Our body is a chest of unknown secrets, yet to be discovered with the fast pace of development in medical science, many secrets of the human body are known to humanity. But still, it remains a mystery yet to be solved.
Recently, a pair of clinically important, the nasopharyngeal salivary gland has been discovered during the Netherlands Cancer Institute and the University of Amsterdam research. They were researching prostate and urethra cancer patients when they found this gland.
How the new organ got its name?
It gets its name from the cartilage present near it named as Taurus tuberous. Taurus tuberous is a structure that gives mechanical support to the entrance of the auditory canal. These newly discovered pair of salivary glands are named 'Tubarial glands' due to their anatomical position.
Its exact anatomical location is under the back or posterior of the Nasopharynx and bilaterally shaped. In layman's language, it's between the throat and nasal cavity. They resemble major salivary glands in appearance. They can only be visualized through nasal endoscopy.
How was to Tubarial gland found?
The imaging techniques such as MRI, CT scan, and ultrasound are not useful in visualizing the gland. To visualize the same, a special type of scanning technique is used. It is named positron emission tomography(PET)/Computed tomography (CT), with radiolabelled ligands to Prostate Specific membrane antigen (PSMA). It is used because of its high sensitivity and specialty.
In this method, the patient is injected with radioactive tracers by the doctors. In turn, these radioactive tracers bind well to the protein PSMA, which is elevated in prostate cancer cells. This is good for detecting salivary tissues as well because they, too, are high in PSMA.
Human Salivary System
It is mainly divided into two different groups: major glands and minor glands.
The major salivary glands constitute Parotid, Submandibular, and Sublingual ( also known as Sub maxillary). The minor glands are found in groups of 100s in the upper aerodigestive mucosal tract. The Submandibular is present under the jaw, Parotid is located back of the jaw, just behind the cheek, and Sublingual is present under the tongue near the frenulum.
The salivary glands secret saliva, which helps in many physiological activities like softening the food for cutting and grinding into pieces, swallowing, dental hygiene, and takes part in the digestion process.
Importance of this particular discovery
Before its discovery, doctors were not aware of their presence and the side effects caused by the damage; hence the cause of the side-effects was left unexplained. During treatment of HNC (head and neck cancer)or brain metastasis, it's known to cause damage (toxicity like acinar atrophy or intestinal fibrosis).
Therefore patients undergoing radiotherapy treatment of cancer, especially for head and neck reasons, can be saved from greater damage by avoiding radiation to measure salivary glance. This can protect the patient from having other harmful side effects like difficulty in eating, speaking, or swallowing, and private fatal cases that lead to hazardous medical complications like Xerostomia and Dysphagia. This can make their life easier and comparatively healthier.
What is the suspected physiological function of these organs?
As per researchers, the physiological function of the Tubarial gland is lubrication and moistening of both the oropharynx and the nasopharynx. Researchers say that more research concerning this is highly essential for better interpretation and conclusions regarding their exact functions.
Why weren't these glands able to be discovered earlier?
It wasn't discovered earlier because of the anatomical position of the Tubarial gland. It can only be visualized through nasal endoscopy.
Nasal endoscopy is a technique in which a tube with a miniature camera and a light are together used to take pictures of the nose along with the sinuses.
Few facts regarding Tubarial gland
Clinical presence of Tubarial glands was extracted from the retrospective examination of no. of confounding'Organs-At-Risk'(OARs). Because all the salivary glands are present closely together, they usually receive comparable radiotherapy during head and neck cancer treatment.
As per research data, the dose received by Parotid glands was nearly correlated to that of Tubarial glands with a correlation coefficient of 0.84. This implies that the complication of Xerostomia and Dysphagia due to the Tubarial gland's damage by RT dose also includes the toxic effect added by dose on the parotid glands. This phenomenon is referred to as multicollinearity, which makes it difficult to measure the toxic effect caused by RT doses to both glands individually.
A similar case is applied to many muscles that are involved in acting swallowing in the context of dysphagia. So, more extensive and comprehensive experiments are needed to clarify and confirm the influence of multicollinearity.
In the present time, the next best initiative that can be taken towards the betterment of humanity can be to develop new techniques of radiotherapy, which could avoid exposure to these newly discovered glands.
What is the reaction of researchers?
After the findings are confirmed by examining 100 patients and few cadavers, then the whole study regarding this was published in "the journal Radiotherapy and Oncology " by a team of researchers, including those from the Netherlands Cancer Institute( NCI).
Among them, Dr. Wouter Vogel said, "As far as we know, the only salivary or mucus glands in the Nasopharynx are microscopically small and up to 1000 are evenly spread out throughout the mucosa. So imagine our surprise when we found these ."
After its discovery, it has become a scorching topic of debate for researchers. It is classified by a few researchers as 4 the major salivary gland because of its similarities with a sublingual gland in terms of volume and the drainage system. Simultaneously, some other researchers regard it as a minor gland because it also has few similarities with them.
So we conclude that the human nasopharynx has this pair of previously ignored bilateral macroscopic Tubarial glands, which is saved from damage that can give a chance to prohibit side effects from radiotherapy and give the cancer patients a better quality of life.
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