The tubarial glands paper: A starting point. A reply to comments

We thank the authors of letters for their constructive comments and thereby contribution to interpretation glandular structure as described in tubarial gland paper clinical consequences its presence [ [1] Valstar M.H. de Bakker B.S. Steenbakkers R.J.H.M. Jong K.H. Smit L.A. Klein Nulent T.J.W. van Es R.J.J. Hofland I. Keizer B. Jasperse Balm A.J.M. der Schaaf A. Langendijk J.A. Smeele L.E. Vogel W.V. The salivary glands: A potential new organ at risk radiotherapy. Radiother Oncol. 2021; 154: 292-298https://doi.org/10.1016/j.radonc.2020.09.034 Abstract Full Text PDF PubMed Scopus (40) Google Scholar ]. Their will be discussed by topic this summarized reply. Our reply a point-by-point response each letter is provided Supplemental material. RE: et al., “The radiotherapy”Radiotherapy OncologyVol. 154PreviewWe would like commend al. on report previously undescribed nasopharyngeal glands. finding was based incidental observations PSMA-avid tissue within nasopharynx, glands nasopharynx confirmed with cadaver dissection [1]. Understandably, investigators used pragmatic approach analyzed only scans obtained indications. As majority PSMA are done stage prostate cancer, which occurs men, design created considerable gender imbalance series: 99 100 patients scan analysis were male. Full-Text Letter editor concerning [Radiother Oncol 2020 Sep 23;S0167-8140(20)30809-4. doi: 10.1016/j.radonc.2020.09.034]Radiotherapy read discovery great interest. discovered pair overlooked, clinically relevant macroscopic agree that these potentially may play an important role regard efficient working protection oropharyngeal mucosa, comparable saliva oral cavity [2]. It known treatment head neck cancer radiotherapy might result swallowing problems [3]. radiotherapyRadiotherapy 154PreviewThe system, three paired major roughly 1000 minor spread throughout aerodigestive tract submucosa, has been detail [1–4]. Its serous, mucous or mixed exocrine acini produce required mastication, swallowing, digestion, tasting dental hygiene. nearby auditory tube submucosa also contains microscopic seromucous (tubal Eustachian tube) [5]. recently introduced molecular imaging modality positron emission tomography/computed tomography radio-labelled ligands prostate-specific membrane antigen (PSMA1 PET/CT) can visualize high sensitivity specificity [6]. Open AccessLetter Editor regarding 154PreviewEditor-in-Chief Radiotherapy Oncology, No convincing evidence have interest manuscript entitled radiotherapy” reviewed publication PSMA-PET/CT found study’s idea originally came from findings 2018 where overall SUVmax healthy pharyngeal wall similar sublingual Unfortunately, we do not believe proven existence “tubarial glands” following reasons: simply sero-mucinous glands?Radiotherapy 154PreviewRecently, article published Oncology journal, claimed discover located dorsolateral around Tube (ET) (or tube), termed Authors proposed present organ. They further argued significance xerostomia (dry mouth) dysphagia, frequently observed receiving Are unknown structure?Radiotherapy recent colleagues, radiotherapy,” describing what they characterize newly makes numerous statements primacy such as: “Previously unnoticed structures posterior nasopharynx;” “to our knowledge, did fit prior anatomical descriptions;” Comments First description head-neck 154PreviewTo Editor, Clinical implications glandsRadiotherapy 154PreviewWith interest, MH al congratulate excellent Tubarial performed cadaveric draining ducts wall, histologically, immunohistochemical staining positive (PSMA) negative amylase functional PET/CT positivity all scanned cases endorsing humans. Salivary ostium already histological literatureRadiotherapy 154PreviewIt pleasure about so-called macroscopical human (tubarial gland) putative Nevertheless, anatomist, I astonished why some literature cited study.