spit take
October 20, 2020 6:35 PM Subscribe
Surprise! There's a Secret Organ in Your Head (Popular Mechanics, Oct. 20, 2020, from New York Times reporting; partial NYT excerpt via Yahoo News) "A team of researchers in the Netherlands has discovered what may be a set of previously unidentified organs: a pair of large salivary glands, lurking in the nook where the nasal cavity meets the throat." The tubarial salivary glands: A potential new organ at risk for radiotherapy [Open access, Radiotherapy & Oncology; also at Science Direct]
Previously, there were three identified pairs of large salivary glands (the parotid glands, the submandibular glands, and the sublingual glands), as well as hundreds of minor salivary glands in the lining of the mouth and throat. These glands are protected during radiation therapy, in hopes of avoiding tissue scarring and post-treatment complications including xerostomia and dysphagia. This new finding may reveal why those efforts are less than successful. Article excerpt:
Doctors take numerous precautions to avoid damaging the glands when administering radiation therapy, which can, with a single misdirected zap, permanently compromise the delicate tissues.[...] It’s not completely clear how these glands eluded anatomists. But “the location is not very accessible, and you need very sensitive imaging to detect it,” said Dr. Wouter Vogel, a radiation oncologist at the Netherlands Cancer Institute and an author on the study. The body’s other large salivary glands, which sit closer to the surface of the skin, can also be poked and prodded; that’s far less feasible with this fourth pair of structures, which are tucked under the base of the skull. The new find, Vogel said, might help explain why people who undergo radiation therapy for cancer of the head or neck so often end up with chronic dry mouth and swallowing problems.
Because these obscure glands weren’t known to doctors, “nobody ever tried to spare them” from such treatments, Vogel said.
Xerostomia: "Xerostomia or dry mouth is one of the most common and disturbing adverse effects following radiotherapy for head and neck cancer (HNC). This complication strongly increases the risk for dental caries, difficulties with chewing, swallowing and sleep disorders with significant impact on patients’ quality of life." (Clinical features and preventive therapies of radiation-induced xerostomia in head and neck cancer patient: a literature review, 2017)
"Dry mouth is very common amongst head and neck cancer patients due to radiation treatments. It is expected that 90-100% of head and neck cancer patients treated with radiation will develop some degree of oral complication, with dry mouth being the most common. Dry mouth is due to direct damage to the salivary glands by radiation, which destroys the ability to make saliva.[...] Depending on the degree of xerostomia, patients may experience burning sensation as well as difficulty with swallowing and speaking due to lack of lubrication. Saliva plays an important role in the health of the mouth, including cleansing of the oral lining, protection of teeth, as well as antibacterial activity. Because of this, long-term dry mouth can lead to bigger problems. These problems include dental cavities and decay, oral thrush, as well as infections of the gums, salivary glands, and jaw." (Xerostomia, David Cognetti, MD, American Head and Neck Society)
Dysphagia: "Radiation therapy is an effective part of treatment for many cancers that arise in the head and neck. But following radiation for these cancers some people develop difficulty swallowing (dysphagia), because the radiation can causes the muscles and mucosal lining of the mouth, throat, and esophagus to become stiff and deformed. Swallowing becomes effortful and painful. Dysphagia is usually categorized as oropharyngeal dysphagia or esophageal dysphagia. In oropharyngeal dysphagia people have difficulty moving food and liquids from the mouth to the throat and esophagus. In esophageal dsyphagia the esophagus becomes scarred and narrowed—this is called a stricture—and food has difficulty passing through the stricture. [Symptoms include: pain while swallowing, inability to swallow, drooling, regurgitation, heartburn, unexpected weight loss, coughing or gagging when swallowing...] Dysphagia can take the joy out of eating and drinking and can lead to more severe complications such as malnutrition, weight-loss, and dehydration. In addition, patients who aspirate liquids or solids (breathe them into the airway while swallowing) can develop respiratory problems such as pneumonia, bronchitis, or other upper respiratory infections." (Radiation Induced Dysphagia, Columbia University Medical Center Health Library)
The new paper on the salivary gland discovery concludes, "Sparing these glands in patients receiving RT may provide an opportunity to improve their quality of life."
