Bringing back the flow Efficacy of sialendoscopy in Sjögren's disease patients

Sjögren’s disease (SjD) is a chronic autoimmune disorder characterized by progressive salivary gland dysfunction, leading to hyposalivation and severe xerostomia with a major negative impact on oral health and quality of life. Effective treatments aimed at restoring salivary gland function are limited. This thesis investigates the efficacy, safety, and clinical applicability of sialendoscopy as a minimally invasive treatment modality for salivary gland dysfunction in patients with SjD.
The first part of this thesis evaluates the short- and long-term effects of sialendoscopy with intraductal saline irrigation, with or without corticosteroids, on salivary flow rates, saliva composition, and patient-reported oral dryness. Randomized controlled studies demonstrate that sialendoscopy significantly improves unstimulated and stimulated salivary flow, reduces xerostomia, and improves patient-reported outcomes up to 24 and 60 weeks after treatment, particularly in patients with residual glandular function.
The second part focuses on the safety of sialendoscopy in SjD patients. A retrospective analysis shows that the procedure is associated with a low rate of predominantly minor complications, with most technical difficulties occurring in the submandibular glands.
The final part explores contrast-enhanced ultrasound sialendoscopy (CEUSS) using sulfur hexafluoride microbubbles to improve intraoperative visualization of salivary gland perfusion and treatment efficacy. The results demonstrate that CEUSS is feasible and safe, offering promising opportunities for optimizing sialendoscopic treatment.
Sialendoscopy is a safe and effective gland-preserving treatment that can improve salivary gland function and reduce xerostomia in selected patients with Sjögren’s disease.