Objectives To assess the effect of sialendoscopy of the major salivary glands on salivary flow and xerostomia in patients with Sjögren’s syndrome (SS).
Methods Forty-nine patients with SS were randomly assigned to a control group (n=15) and two intervention groups: irrigation of the major glands with saline (n=16) or with saline followed by triamcinolone acetonide (TA) in saline (n=18). Unstimulated whole saliva flow (UWS), chewing-stimulated whole saliva flow (SWS), citric acid-stimulated parotid flow (SPF), Clinical Oral Dryness Score (CODS), Xerostomia Inventory (XI) score and the European League Against Rheumatism (EULAR) SS Patient-Reported Index (ESSPRI) were obtained 1 week (T0) before, and 1 (T1), 8 (T8), 16 (T16) and 24 (T24) weeks after sialendoscopy.
Results Median baseline UWS, SWS and SPF scores were 0.14, 0.46 and 0.22 mL/min, respectively. After intervention, significant increases in UWS and SWS were observed in the saline group (at T8 (P=0.013) and T24 (P=0.004)) and the saline/TA group (at T24 (P=0.03) and T=16 (P=0.035)). SPF was increased significantly in the saline/TA group at T24 (P=0.03). XI scores declined after sialendoscopy in both intervention groups. Compared with the control group, CODS, XI and ESSPRI improved in the intervention groups. UWS, SWS and SPF were higher in the intervention groups compared with the control group, but these differences were not significant except for SPF in the saline/TA group at T24 (P=0.005).
Conclusions Irrigation of the major salivary glands in patients with SS enhances salivary flow and reduces xerostomia up to 6 months after sialendoscopy.
- Sjøgren’s syndrome
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Handling editor Josef S Smolen
Contributors KHK conceived the project, contributed to the study design, analysed and interpreted data, drafted the article and approved the final version for submission; AV interpreted the data, critically revised the article and approved the final version for submission; TF conceived the project, contributed to the study design, critically revised the article and approved the final version for submission; HSB contributed to the study design, critically revised the article and approved the final version for submission; FM collected data, critically revised the article and approved the final version for submission; DHJJ conceived and oversaw the project, contributed to the study design, analysed and interpreted data, drafted the article and approved the final version for submission.
Funding The work done in this manuscript is entirely funded by the author’s institutions. The authors did not receive any specific grant for this study from funding agencies in the public, commercial or not-for profit sectors.
Competing interests None declared.
Patient consent Obtained.
Ethics approval The study was conducted in accordance with the ethical principles of the Declaration of Helsinki, International Council for Harmonisation on Good Clinical Practice and the applicable country-specific regulatory requirements. The VU University Medical Center Research Ethics Board (#NL44018.029.13) approved the study.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement All data are deposited in the Dryad repository: https://doi.org/10.5061/dryad.r7m1n.