Xerostomia and hyposalivation impair oral function and quality of life. Current therapies are largely palliative, and systemic sialogogues are often limited by side effects or contraindications. Intraductal salivary gland irrigation (IDSGI) has emerged as an alternative, being a minimally invasive outpatient technique aimed at relieving oral dryness by flushing and stimulation of the major salivary glands with saline or corticosteroid solutions. This technique has been described for various disorders of the salivary glands (e.g. Sjögren’s syndrome, sialadenitis), and substantial objective and subjective benefits following intraductal irrigation have been reported. The present article describes and critically appraises this technique by presenting three randomly chosen patient cases with documented hyposalivation and severe xerostomia. The patients were all treated by intraductal irrigation of their major salivary glands using sterile saline. Before and after therapy, unstimulated and stimulated whole-saliva flow rates, salivary pH, and subjective dryness using a visual analogue scale (VAS) were measured. The procedure was well tolerated with no complications by all three patients included. After one month, unstimulated and stimulated salivary flow rates increased in two cases and one patient previously treated with sialogogues showed no improvement in salivary flow rates. However, all three patients showed a decreased VAS for dryness by 30-50% with subjective improvement persisting also on later check-ups. The cases presented suggest that IDSGI represents a simple and safe outpatient procedure that can improve salivary flow and xerostomia as an adjunct to other conservative measures, particularly when systemically acting sialogogues are ineffective or contraindicated.

Thymic hyperplasia with lymphoepithelial sialadenitis-like features (TH-LESA) is a rare tumor-like condition of the thymic gland with less than 50 cases reported in the literature. Named after its resemblance to lymphoepithelial sialadenitis (LESA) of the salivary glands, TH-LESA is a distinct form of thymic hyperplasia characterized by simultaneous epithelial and lymphoid hyperplasia. Recently, TH-LESA has been linked with autoimmune diseases (AID) and a potential for developing thymic lymphoma. We report 21 additional cases of surgically resected TH-LESA in 15 women and 6 men (mean age 53 years, range 29-74); most cases were identified incidentally. Eleven (52%) patients were African American, 7 (33%) were white and 1 (5%) was Asian; race was unknown for 2 patients. Five (24%) patients had a history of non-myasthenic AID, including systemic lupus erythematosus, Sjögren syndrome, and rheumatoid arthritis. Two (9.5%) patients developed lymphoma within the hyperplastic process: 1 extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) and 1 nodular sclerosis Hodgkin lymphoma (NSHL). Clinical follow-up revealed that 11 patients were alive 3 to 240 months postoperatively and 1 patient had died of cardiac disease; follow-up was unavailable for 9 patients. In this largest single-institution series to date, we confirm the reported association of TH-LESA with AID and lymphoma. Recognition of NSHL developing in TH-LESA expands the spectrum of lymphomas reported in association with this condition. Furthermore, TH-LESA appears to preferentially affect African American women, unlike patients with salivary gland LESA, perhaps providing an epidemiologic clue to its pathogenesis.

Contrast-induced sialadenitis (CIS) is a rare, benign condition characterized by painless salivary gland swelling after iodinated contrast administration. A 60-year-old man developed bilateral neck swelling 14 hours post-contrast-enhanced computed tomography (CT). CIS was diagnosed based on characteristic ultrasonographic findings, namely, salivary gland enlargement with increased blood flow, which resolved spontaneously within three days. Despite corticosteroid premedication before a subsequent contrast-enhanced CT four months later, similar symptoms recurred. The effectiveness of corticosteroids in preventing CIS remains uncertain. This case highlights the potential for CIS recurrence and the need for further investigation to establish optimal management and preventive strategies.

