Integrated therapy of intraductal irrigations and sialoendoscopies of salivary glands to improve mouth dryness

Abstract

ObjectiveTo assess the combination of salivary gland intraductal irrigations (IG) followed by sialoendoscopy irrigations (SI) of the parotid gland on the improvement of salivary gland secretory dysfunction (SGSD).MethodsWe retrospectively analyzed the records of SGSD patients who underwent major salivary gland IG followed by SI during 2014–2020. Records included demographics, systemic background, signs, and symptoms. Improvement was assessed by comparing the mean unstimulated and stimulated whole salivary flow rate (UWSF, SWSF) from the baseline point (before IG procedure) to the last point (after SI) using repeated measures. The between‐subjects effects of various factors and covariants were analyzed using repeated measures ANCOVA.ResultsOne hundred patients were included with an age range of 15–83 years (mean age of 60.1 ± 13.1 years). Improvement was detected on UWSF measurements (p = 0.031, F = 3.83), but not on SWSF measurements (p = 0.165, F = 1.85). The between‐subjects effects on UWSF measurements were statistically significant for sex (p = 0.003, F = 9.526) and salivary gland manipulators use (p < 0.001, F = 15.107) and for the interaction between sex and salivary gland manipulators use (p‐ = 0.002, F = 9.709). Results of long‐term follow‐up for 10.87 ± 11.79 months after the SI procedure demonstrated sustained improvement in UWSF measurements (p = 0.011, F = 4.91).ConclusionsThe combination of IG followed by SI increases UWSF salivary secretion in SGSD patients for a relatively extended duration.

Efficacy of Office-Based Salivary Ductal Steroid Irrigation for Managing Post-Irradiation Xerostomia in Head and Neck Cancer Patients: A Retrospective Study

“…Increased oral wetness may further enhance compliance with further treatments and overall quality of life. In addition, no obvious predictors or indicators were identified relating to the treatment responsiveness from either our study or the previous literature [25,26], which implies that salivary ductal irrigation therapy may have the potential to prevent wide populations being afflicted with xerostomia or repeated salivary glandular swelling, and the success rate is irrelevant to their underlying illness.…”

“…Our findings are in line with several previous studies. Aframian et al [25] analyzed one hundred patients suffering from salivary gland secretory dysfunction (including eight patients status post receiving head and neck irradiation and nineteen patients with radioiodine-related sialadenitis) and revealed improvement in unstimulated whole salivary flow (UWSF) after series of intraductal irrigation followed with sialendoscopy irrigations. The average number of times that irrigation therapy was carried out through the ordinary ductal or sialendoscopic route in their study were 6.87 ± 4.67 and 5.35 ± 3.20 times, respectively.…”

Intraoperative Visualization and Treatment of Salivary Gland Dysfunction in Sjögren’s Syndrome Patients Using Contrast-Enhanced Ultrasound Sialendoscopy (CEUSS)

“…It is suggested that exposure of salivary glands to stress results in the propagation of salivary gland stem cell capabilities due to cellular plasticity in the glands’ parenchyma. This could promote salivary gland repair [ 16 , 17 ]. Future (animal) studies should explore the effect of sialendoscopy on the ductal and acinar compartments to reveal the mechanism that accounts for this finding.…”

“…This minimally invasive technique allows the dilatation of ductal strictures and removal of ductal debris. We, and other groups, showed that this approach alleviated some of the oral symptoms of patients suffering from SS and partially restored glandular function (i.e., saliva flow rate) [14][15][16][17][18][19]. Although sialendoscopy in SS patients has shown promising results, there are several limitations in the current approach.…”