Previously, there were three identified pairs of large salivary glands (the parotid glands, the submandibular glands, and the sublingual glands), as well as hundreds of minor salivary glands in the lining of the mouth and throat. These glands are protected during radiation therapy, in hopes of avoiding tissue scarring and post-treatment complications including xerostomia and dysphagia. This new finding may reveal why those efforts are less than successful. Article excerpt:
Doctors take numerous precautions to avoid damaging the glands when administering radiation therapy, which can, with a single misdirected zap, permanently compromise the delicate tissues.[...] It’s not completely clear how these glands eluded anatomists. But “the location is not very accessible, and you need very sensitive imaging to detect it,” said Dr. Wouter Vogel, a radiation oncologist at the Netherlands Cancer Institute and an author on the study. The body’s other large salivary glands, which sit closer to the surface of the skin, can also be poked and prodded; that’s far less feasible with this fourth pair of structures, which are tucked under the base of the skull. The new find, Vogel said, might help explain why people who undergo radiation therapy for cancer of the head or neck so often end up with chronic dry mouth and swallowing problems.
Because these obscure glands weren’t known to doctors, “nobody ever tried to spare them” from such treatments, Vogel said.
Xerostomia: "Xerostomia or dry mouth is one of the most common and disturbing adverse effects following radiotherapy for head and neck cancer (HNC). This complication strongly increases the risk for dental caries, difficulties with chewing, swallowing and sleep disorders with significant impact on patients’ quality of life." (Clinical features and preventive therapies of radiation-induced xerostomia in head and neck cancer patient: a literature review, 2017)
"Dry mouth is very common amongst head and neck cancer patients due to radiation treatments. It is expected that 90-100% of head and neck cancer patients treated with radiation will develop some degree of oral complication, with dry mouth being the most common. Dry mouth is due to direct damage to the salivary glands by radiation, which destroys the ability to make saliva.[...] Depending on the degree of xerostomia, patients may experience burning sensation as well as difficulty with swallowing and speaking due to lack of lubrication. Saliva plays an important role in the health of the mouth, including cleansing of the oral lining, protection of teeth, as well as antibacterial activity. Because of this, long-term dry mouth can lead to bigger problems. These problems include dental cavities and decay, oral thrush, as well as infections of the gums, salivary glands, and jaw." (Xerostomia, David Cognetti, MD, American Head and Neck Society)
Dysphagia: "Radiation therapy is an effective part of treatment for many cancers that arise in the head and neck. But following radiation for these cancers some people develop difficulty swallowing (dysphagia), because the radiation can causes the muscles and mucosal lining of the mouth, throat, and esophagus to become stiff and deformed. Swallowing becomes effortful and painful. Dysphagia is usually categorized as oropharyngeal dysphagia or esophageal dysphagia. In oropharyngeal dysphagia people have difficulty moving food and liquids from the mouth to the throat and esophagus. In esophageal dsyphagia the esophagus becomes scarred and narrowed—this is called a stricture—and food has difficulty passing through the stricture. [Symptoms include: pain while swallowing, inability to swallow, drooling, regurgitation, heartburn, unexpected weight loss, coughing or gagging when swallowing...] Dysphagia can take the joy out of eating and drinking and can lead to more severe complications such as malnutrition, weight-loss, and dehydration. In addition, patients who aspirate liquids or solids (breathe them into the airway while swallowing) can develop respiratory problems such as pneumonia, bronchitis, or other upper respiratory infections." (Radiation Induced Dysphagia, Columbia University Medical Center Health Library)
The new paper on the salivary gland discovery concludes, "Sparing these glands in patients receiving RT may provide an opportunity to improve their quality of life."
What the actual fuck. We're still discovering organs?!
posted by medusa at 6:59 PM on October 20, 2020 [18 favorites]
posted by medusa at 6:59 PM on October 20, 2020 [18 favorites]
Cool, but I was hoping for something that could do mind-melds.
posted by Halloween Jack at 7:21 PM on October 20, 2020 [5 favorites]
posted by Halloween Jack at 7:21 PM on October 20, 2020 [5 favorites]
My take on this is that when you open people up, it's not all nicely color-coded like in textbooks, it's just a lot of meat and lumps that you have to learn to differentiate. If something is small and tucked away, yeah, I see how it could have gone unlabeled.
