Classification and management of chronic sialadenitis of the parotid gland

Abstract

Saliva has numerous oral functions and multiple functions in relation to digestion in the upper gastrointestinal tract. Chronic salivary hypofunction can lead to severe adverse health outcomes. Chronic sialadenitis is one of the major conditions that can cause salivary hypofunction. A correct diagnosis and management of chronic sialadenitis is essential for the recovery of salivary hypofunction. Chronic sialadenitis of the parotid gland is often seen in the clinic, sometimes also referred to as recurrent pyogenic parotitis, recurrent parotitis, non-obstructive parotitis, sialadenitis or obstructive parotitis, among other terms. The literature describes several different classifications and denominations for chronic sialadenitis of the parotid gland. These various classifications and denominations complicate the definition and diagnostic criteria, and if chronic sialadenitis of the parotid gland can develop into Sjogren's syndrome remains unclear. Treatment of this condition is also a challenging problem. Here, we review the presented classification and denomination of chronic sialadenitis of the parotid gland, proposing a classification based on the disease entities identified in a long-term follow-up investigation, and discuss the treatment principles for the condition.

Sialendoscopy-Assisted Treatment for Radioiodine-Induced Sialadenitis

“…[14][15][16] The management of such cases requires removal of the obstruction. 16,17 Endoscopy-assisted dilation and irrigation of the ducts are commonly used for nonstone causes, whereas sialo-lithotripsy is applied in cases of stones. In cases of radioiodine-induced sialadenitis, sialography depicted stenosis in the main duct and irregular expansion in the bifurcating ducts.…”

“…However, the stent could prevent the stenosis caused by edema. 17,18 The hollow stent allowed saliva to flow out concurrently. The stent was usually removed 2 weeks after the operation.…”

Endoscopic-Assisted Gland-Preserving Therapy for Chronic Sialadenitis<subtitle>A German and US Comparison</subtitle>

“…Only 5 of 19 patients (26.3%) in the US database with multigland involvement met the serologic and pathologic criteria for Sjö gren syndrome. A previous long-term follow-up study 12 in Beijing, China, among patients with chronic sialadenitis of the parotid gland found that 12 of 22 patients (54.5%) in whom Sjö gren syndrome was ruled out at initial presentation went on to develop the disorder after a mean follow-up time of 5.2 years. Seronegative patients with chronic sialadenitis are likely being referred for salivary endoscopy in the United States because of lack of other viable diagnostic and therapeutic alternatives.…”

Effect of Parotid Gland Massage on Parotid Gland Tc-99m pertechnetate Uptake

“…Of the salivary glands, the parotid gland (PG) most frequently produces symptoms after 131 I therapy, and is known to be more radiosensitive than the submandibular salivary gland (10). External massage of the PG is presumed to be helpful in preventing parotid dysfunction after 131 I therapy (3,(11)(12)(13), because it is believed to ''milk out'' accumulated 131 I into the oral cavity, and thus, reduce radiation risks. However, no evidence has been presented that the massage of the PG actually reduces radioisotope accumulation in the PG.…”