1
|
Yalcinkaya Y, Mumcu G, Özdemir FT, Kuruş RE, Ünal AU, Direskeneli H, Bruyn GA, Inanc N. Are Salivary Gland Ultrasonography Scores Associated with Salivary Flow Rates and Oral Health-related Quality of Life in Sjögren Syndrome? J Rheumatol 2020; 47:1774-1779. [PMID: 32358157 DOI: 10.3899/jrheum.190849] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Major salivary gland ultrasonography (SGUS) is a widely used imaging technique to evaluate salivary gland involvement in primary Sjögren syndrome (pSS). The aim of this study was to evaluate the relationship between SGUS, salivary flow rate (SFR) as an objective measure of the gland function, and oral health-related quality of life (OHRQOL) as a patient-reported outcome measure (PROM) in a pSS cohort. METHODS Sixty-six patients with pSS were examined by SGUS according to Hocevar and Milic scoring systems. Patients with inhomogeneity/hypoechoic areas with scores ≥ 2 in parotid and submandibular glands were classified separately as "severe glandular involvement." Further, oral health, SFR, and Oral Health Impact Profile-14 (OHIP-14) for OHRQOL were assessed. RESULTS Both total Hocevar and Milic scores were higher in 21 pSS patients with low unstimulated whole salivary flow rate (U-WSFR) than 45 pSS patients without low U-WSFR (P = 0.001 and P < 0.0001, respectively). Increased scores of homogeneity, hypoechoic areas and glandular border visibility were observed in patients with low U-WSFR (P < 0.05). Among these variables, homogeneity score was found to be an independent risk factor for low U-WSFR in pSS according to logistic regression analysis (OR 1.586, P = 0.001). Moreover, a higher OHIP-14 score was observed in severe parotid involvement compared to nonsevere cases (23.26 ± 21.19 vs 8.32 ± 13.82, P = 0.004). CONCLUSION High Milic and Hocevar SGUS scores are associated with reduced SFR and poor OHRQOL as a PROM. The inhomogeneity component of the SGUS score is associated with low U-WSFR and is an indicator of severely affected gland function.
Collapse
Affiliation(s)
- Yasemin Yalcinkaya
- Y. Yalcinkaya, Associate Professor, A. U. Ünal, MD, H. Direskeneli, Professor, N. Inanc, Professor, Division of Rheumatology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Gonca Mumcu
- G. Mumcu, Dentist, Professor, Department of Health Management, Marmara University School of Health Sciences, Istanbul, Turkey
| | - Filiz Türe Özdemir
- F. Türe Özdemir, PhD, Division of Immunology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Ramazan Esad Kuruş
- R. Esad Kuruş, MD, Marmara University, School of Medicine, Istanbul, Turkey
| | - Ali Uğur Ünal
- Y. Yalcinkaya, Associate Professor, A. U. Ünal, MD, H. Direskeneli, Professor, N. Inanc, Professor, Division of Rheumatology, Marmara University, School of Medicine, Istanbul, Turkey
| | - Haner Direskeneli
- Y. Yalcinkaya, Associate Professor, A. U. Ünal, MD, H. Direskeneli, Professor, N. Inanc, Professor, Division of Rheumatology, Marmara University, School of Medicine, Istanbul, Turkey
| | - George A Bruyn
- G.A. Bruyn, Professor, Department of Rheumatology, MC Groep Hospitals, Leystad, the Netherlands
| | - Nevsun Inanc
- Y. Yalcinkaya, Associate Professor, A. U. Ünal, MD, H. Direskeneli, Professor, N. Inanc, Professor, Division of Rheumatology, Marmara University, School of Medicine, Istanbul, Turkey;
| |
Collapse
|
2
|
Madero-Visbal R, Milas Z. The role of parotidectomy in Sjögren's syndrome. Oral Maxillofac Surg Clin North Am 2014; 26:83-90. [PMID: 24287196 DOI: 10.1016/j.coms.2013.09.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Sjögren's syndrome, a chronic and progressive autoimmune disorder mainly characterized by xerophthalmia, xerostomia, and parotid enlargement, is primarily managed medically, but some patients will require surgical management. Patients with Sjögren's syndrome have an increased risk of non-Hodgkin lymphoma. Superficial parotidectomy is indicated for diagnostic purposes and can be therapeutic in limited circumstances. Surgical indications for parotidectomy in Sjögren's syndrome include recurrent parotitis refractory to medical management; salivary gland malignancy; and severe, refractory pain. Surgical complications include transient or permanent facial nerve injury, post-operative pain, persistent inflammation of remnant parotid tissue, Frey syndrome, and facial scarring.
Collapse
Affiliation(s)
- Rafael Madero-Visbal
- MD Anderson Cancer Center, Orlando, 1400 S Orange Avenue, Orlando, FL 32806, USA
| | | |
Collapse
|