This attitude helps me when I have to ask a dr. "Why is this weird thing happening?" and they have to shrug.
posted by emjaybee at 7:25 PM on October 20, 2020 [4 favorites]
This attitude helps me when I have to ask a dr. "Why is this weird thing happening?" and they have to shrug.
posted by emjaybee at 7:25 PM on October 20, 2020 [4 favorites]
Oh yes, we're still finding them. We're not even 100% sure about some of them we suspect might exist. Like, at this point I think the consensus is pretty strong that humans don't have a vomeronasal organ (aka the accessory olfactory organ, what a lot of mammals use to sense pheromones), but at least as of a few years ago there was some argument there might be a vestigial one. Anatomy isn't easy.
posted by biogeo at 7:31 PM on October 20, 2020 [5 favorites]
posted by biogeo at 7:31 PM on October 20, 2020 [5 favorites]
What the actual fuck. We're still discovering organs?!
Shh, don't tell Barry
We'll see ourselves out
posted by Thella at 7:31 PM on October 20, 2020 [3 favorites]
Shh, don't tell Barry
We'll see ourselves out
posted by Thella at 7:31 PM on October 20, 2020 [3 favorites]
metafilter: it's not all nicely color-coded like in textbooks, it's just a lot of meat and lumps that you have to learn to differentiate
posted by lalochezia at 7:55 PM on October 20, 2020 [13 favorites]
posted by lalochezia at 7:55 PM on October 20, 2020 [13 favorites]
MeatFilter: it's just a lot of meat and lumps that you have to learn to differentiate
posted by oulipian at 7:55 PM on October 20, 2020 [7 favorites]
posted by oulipian at 7:55 PM on October 20, 2020 [7 favorites]
Yes, I absolutely believe in science and definitely believe there is stuff that humanity at large and me (very extremely) specifically doesn't know yet about the human body.
But, honestly, this all sounds like something an alien race of parasites that have recently colonized all our throats might write to throw us off the scent.
posted by MCMikeNamara at 8:14 PM on October 20, 2020 [4 favorites]
But, honestly, this all sounds like something an alien race of parasites that have recently colonized all our throats might write to throw us off the scent.
posted by MCMikeNamara at 8:14 PM on October 20, 2020 [4 favorites]
Metafilter: it's just a lot of meat and lumps
posted by biogeo at 8:18 PM on October 20, 2020 [2 favorites]
posted by biogeo at 8:18 PM on October 20, 2020 [2 favorites]
. . . vomeronasal organ . . .
I came here wondering if that’s actually what we found.
posted by [insert clever name here] at 8:23 PM on October 20, 2020 [3 favorites]
I came here wondering if that’s actually what we found.
posted by [insert clever name here] at 8:23 PM on October 20, 2020 [3 favorites]
Oh yes, we're still finding them. We're not even 100% sure about some of them we suspect might exist. Like, at this point I think the consensus is pretty strong that humans don't have a vomeronasal organ (aka the accessory olfactory organ, what a lot of mammals use to sense pheromones), but at least as of a few years ago there was some argument there might be a vestigial one. Anatomy isn't easy.
That's extremely interesting, biogeo.
This article from 2016 might be a part of the argument a few years ago you allude to, though I've been hearing about erectile tissue in the nose for decades now, and I seem to recall that one of Freud's crankier associates (or so I've thought) Fliess, went on at length about the importance of the nasogenital connection, and killed one of Freud's longest-term patients Emma Eckstein with a botched operation on her nose to cure neurosis:
posted by jamjam at 8:31 PM on October 20, 2020 [2 favorites]
That's extremely interesting, biogeo.
