Anatomy of a Discovery: Exploring the Impact of New Salivary Gland Finding

It’s not every day a new part of the human body is identified. But, that’s what happened when scientists at the Netherlands Cancer Institute found a pair of previously overlooked salivary glands behind the nose. The researchers have dubbed them tubarial glands and believe they may be used to moisten and lubricate the upper part of the throat and back of the nose. Allan Vescan, a professor and Director of Undergraduate Medical Education in the Department of Otolaryngology - Head & Neck Surgery whose primary clinical appointment is at Mount Sinai Health System, spoke with Temerty Medicine writer Erin Howe about the finding.

How exciting is it, that in the year 2020, a new organ is discovered?

It's very rare to find something like this. We assume most of the discoveries in human anatomy occurred centuries ago and all we're left to do is make the names easier to remember and teach. It's not often that we encounter something entirely new like this salivary gland. I was quite shocked to read about it.

Because the discovery of these tubarial glands is so recent, what might need to happen to replicate the findings and have them become accepted as established knowledge?

These salivary glands were found during imaging investigations for prostate cancer. To confirm these types of findings, additional anatomical studies will be needed. Something like this could be done in as little as a year or two.

The new salivary glands were found using a type of imaging used to look at the prostate. But they weren’t visible using more traditional imaging methods to look at this part of the body — CT, MRI or ultrasound. Can you tell me more about this?

Those imaging modalities are so detailed and that’s why it's such a remarkable, almost unbelievable, discovery. We always knew there was salivary tissue in the back of the nose, but the study shows this is an organized major salivary gland, which is what’s unique.

The tissue lines this area of the body in a way that isn't obvious to conventional imaging. Only by looking at functional imaging, can we see this tissue is organized in a way that makes it a major salivary gland and not just a bunch of small, scattered minor salivary glands.

The study’s authors highlight the potential to spare these glands during radiation therapy, which could improve the quality of life for people undergoing cancer treatment. What other implications might there be?

I think it's going to help further our understanding of functional issues with saliva and mucus production in the back of the nose. It may also allow us to target therapy to these areas during surgical or medical treatments.

One of the most troublesome quality-of-life side effects for patients who’ve been through radiation to the head and neck is losing the function of their major salivary glands. They end up with problems related to saliva production — dry mouth, dry throat, difficulty swallowing and eating or difficulty with their speech. Salivary cancer is very rare, but these findings might also help us understand some of its nuances, the origins of these tumors and how to best treat them.

One of the most common complaints and concerns patients share with their otolaryngologists has to do with post nasal drip. A lot of people experience it, but beyond ruling out things like an infection or sinus issues, we often can’t identify the cause. So, perhaps this finding could help us better understand this problem.