Alpha‐1‐Blockers for Obstructive Salivary Gland Diseases

Philippe Katz M.D. I.E.F.G.S. Email: drkatz.philippe@gmail.com Phone: +33 1 42 67 33 19 Website:www.salivarygland-diseases.com Objectives: Alpha-blockers are widely used in urology as an aid in treating stenosis and lithiasis. A similar pathophysiology is encountered in the salivary gland, and alpha-1 adrendoreceptors have been shown to exist in salivary ducts. The aim of our study was to evaluate the safety and effectiveness of alphablockers in treating obstructive salivary gland diseases. Methods: Retrospective study over 3 years of patients with ductal stenosis, allergic pseudo-parotitis or sialolithiasis after lithotripsy in the parotid or submandibular glands. Male patients were given 2.5 mg bid of the alpha-blocker alfuzosin and female patients 2.5 mg bid. At 3 months, ultrasound was performed and a subjective evaluation of symptoms was obtained via a questionnaire. Results: 352 patients were treated for 3 to 24 months (average 8 months). Twelve patients (3.4%) reported adverse effects (orthostatic hypotension, cutaneous allergy, dysejaculation, dysuria) and 10 (2.8%) stopped the treatment after 3 months. A large subjective improvement in symptoms was reported by 80% of the 69 patients with stenosis, 79% of the 89 with allergic pseudo-parotitis, and 67% of the 112 with residual parotid lithiasis. 42% of the 82 patients treated for residual submandibular lithiasis reported a large improvement, significantly lower than for the other diseases (p < 0.05). No male-female difference was noted for safety or efficacy. Ultrasound showed in all cases a decrease in intraglandular ductal distension. Conclusion Alfuzosin was well-tolerated and improved symptoms related to stenosis or lithiasis of the parotid and submandibular glands in a majority of patients. A randomized controlled study is warranted to confirm the efficacy of this approach as compared to conventional treatments. Alpha-1-Blockers for Obstructive Salivary Gland Diseases