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

Objectives: To verify the role of interventional sialendoscopy and steroidal ductal irrigation in patients with recurrent sialadenitis. Design: A prospective, cross-sectional pilot study. Setting: University of Milan. Participants: Fifty-four patients with sine causa recurrent sialadenitis who underwent interventional sialendoscopy (group A, 36 patients) or interventional sialendoscopy followed by a intraductal steroidal irrigations (group B, 18 patients). Main outcomes measures: The number of episodes of sialadenitis three and 6 months before and after sialendoscopy, and their severity assessed by means of a 0-10 pain visual analogue scale. Results: In the population as a whole, a significant posttreatment reduction in the number of episodes of 30.7 +/- 5.5 after 3 months and 34.6 +/- 10.2 after 6 months (P < 0.001) and a significant reduction in pain visual analogue scale values of 4.7 +/- 0.4 after 6 months (P < 0.001) occurred. There was a statistically significant reduction in both parameters at the same time points in both treatment groups (P = 0.001), with no significant between-group difference in pain visual analogue scale values, an albeit non-significant trend in favour of group B in terms of the number of episodes 3 months after therapy that became significant after 6 months (11.0 +/- 9.9 versus 20.5 +/- 9.5; P = 0.05). Conclusions: 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.