Iodinated contrast media are essential diagnostic tools widely used in radiographic and computed tomography (CT) examinations, with millions of procedures performed annually. Although generally well tolerated, these agents can, rarely, cause adverse reactions, including hypersensitivity reactions, acute kidney injury, and contrast-induced sialadenitis (iodide mumps). Contrast-induced sialadenitis is an uncommon, benign reaction to iodinated contrast media that most frequently involves the parotid glands and is likely underrecognized. Submandibular gland involvement with associated cervical lymphadenopathy is particularly rare and may mimic infectious or obstructive salivary gland pathology. We report a case of a 64-year-old woman who developed acute bilateral submandibular swelling and pain three to four hours after iodinated contrast administration for a CT performed to evaluate acute abdominal pain. The patient had a history of similar, self-limited episodes following prior contrast exposure. Physical examination revealed diffuse submental and submandibular swelling with mild tenderness but no signs of infection or airway compromise. Ultrasound demonstrated bilateral submandibular gland enlargement with heterogeneous echotexture, increased vascularity, and reactive cervical lymphadenopathy. Based on the temporal relationship to contrast exposure, prior similar episodes, absence of infectious features, and supportive imaging findings, a diagnosis of contrast-induced submandibular sialadenitis was made. Symptoms improved rapidly with conservative management and resolved within two days. This case highlights the importance of recognizing contrast-induced submandibular sialadenitis as a rare but benign and self-limiting condition. Awareness of this entity can help clinicians avoid unnecessary antibiotics, corticosteroids, and extensive diagnostic workup. Proper recognition and documentation are also important for counseling patients about future contrast exposure and considering alternative imaging modalities when appropriate.

Primary Sjögren's syndrome (pSS) is a systemic autoimmune disease characterized by lymphocytic infiltration and progressive dysfunction of exocrine glands, leading to xerostomia, xerophthalmia, and recurrent sialadenitis. Conventional management focuses on symptomatic relief with saliva substitutes, oral hygiene, secretagogues, and systemic immunomodulation for extra-glandular disease. However, these approaches do not directly address ductal obstruction, periductal inflammation, or intraductal strictures that contribute to persistent glandular dysfunction. This review critically evaluates the role of sialendoscopy-assisted ductal irrigation compared with standard care in patients with pSS, with emphasis on clinical efficacy, safety, and future research needs. Randomized controlled trials, prospective cohorts, and systematic reviews were prioritized. Representative high-quality sources were examined in full, with data synthesized into comparative tables. Evidence from controlled trials and prospective cohorts indicates that sialendoscopy with ductal dilation and irrigation, often with corticosteroid instillation, improves unstimulated salivary flow, reduces glandular swelling, and alleviates subjective xerostomia more effectively than conservative therapy alone. Safety data suggest the procedure is well tolerated, with transient glandular discomfort and swelling being the most common adverse events. Compared to standard care, sialendoscopy provides unique advantages by directly targeting ductal pathology, though variability in techniques, small sample sizes, and limited long-term data constrain definitive conclusions. Sialendoscopy-assisted ductal irrigation represents a promising adjunctive therapy for managing salivary gland dysfunction in pSS, addressing pathophysiological mechanisms beyond symptomatic relief. While short-term efficacy and safety appear favourable, larger multicenter randomized trials, standardized protocols, and long-term outcome studies are needed to establish its role within evidence-based treatment algorithms.

In combined approach sialendoscopy surgery, the sialendoscope tip may be used to illuminate the duct and serve as a visual target during cut down dissection. While this can assist in identifying the location of the duct and any obstruction, it also runs the risk of damaging the endoscope. In this prospective single-arm trial, we investigated the safety of an infrared ureteral stent as a means of identifying the path of the salivary ducts. Five patients were enrolled to test the feasibility and safety of this device while undergoing sialendoscopy, which was trialed in 2 submandibular glands and 4 parotid glands. There was 1 instance of device failure which required intraductal exploration to rectify. Infrared light was able to be identified through tissue both transorally and transcutaneously, and in some instances was capable of identifying duct location when visible light was not. Future development in this technology targeting sialendoscopy may provide significant clinical utility for otolaryngologists.