This article from 2016 might be a part of the argument a few years ago you allude to, though I've been hearing about erectile tissue in the nose for decades now, and I seem to recall that one of Freud's crankier associates (or so I've thought) Fliess, went on at length about the importance of the nasogenital connection, and killed one of Freud's longest-term patients Emma Eckstein with a botched operation on her nose to cure neurosis:
Swelling of Erectile Nasal Tissue Induced by Human PheromonesThe parts of this article I can access don't use the term 'vomeronasal', but I'd think people who have the erectile response which was the subject of the study would have the organ if anybody would, and if it's a retained ancestral (plesiomorphic) trait, perhaps it's found relatively infrequently.
Most chemically mediated sexual communication in humans remains uncharacterized. Yet the study of sexual communication is decisive for understanding sexual behavior and evolutive mechanisms in our species. Here we provide the evidence to consider 4,16-androstadien-3-one (AND) as a man's sexual pheromone. Our experiment provides support for the physiological effect of AND on nasal airway resistance (Rna) in women, as assessed by anterior rhinomanometry. We found that AND administration increased the area of turbinate during the ovulatory phase, resulting in an increase of Rna. Thus, we discovered that minute amounts of AND, acting through neuroendocrine brain control, regulate Rna and consequently affect the sexual physiology and behavior. Fascinatingly, this finding provides the evidence of the preservation of chemosexual communication in humans, which it has been largely neglected due to its unconscious perception and concealed nature. Therefore, chemical communication is a plesiomorphic evolutive phenomenon in humans.
posted by jamjam at 8:31 PM on October 20, 2020 [2 favorites]
One time I met someone who was super freaked out and thought something was wrong that her dog tasted other dogs' urine, and I got to be all "It's cool, that's how dogs use their vomeronasal organs to decide when it's sexytimes" and she was all amazed and I got to be a hero. At least in my mind.
posted by medusa at 8:32 PM on October 20, 2020 [3 favorites]
posted by medusa at 8:32 PM on October 20, 2020 [3 favorites]
What the actual fuck. We're still discovering organs?!
Yep. And in the last few years, we've found several, including:
-the brain's lymph node system, hidden like a thin membrane on the inside of the skull.
-that our 'connective tissue' that holds our muscle groups together and our organs in place is actually all connected together. (If you cook chicken and remove the skin, and then there's another thin, white membrane underneath, that's connective tissue.)(The crazy part, to me, is not just that it's a new organ, but also, one of the biggest.)
-the contents of the alimentary tract, ie your food and poop. (There's currently a big push to have it defined as an organ, because even though it's constantly changing, it's always there, and affects so much of our functioning.)
Also, it's been recently discovered that our cells, um, fuck. They extend tubules (or microtubules) into each other to exchange organelles (mitochondria, for example). This is apparently the main way our immune cells exchange antibody recipes...when an immune cell encounters a new pathogen and defeats it, it immediately goes and clumps together with other immune cells, they poke each other, and then the other cells go pathogen hunting.
posted by sexyrobot at 8:40 PM on October 20, 2020 [31 favorites]
Yep. And in the last few years, we've found several, including:
-the brain's lymph node system, hidden like a thin membrane on the inside of the skull.
-that our 'connective tissue' that holds our muscle groups together and our organs in place is actually all connected together. (If you cook chicken and remove the skin, and then there's another thin, white membrane underneath, that's connective tissue.)(The crazy part, to me, is not just that it's a new organ, but also, one of the biggest.)
-the contents of the alimentary tract, ie your food and poop. (There's currently a big push to have it defined as an organ, because even though it's constantly changing, it's always there, and affects so much of our functioning.)
Also, it's been recently discovered that our cells, um, fuck. They extend tubules (or microtubules) into each other to exchange organelles (mitochondria, for example). This is apparently the main way our immune cells exchange antibody recipes...when an immune cell encounters a new pathogen and defeats it, it immediately goes and clumps together with other immune cells, they poke each other, and then the other cells go pathogen hunting.
posted by sexyrobot at 8:40 PM on October 20, 2020 [31 favorites]
jamjam, I think that's right, the whole discussion about whether or not humans have true pheromones is definitely tied up with whether there's a VNO or a VNO-like organ. I think the consensus is that whatever pheromone activity is present in humans (the nature of which is still debated) is almost certainly handled entirely by the main olfactory epithelium, and the suggestion that there may be a functional VNO in humans is a minority viewpoint, but this is outside my area of expertise. The nerve associated with the VNO, cranial nerve zero, does seem to be generally present in humans, but this could be a developmental constraint and its function isn't clear. Interestingly, Wikipedia flatly asserts that the human VNO is present but vestigial, but does cite some interesting references from recent years.
