Unexpected discovery of salivary glands deep inside the human head

A pair of previously unknown salivary glands has been discovered nestled deep in the back of the visible throat (nasopharynx). This new discovery may help prevent overlooked damage or complications from head and neck cancer radiotherapy.

Some time ago, oral surgeon Matthijs Valstar and radiation oncologist Wouter Vogel noticed a pair of unexpected areas of the head lighting up while examining PSMA PET/CT scans,originally developed to image patients with prostate cancer. The scans suggested these were salivary glands, but the pair of researchers from the Netherlands Cancer Institute (NKI) knew there were no known salivary glands in those particular areas.

People have three sets of large salivary glands, and the only salivary or mucous glands in the nasopharynx are microscopically small and evenly spread out throughout the mucosa, Vogel said.

However, a larger and more systematic investigation – analysis of 100 historical PSMA PET/CT scans and medical records from over 720 head and neck cancer patients as well as two targeted autopsies– confirmed the presence of the salivary glands.

The researchers also found that patients with the highest volume of salivary complications following radiation therapy were the ones where the treatment was most concentrated on the areas containing the glands. “Radiation therapy can damage the salivary glands, which may lead to complications,” explained Vogel. “Patients may have trouble eating, swallowing, or speaking, which can be a real burden.”

Vogel suggests that negative side effects from damage to the “tubarial glands,” named due to their position over the torus tubarius, in the cushioned part of the nasopharynx, could be mitigated by ensuring the radiation is more precisely targeted away from this location.

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