Tükürük Bezlerine Güncel Bakış: Yeni Bir Organ Tartışması

Tükürük bezleri, ağız boşluğuna tükürük adı verilen salgıyı yapan ekzokrin bezlerdir. Salgılanan tükürük, tüm ağız veyutak boşluğu mukoza tabakasının nemlendirilmesi yanında, ağız ve dişlerin temizlenmesini de sağlamaktadır.Tükürüğün büyük kısmını salgılayan parotis, submandibular ve sublingual olmak üzere üç çift majör tükürük bezlerisalgıyı bir kanal ile ağız boşluğuna iletir. Ayrıca, mukozada yer alan ve doğrudan ağız boşluğuna açılan çok sayıda minörtükürük bezleri de bulunmaktadır. Eylül 2020’de Valstar ve arkadaşları tarafından yayınlanan bir makalede,posterolateral nasopharyngeal duvarda çift olarak bulunan ve serömüköz salgı yapan bezlerin varlığı gösterildi. Torustubarius’un üzerinde bulunması nedeniyle, tubarial bezler olarak adlandırılan bu yapıların yeni bir organ oldukları ilerisürüldü. Bu çalışma, bilim dünyasında oldukça ilgi çekici bulunduğu kadar, beraberinde bazı soru işaretlerinin varlığınıda gündeme getirmiş ve tepkilere neden olmuştur. Sunulan bu çalışmada, geçmişten günümüze tükürük bezlerininkeşifleri yanında, embriyolojik gelişimleri ile anatomik ve histolojik yapılarının güncel bilgiler ışığında gözden geçirilmesive yeni bir organ olarak bilim dünyasına sunulan tubarial tükürük bezleri ile ilgili tartışmanın tüm yönleriyle ele alınmasıamaçlandı

An updated view on the salivary glands: Discussion on a newly discovered organ

Salivary glands are exocrine glands that produce the secretion named as saliva into oral cavity. The saliva provides the cleaning of the mouth and teeth as well as moisturizing the mucous layer of the cavity of oral and pharynx. Three pairs of major salivary glands, parotid gland, sublingual gland, submandibular gland which secrete most of the saliva transfer the saliva to the oral cavity via a duct. There are also many minor salivary glands located at the mucosa layer that open directly into the oral cavity. In an article published by Valstar et al., in September 2020, the presence of double glands located at the posterolateral nasopharynegeal wall and produce seromucous secretion was demonstrated. These structures located on the torus tubarius and therefore named as tubarial glands are claimed to be a new organ. While this study was of interest to the world of science, some questions arouse herewith, leeding to some reactions. In the present review, the aim is to discuss the discovery of the salivary glands from past to present, reviewing the anatomical and histological structures as well as the embryological development of these glands in the light of the new information, and to cover the debate about the tubarial glands presented to the world of science as a new organ.

