Tsikopoulos Alexios, Garefis Konstantinos, Sidiropoulos Konstantinos, Triaridis Stefanos, Nikolaidis Vasileios, Konstantinidis Iordanis
School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
2nd Academic ORL, Head and Neck Surgery Department, Aristotle University of Thessaloniki, Papageorgiou Hospital, 56403 Thessaloniki, Greece.
J Clin Med. 2025 Jul 23;14(15):5202. doi: 10.3390/jcm14155202.
Recent evidence has suggested that sialendoscopy should be the first-line treatment for chronic sialadenitis. This study aimed to assess the efficacy of steroid irrigation during sialendoscopy in non-lithiasic chronic sialadenitis. We conducted a systematic search of the databases of PubMed, Scopus, and Web of Science up to the 3rd of November 2024 for completed studies investigating the efficacy of steroid irrigation during sialendoscopy for chronic non-lithiasic sialadenitis. Primary outcomes were the number of patients with recurrence of sialadenitis symptoms and the number of patients who required a revision sialendoscopy. Secondary outcomes included the assessment of major complications of the procedure. Random-effect meta-analysis of proportion was conducted using Open Meta-Analyst software. Additionally, separate subgroup analyses linked to the underlying salivary gland disease were carried out. The quality of the included studies was evaluated utilizing the Moga tool and the ROBINS-I tool. Thirty studies qualified for inclusion in the present systematic review. The weighted pooled proportion of recurrence after sialendoscopy by patient was 27.49% (95% CI: 21.04-34.45), whereas the revision rate was 10.64% (95% CI: 7.74-13.93). In every subgroup, the proposed intervention exhibited adequate efficacy for the symptomatic relief of patients, with similar rates of revision and repetition. The rate of major complications per patient was 0.77%. This study demonstrates that interventional sialendoscopy with intraductal steroid irrigation may yield therapeutic benefit for patients with chronic non-lithiasic sialadenitis and could be considered a safe treatment.
近期证据表明，唾液腺内镜检查应作为慢性涎腺炎的一线治疗方法。本研究旨在评估唾液腺内镜检查期间类固醇冲洗治疗非结石性慢性涎腺炎的疗效。我们对截至2024年11月3日的PubMed、Scopus和Web of Science数据库进行了系统检索，以查找关于唾液腺内镜检查期间类固醇冲洗治疗慢性非结石性涎腺炎疗效的完整研究。主要结局是涎腺炎症状复发的患者数量以及需要进行唾液腺内镜复查的患者数量。次要结局包括对该手术主要并发症的评估。使用Open Meta-Analyst软件进行比例的随机效应荟萃分析。此外，还针对潜在的唾液腺疾病进行了单独的亚组分析。利用Moga工具和ROBINS-I工具评估纳入研究的质量。30项研究符合纳入本系统评价的条件。唾液腺内镜检查后患者复发的加权合并比例为27.49%（95%CI：21.04-34.45），而复查率为10.64%（95%CI：7.74-13.93）。在每个亚组中，所提议的干预措施对患者的症状缓解均显示出足够的疗效，复查和重复率相似。每位患者的主要并发症发生率为0.77%。本研究表明，导管内类固醇冲洗的介入性唾液腺内镜检查可能对慢性非结石性涎腺炎患者产生治疗益处，可被视为一种安全的治疗方法。
