Corticosteroid irrigation of parotid gland for treatment of xerostomia in patients with Sjogren's syndrome

Objective-To determine the efficacy of corticosteroid irrigation of the parotid gland in relieving salivary flow deficiency in patients with Sjogren's syndrome. Methods-The parotid glands of 31 patients with primary (24) or secondary (seven) Sjogren's syndrome were irrigated either with saline solution followed by corticosteroid solution, or with saline solution alone. Salivary function was assessed by Saxon test. Results-Corticosteroid irrigation significantly increased the salivary flow rate in patients with Sjogren's syndrome (p< 0.0001), with clinical improvement detectable 3.7 (2.4) weeks (mean (SD)) after initial corticosteroid irrigation. The extent of improvement in salivary function was reciprocal to the clinical severity of the disease, with patients at the early stages obtaining 1.20 (0.57) g net increase in salivary flow rate, and patients at the most advanced stages obtaining 0.20 (0.47) g net increase. Repeated corticosteroid irrigations did not evoke corticosteroid refractoriness of the salivary gland; similar levels of net increase in salivary flow rate were observed after the second to fourth challenge of the corticosteroid in these patients. The sustained period was 8.4 (3.5) months (mean (SD)). Conclusion-These findings suggest the clinical usefulness of corticosteroid irrigation therapy in relieving xerostomia in patients with Sjogren's syndrome.