___

  • 1. Arıncı K, Elhan A. Anatomi 1. Cilt Kemikler, Eklemler, Kaslar, İç Organlar. 7.baskı. Ankara: Güneş Tıp Kitabevleri, 2020.
  • 2. Gökmen FG. Sistematik Anatomi. 1.Baskı. İzmir: İzmir Güven Kitabevi, 2003.
  • 3. Snell RS. Topografik Klinik Anatomi. 9.Baskı. (Çev Ed. Yıldırım M.) Ankara, Palme Yayıncılık, 2015.
  • 4. Gupta S, Ahuja N. Salivary Glands. London UK 2018. Available from: www.Intechopen. Accessed: 01 December 2020.
  • 5. Punj A. Secretions of human salivary gland. Salivary glands. New approaches in diagnostics and treatment. London UK 2018. Available from:www. Intechopen/ doi:10.5772/intechopen. Accessed: 01 December 2020.
  • 6. Lydiatt DD. Bucher GS. The historical evolution of the understanding of the submandibular and sublingual salivary glands. Clin Anat. 2012;25:2-11
  • 7. Melo GM, Cervantes O. Abrahao M, Covolan L, Ferreira ES, Baptista HA. A brief history of salivary gland surgery. Rev Col Bras Cir. 2017;44:403-12.
  • 8. Strkalj G. Niels Stensen and the discovery of the parotid duct. Int J Morphol. 2013;31:1491-7.
  • 9. Valstar MH, De Bakker BS, Steenbakkers RJHM, De Jong KH, Smit LA, Klein Nulent TJW et al. The tubarial salivary glands: A potential new organ at risk for radiotherapy. Radiother Oncol. 2021;154:292-8.
  • 10. Yücel AH. Dere Anatomi Atlası ve Ders Kitabı. 7.baskı. Adana:Akademisyen Kitabevi, 2018.
  • 11. Pawlina W. Histology. A text and Atlas. 7th ed. China:Wolters Kluwer, 2016.
  • 12. Kierszenbaum AL, Tres LL. Histology and Cell Biology. Third ed. New York: Elsevier Saunders, 2012.
  • 13. Leeson CR, Leeson T, Paparo A. Text/Atlas of Histology Leeson Leeson Paparo. First ed. United States; WB Saunders, 1988.
  • 14. Mescher AL. Junqueira’s Basic Histology. Text and Atlas. 12th Edition. McGraw Hill, 2013.
  • 15. Ghannam MG, Singh P. Anatomy, head and neck, salivary glands. StatPearls, Treasure Island:Stat Pearls Publishing. Available from: https:// www.ncbi.nlm.nih.gov/ books/ NBK538325. Accessed: 01 December 2020.
  • 16. The normal salivary glands. Available from: www.arppress.org. Accessed: 01 December 2020.
  • 17. Witt RL. Salivary gland diseases. Surgical and medical management. First ed. Thime Medical Publishers, Newyork, 2005.
  • 18. Moore KL, Persaud TVN, Torchia MG. Klinik Yönleriyle İnsan Embriyolojisi. Onuncu baskı. (Çeviri Editörü: Dalçık H.,). İstanbul: Nobel Tıp Kitabevleri, 2016.
  • 19. Pappas S. Scientists discover new organ in the throat. Available from: www.livescience.com. Accessed: 20 October 2020.
  • 20. Tos M. Mucous glands in the developing human rhinopharynx. Laryngoscope. 1977;87:987–95.
  • 21. Richardson MS. Non-neoplastic lesions of the salivary glands. In Thompson L. ed. Head and neck pathology (a volume of foundations in diagnostic pathology). 2nd ed. Elsevier Saunders, 2013; 228.
  • 22. Berger G. Eustachian tube submucosal glands in normal and pathological temporal bones. J. Laryngol. Otol. 1993;107:1099– 105.
  • 23. Loutfi I, Nair M, Ebrahim A. Salivary gland scintigraphy: the use of semiquantitative analysis for uptake and clearance. J. Nucl. Med. Technol. 2003;31:81–5.
  • 24. Klein Nulent TJW, Valstar MH, De Keizer B, Willems SM, Smit LA, Al-Mamgani A et al. Physiologic distribution of PSMAligand in salivary glands and seromucous glands of the head and neck on PET/CT. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018;125:478-86.
  • 25. Frick H, Leonhardt H, Starck D. Human anatomy. 1st ed. Thieme; 1991.
  • 26. Korsrud FR, Brandtzaeg P. Characterization of epithelial elements in human major salivary glands by functional markers: localization of amylase, lactoferrin, lysozyme, secretory component, and secretory immunoglobulins by paired immunofluorescencstaining. J Histochem Cytochem. 1982;30:657-66.
  • 27. Bradley P, Guntinas-Lichius O. Salivary gland disorders and diseases: diagnosis and management. 1st ed. Stuttgart and New York: Thieme Publishing Group, 2011.
  • 28. Demirci E, Sahin OE, Ocak M, Akovali B, Nematyazar J, Kabasakal L. Normal distribution pattern and physiological variants of 68Ga-PSMA-11 PET/CT imaging. Nucl Med Commun. 2016;37:1169-79
  • 29. Hatfield S. Tubarial salivary glands: Scientists discover New salivary glands in human throat. Available from: www.todaysrdh.com. Accessed:26 October 2020.
  • 30. Narayan, R.K., Kumari, C., Panchal, P., Ghosh, S.K., Kumar, A., A macroscopic salivary gland and a potential organ or simply tubarial sero-mucinous glands?, Radiother Oncol. 2021;154:324-5.