Alpha-1-Blockers Are Useful in the Symptomatic Management of Obstructive Salivary Gland Diseases

Presented at AAO-HNSF

By Cheryl Lathrop

BOSTON -- October 3, 2010 -- Alfuzosin was well tolerated and improved symptoms
related to stenosis or lithiasis of the parotid and submandibular glands in a
majority of patients, according to results of a study presented here on
September 27 at the American Academy of Otolaryngology-Head and Neck Surgery
Foundation (AAO-HNSF) Annual Meeting 2010.

Philippe Katz, MD, Institut d’Explorations Fonctionnelles des Glandes
Salivaires, Paris, France, and colleagues retrospectively analysed the files of
patients treated with alfuzosin between January 2005 to January 2008 for
submandibular or parotid ductal stenosis, allergic pseudo-parotitis, or remnant
sialolithiasis after extracorporeal lithotripsy to the parotid or submandibular
glands.

At the first 3-month follow-up visit, an ultrasound was performed and a
subjective evaluation of salivary symptoms was obtained by questionnaire.
Patients then had an ultrasound every 3 months. If treatment was well
tolerated, it was continued for 2 years. Treatment was discontinued if side
effects occurred (patients were questioned about side effects at every 3-month
visit) or if salivary symptoms completely resolved.

Of the 352 patients (282 male, 70 female) 69 had ductal stenosis, 89 had
allergic pseudo-parotitis, 112 had residual parotid lithiasis, and 82 had
residual submandibular lithiasis.

At the first 3-month visit, 80% of the patients with stenosis, 79% of the
patients with allergic pseudo-parotitis, and 67% of the patients with residual
parotid lithiasis reported “very much improved” or “completely resolved.”
However, only 42% of the patients with residual submandibular lithiasis
reported a large improvement (significantly lower than for the other 3
diseases), which the researchers found surprising.

The average follow-up was 33 months. No male/female difference was noted for
safety or efficacy.

Alfuzosin was well tolerated with only 12 (3.4%) patients reporting adverse
effects. Ten patients discontinued the treatment within the first 3 months. The
low complication rate and high efficacy rate imply that alpha-blockers may be
useful in the symptomatic management of obstructive salivary gland diseases.

“A randomised controlled study is warranted to confirm the efficacy of this
approach as compared to conventional treatments,” the researchers noted.

[Presentation title: Alpha-1-Blockers for Obstructive Salivary Gland
Diseases. Abstract 194]