Efficacy of Sialendoscopy with Steroid Irrigation for Non-Lithiasic Chronic Sialadenitis: A Systematic Review and...

Objective: 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. Methods: 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. Results: 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%. Conclusions: 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.