent infections from migrating systemically via tissue and blood.
- Saliva neutralizes the pH in the oral cavity aiding in protecting against acidic foods, beverages, and bacteria that thrive and wreak havoc in acidic environments. Salivary pH prevents demineralization of teeth and prevents tooth decay.
Tubarial Gland impact on cancer treatment therapies:
Oncologists are now taking part in this amazing discovery, especially with patients that need radiological treatment in the head, neck, throat, and tongue regions. The Tubarial glands are considered major organs in retaining the preservation of the tissues during any form of radiation treatment.
Oncologists have discovered ways to maintain the natural function of these glands to significantly reduce the risk of developing xerostomia and dysgeusia, a major post-op side effect of radiation therapy in cancer patients.
How Tubarial glands can prevent xerostomia and dysgeusia:
Tubarial glands are susceptible to tissue damage during radiation treatment; thus, measures must be taken to prevent tissue necrosis.
Oncologists and research scientists are looking into ways to decrease xerostomia and dysgeusia as significant side effects of chemotherapy and radiation therapy. Patients with head and neck, throat, and tongue cancer are at an increased risk of developing xerostomia due to chemotherapy and radiation therapy. This is mainly because all the major salivary glands and taste buds are in the oral cavity. Heavy radiation to those areas will cause disruption, dysregulation, and sometimes permanent damage.
Oncologists are consciously focusing radiation away from the Tubarial glands by bypassing the site during radiation treatment and navigating other pathways to cancer sites. This will reduce the risk for Tubarial gland dysfunction and dysregulation and significantly decrease symptoms of xerostomia during and after therapy.
The discovery of the body containing additional salivary glands, in conjunction with oncologists paying close attention to bypassing Tubarial glands during radiation treatment, will have a profound impact on the quality of life for cancer patients. This will decrease salivary dysregulation and disruption, reducing the side effects of dry mouth and dysgeusia.
Eliminating symptoms of xerostomia and dysgeusia allows cancer patients to maintain nourishment from proper food and beverages to boost their immune systems in times of immunosuppression.
We, as dental professionals, can aid by educating our patients undergoing cancer treatment about the discovery of the Tubarial glands and work towards improving their quality of life.
Cited Work:
https://www.youtube.com/watch?v=W1lbil-sFWk
http://www.sci-news.com/medicine/tubarial-glands-08972.http.
The tubarial salivary glands: A potential new organ at risk for radiotherapy. (2020). Radiotherapy and Oncology. https://doi.org/10.1016/j.radonc.2020.09.034