The role of interventional sialendoscopy and intraductal steroid therapy in patients with recurrent sine causa sialadenitis: a prospective cross‐sectional study

Abstract

Interventional sialendoscopy is effective for the treatment of recurrent sialadenitis; the addition of intraductal steroidal irrigations seems to increase its value in the medium term. Further studies of larger case series with longer follow-up are needed to establish the possibly primary role of steroid therapy in blocking inflammation.

The Positive Effect of Sialendoscopy with Irrigation Lavage for Sialadenitis without Sialolithiasis or Stenosis

“…Hence, the type of irrigation and the content of the solution probably only play a minor role. Generally speaking, the use of corticosteroid solution seems to be beneficial for chronic infection of a salivary gland and there are no relevant side effects [2]. Sialendoscopy is considered to be a relevant diagnostic and therapeutic tool in most kinds of intermittent salivary gland swellings, and not only in cases of sialolithiasis or salivary duct stenosis [2,13].…”

“…Generally speaking, the use of corticosteroid solution seems to be beneficial for chronic infection of a salivary gland and there are no relevant side effects [2]. Sialendoscopy is considered to be a relevant diagnostic and therapeutic tool in most kinds of intermittent salivary gland swellings, and not only in cases of sialolithiasis or salivary duct stenosis [2,13]. In our opinion, sialendoscopy may be recommended for any case of recurrent and impairing gland swelling and inflammation, even without signs of sialolithiasis, also when considering the small complication rate to be expected intra-or postoperatively [17].…”

“…Compared to other studies [2,13] we were able to include more patients (n = 94) and had a longer follow-up with 11.6 months (1-24 months). Still, given the small measurement scale, and the relatively low patient numbers after allocating them to 3 treatment groups, a type II error (i.e., a true difference between the interventions is obscured) cannot be ruled out completely.…”

“…Sialodochitis is characterized by an inflammation of the intraglandular duct system, with or without evidence of sialolithiasis or duct stenosis, and is diagnosed in 8-31% of sialendoscopies performed [1][2][3]. Patients are typically confronted with recurrent or persisting swelling of the affected gland, sometimes associated with intermittent pain.…”

“…In cases of sialodochitis, the irrigation with saline solution during the endoscopic procedure has already been shown to improve treatment success [11]. Moreover, irrigation with corticosteroids has been shown to reduce symptoms and relieve pain [1][2][3]. However, up to now, it is unclear whether the use of corticosteroids has a beneficial effect over irrigation with normal saline when dealing with sialodochitis.…”