Efficacy of glandular irrigation and sialendoscopy in salivary glands affected by Sjögren's syndrome

Sjögren’s syndrome is a progressive disease characterized by a gradual and irreversible decrease in both the quantity and quality of saliva that eventually leads to xerostomia. Hyposalivation can increase susceptibility to dental caries, dental erosion, fungal and bacterial infections, digestive disorders, loss of taste, and difficulty in swallowing, which reduces the quality of life in patients. To date, no ideal medications have been available to treat hyposalivation and xerostomia effectively, and consequently, there is still a need for development of therapeutic agents and strategies. Recently, ductal irrigation and sialendoscopy of the parotid and submandibular glands have gained popularity for its efficacy as palliative treatments. In glandular irrigation, Stensen’s ducts in the parotid glands and Wharton’s ducts in the submandibular glands are irrigated with, for example, saline or corticosteroids by using a cannula. In sialendoscopy, endoscopes that are small enough to be introduced into the salivary ducts of the major salivary glands are utilized. Through these endoscopes, the ducts can be irrigated under direct visualization, blockages can be removed, and strictures can be dilated. An overview of both techniques and their efficacy in relieving symptoms of xerostomia and hyposalivation in patients with Sjögren’s syndrome is presented.