Introduction/Objectives Sjögren’s disease (SjD) and non-Sjögren sicca syndrome are characterized by salivary gland dysfunction leading to chronic xerostomia. Obstructive ductal pathology, including strictures and mucous plugs, plays a significant role in secretory impairment. This study aimed to evaluate the effectiveness and safety of parotid gland irrigation with corticosteroids, associated with sialendoscopy, in improving clinical oral dryness in patients with suspected SjD or sicca syndrome. Methods This was a retrospective longitudinal study of 17 patients (13 analyzed; mean age 67.3 ± 9.9 years; 9 with SjD) treated between January 2020 and January 2022 at a multidisciplinary SjD clinic. Patients underwent sialendoscopy and intraductal prednisolone irrigation (2 mg/ml), with an average of 5.2 ± 2.5 procedures per patient. Outcomes included Clinical Oral Dryness Score (CODS), Xerostomia Inventory (XI), and treatment tolerability (VAS). Paired t-tests and Pearson correlations were used. Results Significant improvement was observed in both CODS (mean reduction: 1.15 ± 0.32; p = 0.002) and XI (5.62 ± 2.16; p = 0.012). More severe baseline xerostomia was associated with greater improvement in CODS (r = − 0.641; p = 0.009) and XI (r = − 0.598; p = 0.016). A higher number of irrigations correlated with greater XI improvement (r = − 0.525; p = 0.033). No adverse events were reported. Conclusions Corticosteroid irrigation combined with sialendoscopy significantly improved both objective and subjective xerostomia measures in SjD and sicca patients. This minimally invasive protocol appears safe, well tolerated, and particularly beneficial in patients with early or less fibrotic glandular involvement. Further prospective controlled studies are warranted to optimize treatment protocols and patient selection.<Table Float="No" ID="Taba"> <tgroup cols="2"> <colspec align="left" colname="c1" colnum="1" /> <colspec align="left" colname="c2" colnum="2" /> <tbody> <row> <entry align="left" nameend="c2" namest="c1"> Key Points • Corticosteroid irrigation combined with sialendoscopy significantly reduces xerostomia symptoms. • Greater baseline symptom burden predicts greater clinical response. • The procedure is safe and well tolerated, with no adverse events reported. • Findings support early intervention in patients with less advanced glandular damage. </entry> </row> </tbody> </tgroup> </Table>

Corticosteroid irrigation of parotid glands for oral dryness in Sjögren’s and non-Sjögren’s sicca disease: a longitudinal study

期刊论文
发表日期：

2025年10月16日

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Gonçalo Cunha Coutinho,
Vasco C. Romão,
José Cunha Coutinho,
Rita Simão,
Matilde Bandeira,
João Eurico Fonseca,
Francisco Salvado

摘要

Introduction/Objectives

Sjögren’s disease (SjD) and non-Sjögren sicca syndrome are characterized by salivary gland dysfunction leading to chronic xerostomia. Obstructive ductal pathology, including strictures and mucous plugs, plays a significant role in secretory impairment. This study aimed to evaluate the effectiveness and safety of parotid gland irrigation with corticosteroids, associated with sialendoscopy, in improving clinical oral dryness in patients with suspected SjD or sicca syndrome.

Methods

This was a retrospective longitudinal study of 17 patients (13 analyzed; mean age 67.3 ± 9.9 years; 9 with SjD) treated between January 2020 and January 2022 at a multidisciplinary SjD clinic. Patients underwent sialendoscopy and intraductal prednisolone irrigation (2 mg/ml), with an average of 5.2 ± 2.5 procedures per patient. Outcomes included Clinical Oral Dryness Score (CODS), Xerostomia Inventory (XI), and treatment tolerability (VAS). Paired t-tests and Pearson correlations were used.

Results

Significant improvement was observed in both CODS (mean reduction: 1.15 ± 0.32; p = 0.002) and XI (5.62 ± 2.16; p = 0.012). More severe baseline xerostomia was associated with greater improvement in CODS (r = − 0.641; p = 0.009) and XI (r = − 0.598; p = 0.016). A higher number of irrigations correlated with greater XI improvement (r = − 0.525; p = 0.033). No adverse events were reported.

Conclusions

Corticosteroid irrigation combined with sialendoscopy significantly improved both objective and subjective xerostomia measures in SjD and sicca patients. This minimally invasive protocol appears safe, well tolerated, and particularly beneficial in patients with early or less fibrotic glandular involvement. Further prospective controlled studies are warranted to optimize treatment protocols and patient selection.

Key Points

• Corticosteroid irrigation combined with sialendoscopy significantly reduces xerostomia symptoms.

• Greater baseline symptom burden predicts greater clinical response.

• The procedure is safe and well tolerated, with no adverse events reported.

• Findings support early intervention in patients with less advanced glandular damage.