posted by biogeo at 10:07 PM on October 20, 2020 [2 favorites]
posted by biogeo at 10:07 PM on October 20, 2020 [2 favorites]
That was incredible. No fur, claws, horns, antlers or nothin'... Just meat and lumps.
posted by Cardinal Fang at 11:32 PM on October 20, 2020 [2 favorites]
posted by Cardinal Fang at 11:32 PM on October 20, 2020 [2 favorites]
I seem to recall an article a few years back that a new tendon or ligament had been discovered in the knee, as well.
It amazed me then to think that the knee, of all parts of the body, still had new anatomy waiting to be discovered.
Ah yes, here it is. Known already, I guess, but only recently classified.
It amazed me then to think that the knee, of all parts of the body, still had new anatomy waiting to be discovered.
Ah yes, here it is. Known already, I guess, but only recently classified.
Four main ligaments - or thick fibrous bands - surround the knee joint, criss-crossing between the upper and lower leg bones to provide stability and prevent excessive movement of our limbs.posted by darkstar at 1:30 AM on October 21, 2020 [3 favorites]
But the anatomy of the knee remains complex, and several international groups have been exploring the less-defined structures of the joint for some time.
The notion of this particular ligament was first made by French surgeon Paul Segond in 1879 but it has evaded definitive surgical classification for many years.
lurking in the nook where the nasal cavity meets the throat
....I wonder....I have always had a super-strong gag reflex, that seems especially sensitive when it's the cold/flu season or when my allergies act up and I get post-nasal drip. Would these things be involved in some way maybe?
posted by EmpressCallipygos at 3:51 AM on October 21, 2020
....I wonder....I have always had a super-strong gag reflex, that seems especially sensitive when it's the cold/flu season or when my allergies act up and I get post-nasal drip. Would these things be involved in some way maybe?
posted by EmpressCallipygos at 3:51 AM on October 21, 2020
~lurking in the nook where the nasal cavity meets the throat
~I wonder....I have always had a super-strong gag reflex, that seems especially sensitive when it's the cold/flu season or when my allergies act up and I get post-nasal drip. Would these things be involved in some way maybe?
I have almost constant, heavy drainage down the back of my throat that no one can figure out where it's coming from. It's kind of debilitating. To say that this new organ discovery made me sit-up and take notice is an understatement.
posted by Thorzdad at 5:06 AM on October 21, 2020 [6 favorites]
~I wonder....I have always had a super-strong gag reflex, that seems especially sensitive when it's the cold/flu season or when my allergies act up and I get post-nasal drip. Would these things be involved in some way maybe?
I have almost constant, heavy drainage down the back of my throat that no one can figure out where it's coming from. It's kind of debilitating. To say that this new organ discovery made me sit-up and take notice is an understatement.
posted by Thorzdad at 5:06 AM on October 21, 2020 [6 favorites]
Metafilter: It's just a lot
posted by nebulawindphone at 5:43 AM on October 21, 2020 [5 favorites]
posted by nebulawindphone at 5:43 AM on October 21, 2020 [5 favorites]
MetaFilter: It's...
posted by Naberius at 6:10 AM on October 21, 2020 [2 favorites]
posted by Naberius at 6:10 AM on October 21, 2020 [2 favorites]
it immediately goes and clumps together with other immune cells, they poke each other
Yeah, like a sexyrobot wouldn't see it that way
posted by glasseyes at 6:25 AM on October 21, 2020 [3 favorites]
Yeah, like a sexyrobot wouldn't see it that way
posted by glasseyes at 6:25 AM on October 21, 2020 [3 favorites]
> EmpressCallipygos:
"lurking in the nook where the nasal cavity meets the throat
....I wonder....I have always had a super-strong gag reflex, that seems especially sensitive when it's the cold/flu season or when my allergies act up and I get post-nasal drip. Would these things be involved in some way maybe?"