Sialadenitis represents an intricate inflammatory condition affecting the salivary glands, marked by tissue damage, inflammation, and compromised secretory function, though targeted therapeutic approaches with proven efficacy continue to be scarce. Lipocalin-2 (Lcn2), a versatile protein that participates in inflammation and apoptosis regulation, has been associated with numerous inflammatory conditions. The present research examined the protective function of Lcn2 in sialadenitis, with particular focus on its anti-inflammatory and anti-apoptotic mechanisms as well as its latent capacity as a therapeutic target. Lcn2-associated alterations in salivary gland tissues and cells were evaluated through assessments of inflammatory injury, apoptotic markers (caspase-3, Bax, Bcl2), and functional molecules critical for glandular secretion (AQP5, MUC1, α-amylase) using human samples, LPS-induced murine models, RNA sequencing, immunohistochemistry, Western blotting, and siRNA-mediated Lcn2 knockdown. To further assess the functional role of Lcn2, mice were administered adeno-associated virus 2 (AAV2) to suppress Lcn2 expression during LPS-induced sialadenitis. LPS treatment markedly induced glandular damage, inflammation, and apoptosis, accompanied by robust upregulation of Lcn2. Lcn2 co-localized with caspase-3 in epithelial cells, and its suppression aggravated apoptosis and inflammation, whereas AAV2-mediated Lcn2 knockdown exacerbated tissue injury and disrupted secretion-related protein expression. Mechanistically, Lcn2 knockdown further enhanced LPS-induced phosphorylation of NF-κB p65, JNK, and p38. Inhibition of NF-κB with BAY11-7082 abolished the excessive inflammatory response, while inhibition of JNK with SP600125 attenuated the pro-apoptotic effect of Lcn2 silencing. Moreover, molecular docking and co-immunoprecipitation confirmed a direct physical interaction between Lcn2 and Bcl2. Conversely, Lcn2 overexpression alleviated these deleterious effects by modulating apoptotic and inflammatory mediators. Collectively, these findings demonstrate that Lcn2 confers protection against salivary gland injury in sialadenitis by regulating apoptosis and inflammation, at least partially via directly binding to Bcl2 and suppressing NF-κB and JNK/p38 MAPK signaling pathways, highlighting Lcn2 as one prospective therapeutic target for alleviating salivary gland dysfunction and inflammation.

Intermittent fasting confers protection in diverse diseases through various mechanisms, including the clearance of senescent and pathogenic cells, modulation of tissue inflammation and enhancement of stem/progenitor cell niche and functionality. Our previous study demonstrated the beneficial impact of alternate-day fasting (ADF) on xerostomia and sialadenitis, along with an improvement in salivary gland ductal compartments, where salivary gland progenitor cells reside, in non-obese diabetic mice, a spontaneous model of Sjögren's syndrome (SS). In the present study, we induced SS-associated hyposalivation in KRT5CreERT2; R26tdTomato lineage tracing mice by immunizing them with submandibular gland proteins from wild-type C57BL/6 mice. ADF alleviated salivary gland hypofunction, which was accompanied by decreased expression of the senescent cell marker p16INK4a, reduced protein levels of anti-apoptotic proteins BCL-2, BCL-XL, and MCL-1, and attenuated NLRP3 inflammasome activity in the submandibular glands, particularly within the ductal compartments, of this inducible model. Furthermore, immunofluorescence staining of submandibular gland sections revealed the expression of the acinar cell marker aquaporin 5 in a small subset of Keratin 5+ cells in 2 of 9 mice that were subjected to ADF, whereas no such cells were detected in the control mice. Taken together, these findings indicate that ADF favorably modulates the salivary gland progenitor cell niche, potentially by promoting apoptosis-mediated senescent cell clearance, suppressing NLRP3 inflammasome signaling, and promoting Keratin 5+ progenitor cell-derived acinar cell replenishment, thereby contributing to the structural and functional restoration of damaged salivary glands in autoimmune exocrinopathy.

Facial thread lifting is a popular, minimally invasive procedure for facial rejuvenation. While most complications are mild and self-limiting, severe adverse events may occur rarely. Injury to the parotid gland or its ducts represents a serious complication, particularly when leading to delayed sequelae such as sialolithiasis. We present the case of a 45‑year‑old female who developed acute suppurative parotitis and sialolithiasis three years after facial thread lifting. The patient received antibiotic therapy followed by surgical removal of the calculi. Intraoperatively, suture remnants were identified within the calculi. The patient recovered well postoperatively. This case highlights the risk of parotid duct injury and secondary chronic sialolithiasis following thread lifting, which may predispose patients to suppurative parotitis. Clinicians should be aware of this rare but significant delayed complication. Precise surgical technique and strict adherence to anatomical planes are crucial to prevent such adverse events.

Acute neonatal sialadenitis is a rare condition, most commonly involving the parotid gland, whereas isolated submandibular gland involvement is uncommon and may pose diagnostic challenges. We report the case of a two-week-old term male infant who presented with right submandibular swelling in the absence of fever, systemic signs of infection, or abscess formation. Laboratory evaluation revealed leukocytosis with elevated inflammatory markers, and ultrasound imaging confirmed acute submandibular sialadenitis. The infant responded well to intravenous antibiotics without the need for surgical intervention. This case highlights the clinical variability of neonatal sialadenitis and emphasizes the importance of early recognition, appropriate imaging, and targeted antimicrobial therapy to prevent complications.