IMPROVING SURGICAL TREATMENT OF INFLAMMATORY SALIVARY GLAND DISEASES ASSOCIATED WITH SYSTEMIC DISEASES

Abstract

Systemic autoimmune and fibroinflammatory diseases may cause persistent inflammation of the major salivary glands, recurrent swelling, ductal stenosis and progressive salivary hypofunction. This thesis evaluates improvement of surgical treatment through a differentiated gland-preserving approach. In Sjogren disease, sialendoscopy with ductal dilation, lavage and removal of obstructive debris may improve salivary flow and reduce xerostomia in selected patients. Open gland surgery should be reserved for refractory infection, destructive complications or suspected neoplasia. In IgG4-related sialadenitis, routine gland excision is not appropriate as definitive treatment because the underlying process is systemic. Combining systemic disease control with minimally invasive ductal surgery can preserve residual salivary function and reduce unnecessary gland loss.