Eosinophilic Sialodochitis: A Review of the Literature

Eosinophilic sialodochitis is an uncommon, chronic inflammatory disorder of the major salivary glands characterized by intermittent pain, swelling, and mucous plugging containing eosinophils. Despite increasing reports, optimal diagnostic criteria and management remain unclear.

PubMed, ScienceDirect, Google Scholar, and Ovid databases were searched to August 2025. Data were collected from eligible studies published after 2000 in English, noting that some significant reviews also summarize the Japanese literature.

Twenty-four studies (n = 309 patients) were included. The mean age was 39 years, with a male: female ratio of 1:2.5. The parotid gland was most often affected (50.8%), with bilateral involvement in 43.4% of cases. Most patients (87.4%) had atopy, particularly allergic rhinitis (75.4%). Swelling (94.5%), mucous plugs (46.0%), and pain (24.6%) were the most common symptoms. IgE was elevated in 66.3%, peripheral eosinophilia in 36.0%, and both in 6.5%. Imaging revealed ductal ectasia and stenosis, while histopathology demonstrated periductal fibrosis and eosinophilic infiltration. Endoscopy-assisted ductal irrigation and dilation were the most effective treatments, followed by conservative surgical excision. Medical treatments such as antihistamines, corticosteroids, and leukotriene receptor antagonists achieved variable treatment success.

Future multicenter studies may eventually establish a definitive diagnostic algorithm based on combinations of clinical findings, IgE/eosinophils, and imaging.