Beyond the torus tubarius - clinical relevance of tubarial glands in trauma and radiotherapy - Letter to the Editor

Sep 29, 2026

Uploaded by dhado

Paired tubarial glands (glandulae tubariae) lie in the posterolateral nasopharyngeal wall near the torus tubarius and are composed mainly of mucous acini with drainage ducts. They contribute to nasopharyngeal/oropharyngeal lubrication, epithelial hydration retention, mucosal integrity, and antimicrobial defense, and they are detectable with prostate-specific membrane antigen PET/CT. In head and neck radiotherapy and nasopharyngeal trauma, restricting or protecting these glands may reduce xerostomia, dysphagia, and overlooked salivary fistula complications, while improved imaging, guidelines, and regenerative biomaterials are needed.

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Letter to the Editor

Clinical relevance in trauma and radiotherapy

Anatomy, function, and imaging detection

Radiation therapy implications and knowledge gaps

Post-traumatic complications and management needs

Future directions: guidelines and regenerative approaches

Letter to the Editor Beyond the torus tubarius: clinical relevance of tubarial glands in trauma and radiotherapy Tahir Abdul Qadir, MBBSa , Muhammad Talha, MBBSb , Omar Abdullah Gill, MBBSb , Raghabendra Kumar Mahato, MBBSc ,*, Laiba Riaz, MBBSa To the Editor, The newly discovered tubarial glands (TGs), which are also referred to by their Latin name glandulae tubariae, have garnered significant scientific interest as a possible enhancement to the human salivary gland system. They are paired structures found in the posterolateral wall of the nasopharynx close to the torus tubarius, and they consist mainly of mucous acini accompanied by numerous drainage ducts. According to histological and imaging studies, these glands are among the factors that enable smooth swallowing and protect the mucosa by contributing to the lubrication of the nasopharynx and oropharynx[1] . They are thought to be instrumental in the retention of epithelial hydration, mucosal integrity, and antimicrobial defense in the upper aerodigestive tract by secreting mucin-rich saliva. One important thing is that both TGs and other salivary glands are detectable through prostate-specific membrane antigen positron emission tomography/computed tomography (PET/CT) imaging[2] . The TGs have become the focus of radiation therapy research due to their interesting location and role in upper airway lubrication. In head and neck radiotherapy, restricting the radiation exposure to these glands can help avoid xerostomia and dysphagia in patients. Still, there are some knowledge gaps about their actual incidence, portrayal on imaging, histological structure, and radiosensitivity, underlining the necessity of more anatomical and functional studies to reveal their clinical importance[3] . In the case of nasopharyngeal trauma, damage to the TGs and their ducts can lead to often-overlooked complications. Such injury disrupts local mucosal lubrication and antimicrobial homeostasis, delays epithelial healing, and may increase the aDepartment of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan, bDepartment of Medicine, King Edward Medical University, Lahore, Pakistan and cDepartment of Medicine, Gandaki Medical College Teaching Hospital and Research Centre, Pokhara, Nepal Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. *Corresponding author. Address: Department of Medicine, Gandaki Medical College Teaching Hospital and Research Centre, Pokhara 33700, Nepal. Tel.: +977 9745829807. E-mail: [102raghabendrakumarmahato@gmail.com](102raghabendrakumarmahato@gmail.com)[ ](102raghabendrakumarmahato@gmail.com)(R.K. Mahato). Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc. This isan open access article distributed under the terms of the Creative Commons AttributionNon Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Annals of Medicine & Surgery (2026) 88:1122–1123 Received 13 November 2025; Accepted 25 November 2025 Published online 9 December 2025 [http://dx.doi.org/10.1097/MS9.0000000000004530](http://dx.doi.org/10.1097/MS9.0000000000004530) risk of developing persistent salivary fistulas. These fistulasoften mimic a chronic infection due to recurrent serous drainage and mild inflammatory change. Similar post-traumatic fistulous phenomena have been described in major salivary glands, wherein duct disruption leads to persistent leakage of saliva unless the tract is managed or sealed appropriately [4] . Understanding the healing contribution made by tubarial secretions may thus help explain the recurrence of fistulous tracts after trauma and the need for targeted diagnostic and regenerative approaches. The occurrence of these fistulas reappearing requires strict adherence to a separate tr

FAQs

What are the tubarial glands and where are they located?

They are paired glandular structures (glandulae tubariae) in the posterolateral wall of the nasopharynx near the torus tubarius.

How might tubarial glands affect outcomes in head and neck radiotherapy?

Restricting radiation exposure to these glands may help avoid xerostomia and dysphagia, though their incidence, imaging portrayal, and radiosensitivity still require further study.

Why are tubarial gland injuries important in nasopharyngeal trauma?

Damage can disrupt mucosal lubrication and antimicrobial homeostasis, delay epithelial healing, and increase the risk of persistent salivary fistulas that can mimic chronic infection.

Sep 29, 2026

Uploaded by dhado