J Korean Assoc Oral Maxillofac Surg.  2017 Oct;43(5):299-304. 10.5125/jkaoms.2017.43.5.299.

Rabbit submandibular salivary gland replantation

• Almansoori AA
• Khentii N
• Hei WH
• Seo N
• Lee SH
• Kim SM
• Lee JH

• KMID: 2393594
• DOI: http://doi.org/10.5125/jkaoms.2017.43.5.299

Abstract

OBJECTIVES
To test the feasibility of submandibular salivary gland (SMG) replantation techniques and the survival of the replanted glands. Such a study can provide a rationale for later allotransplantation procedures, along with implementation of conventional and advanced immunosuppression therapy.
MATERIALS AND METHODS
Six SMG replantations were performed in New Zealand white rabbits. One week postoperatively, (99m)Tc scintigraphy was performed and the uptake ratio and salivary excretion fraction were calculated. Two to four weeks later, submandibular glands were excised, fixed, and stained with H&E for histomorphometric evaluation.
RESULTS
Intraoperatively, all glands showed patent blood perfusion except gland 5. Positive tracer uptake and saliva excretion were documented by scintigraphy. On excision, all of the glands except glands 4 and 5 looked viable, with a red color and patent pedicles. Gland 4 was infected and filled with creamy pus, while gland 5 looked pale and necrotic. Histologically, glands 1, 2, 3, and 6 had preserved normal glandular tissue with slight variations from the contralateral normal glands, as their parenchyma was composed of mildly atrophic acini.
CONCLUSION
Four out of six replanted SMGs successfully survived. The glands maintained good viability and function. Such success depends on safe harvesting, short anastomosis time, and strict control of infection.

Keyword

Rabbits; Submandibular gland; Replantation

MeSH Terms

Immunosuppression
Perfusion
Rabbits
Radionuclide Imaging
Replantation*
Saliva
Salivary Elimination
Salivary Glands*
Submandibular Gland
Suppuration

Figure

• 

  Fig. 1 A. Intraoperative photo showing the replanted gland (white arrow), 0.5 mm tube cannulated into Wharton's duct (black arrow), anastomosed linguofacial vein (arrowhead), and common carotid artery (unviewed, located medially). B. The replanted gland 3 showing anastomosed common carotid artery (arrow) and anastomosis of the glandular vein to the linguofacial vein.

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  Fig. 2 A. Summit sialoscintigraphy (15th to 20th minute) of rabbit 2 showing higher uptake of tracer in the replanted gland left side in compare to the contralateral normal right side (arrows). B. Postcarbachol-injection sialoscintigraphy (40th to 45th minute) where both glands exhibited tracer excretion.

• 

  Fig. 3 A. Histologic structure of a control submandibular gland with intact acini and ducts (H&E staining, ×20; scale bar=100 µm). B. Histologic structure of the viable replanted gland 6 with mild atrophy of acinar cells (arrow) (H&E staining, ×20; scale bar=100 µm). C. Histologic structure of the infected-nonviable replanted gland 4 with cords of connective tissue, inflammatory cell invasion, and total disappearance of acini (H&E staining, ×20; scale bar=100 µm). D. Histologic structure of the necrotic replanted gland 5 with degeneration of acini (H&E staining, ×20; scale bar=100 µm).

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