every once in a while I get a weird clicking-type noise/feeling that seems to be coming from this area, almost like something is dripping or bubbling. i bet that's connected some how?
posted by ArgentCorvid at 7:33 AM on October 21, 2020
"lurking in the nook where the nasal cavity meets the throat
....I wonder....I have always had a super-strong gag reflex, that seems especially sensitive when it's the cold/flu season or when my allergies act up and I get post-nasal drip. Would these things be involved in some way maybe?"
every once in a while I get a weird clicking-type noise/feeling that seems to be coming from this area, almost like something is dripping or bubbling. i bet that's connected some how?
posted by ArgentCorvid at 7:33 AM on October 21, 2020
Thorzdad - me too, drip, me too, reaction to the news. And once again I’ll have to bring it up to my doctor.
posted by njohnson23 at 8:26 AM on October 21, 2020 [1 favorite]
posted by njohnson23 at 8:26 AM on October 21, 2020 [1 favorite]
This might be the single most interesting thing i've read on MeFi. I'm a dentist and a survivor of throat cancer. I've had radiation to that exact area, had xerostomia as described in the abstract, and i've counseled dozens of patients over the years on the effects of radiation therapy to the mandible, throat, nasopharynx. Way back in dental school we did those dissections, but never imagined a 3cm by 3cm by 3cm (that's huge) glandular organ in that area. absolutely fascinating stuff, with interesting ramifications for targeted radiation therapy going forward.
posted by OHenryPacey at 8:28 AM on October 21, 2020 [9 favorites]
posted by OHenryPacey at 8:28 AM on October 21, 2020 [9 favorites]
I stumbled upon an anatomy video within the time of Pandemic Boredom that went back and forth between a cadaver and the illustration of nerves it was trying to show; and while I know our bodies aren’t color coded; I was genuinely surprised at the difficulty for me as a lay person differentiating tissues. I have no idea how the instructor in the video was able to identify nerve from the rest of the tissue- he was able to do quickly and with ease but it really did look all the same to me.
So I’m absolutely not surprised we haven’t identified everything. Some parts are obviously different, but some not.
(I also just freaked myself out at the idea when I’m eating chicken quarters (thigh and leg), I don’t know how much nerve I’m eating. Like I don’t have a reason to care, and I don’t know what or where the neuromuscular junctions are so maybe not much but also *shudders*)
posted by [insert clever name here] at 9:51 AM on October 21, 2020 [1 favorite]
So I’m absolutely not surprised we haven’t identified everything. Some parts are obviously different, but some not.
(I also just freaked myself out at the idea when I’m eating chicken quarters (thigh and leg), I don’t know how much nerve I’m eating. Like I don’t have a reason to care, and I don’t know what or where the neuromuscular junctions are so maybe not much but also *shudders*)
posted by [insert clever name here] at 9:51 AM on October 21, 2020 [1 favorite]
metafilter: lumps
posted by Marticus at 3:49 PM on October 22, 2020 [1 favorite]
posted by Marticus at 3:49 PM on October 22, 2020 [1 favorite]
In Scientists Discover New Human Salivary Glands (TheScientist, Oct. 21, 2020), debate: Vincent Vander Poorten, an otorhinolaryngologist at University Hospital Leuven (UZ Leuven) in Belgium who was not involved in this study but has collaborated with the authors on other projects, says that while he agrees that the authors have found a new cluster of minor glands, whether the tubarial gland is truly a separate, major gland is somewhat controversial. “Of course, you could say that it’s just a cluster of minor salivary glands that are all over the place in the mucous membranes of the head and neck.”
posted by Iris Gambol at 3:59 PM on October 22, 2020
posted by Iris Gambol at 3:59 PM on October 22, 2020
Is there an agreed-on definition for "gland"? Or is this going to be an "Oh crap I guess we need to draw an arbitrary line now" situation?
posted by nebulawindphone at 6:56 PM on October 22, 2020 [1 favorite]
posted by nebulawindphone at 6:56 PM on October 22, 2020 [1 favorite]
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posted by Iris Gambol at 6:35 PM on October 20, 2020 [3 favorites]