Objective(s): To confirm that hilar transoral submandibular sialolitectomy (TOSL) is the first treatment option for submandibular hilar lithiasis (SHL) in terms of glandular parenchyma recovery, salivary system restoration, and patient quality of life (QoL) improvement. Methods: Depending on whether the stone was easily palpable, TOSL was carried out with or without sialendoscopy. For the first time in the literature, Magnetic Resonance Sialography (MR-Si) was performed before and after TOSL, to evaluate stone characteristics, glandular parenchyma status, hilum dilation and main duct recanalization. Radiological data was examined independently by two radiologists. COSQ, a recently validated and specific questionnaire, was used to assess associated QoL. Results: Between 2017 and 2022, 29 TOSL patients were examined. With a high interobserver correlation, MR-Si was confirmed as a very useful radiological test in the pre- and post-surgical evaluation of SHL. The salivary main duct was completely recanalized in all cases. The presence of lithiasis was found in 4 patients (13.8%). After surgery, the majority of patients (79.31%) had hilum dilation. There was a statistically significant improvement in parenchyma status, but no significant progression to glandular atrophy. After surgery, COSQ mean values always improved (22.5 to 4.5). Conclusions: TOSL is the ideal surgical technique for the management of SHL, resulting in improved parenchymal inflammatory changes, recanalization of Wharton’s duct, and enhancement patients’ QoL. As a result, before removing the submandibular gland, TOSL should be considered as the first treatment option for SHL.

Objectives: To evaluate the loss of quality of life (QoL) in patients with chronic obstructive sialadenitis (COS) using the Chronic Obstructive Sialadenitis Questionnaire (COSQ). Methods: The COSQ was administered to patients diagnosed with COS, with the diagnosis confirmed by sialendoscopy. Epidemiological data, obstructive causes and potentially obstructive entities were collected. QoL was assessed using the COSQ. Results: A total of 344 glands in 278 patients with COS were analyzed. Most patients were women (71.94%), and the main obstructive cause was stenosis (47.96%), followed by lithiasis, lack of papilla distensibility (LPD), and mucus plug. Stenosis was significantly more frequent in the parotid gland and in women, whereas lithiasis predominated in the submandibular gland and in men. The mean COSQ score was 30.55 and it was significantly higher in women (p < 0.005), parotid gland (p < 0.005), and in long-standing cases (p < 0.05). Stenosis and LPD were the obstructive causes with the greatest impact on QoL (p < 0.005), while lithiasis had the least impact. Potentially Obstructive Entities (POEs), such as eosinophilic sialodochitis, Sjögren’s syndrome, or radioiodine-induced sialadenitis, were associated with a notable loss of QoL. Likewise, patients without associated POEs presented significantly lower COSQ values (p < 0.05). Conclusions: COS significantly affects QoL, particularly in women and in cases of parotid gland, stenosis, and LPD. Lithiasis has the least impact on QoL. It is important to standardize a thorough evaluation of COS using validated tools such as the COSQ, which are fundamental for understanding the disease and predicting the outcomes of therapeutic interventions.

(1) Background: Eosinophilia has traditionally been linked to eosinophilic asthma, for which it is the gold-standard prognostic biomarker. However, the association between eosinophilia and the presence of other diseases and comorbidities is yet unclear. (2) Methods: For this retrospective study, we reviewed the electronic medical records of 49,909 subjects with blood eosinophilia to gather data on the presence of asthma, COPD, sleep apnea, tuberculosis, dyslipidemia, hypertension, and other cardiovascular diseases and severe CRSwNP among these subjects. Demographic features including age, sex, and smoking habits were collected, as well as the number of hospitalizations and emergency department visits. T-tests, ANOVA, Fisher test, and logistic regression models were used. (3) Results: For all age groups studied, eosinophilia was significantly more prevalent among asthmatic subjects than nonasthmatics, especially in patients also presenting CRSwNP, hypertension, and dyslipidemia. The likelihood of developing asthma, COPD, and CRSwNP, and hospitalization, was increased when BEC was above 600 eosinophils/μL. The association between asthma, CRSwNP, and BEC was corroborated by multiple logistic regressions models. (4) Conclusions: We demonstrated the association of having over 600 blood eosinophils/μL with a higher number of hospitalizations and comorbidities (CRSwNP and COPD), which proves that BEC is a highly useful parameter to consider in subjects who present blood eosinophilia.

Eosinophilic sialodochitis is an under-recognized obstructive inflammatory disorder of the major salivary ducts that has been described under heterogeneous terms, including allergic parotitis, fibrinous sialodochitis, and Kussmaul disease. We systematically reviewed the literature to summarize nomenclature, clinical presentation, diagnostic assessment, treatment, and consistency with proposed diagnostic criteria. We searched six bibliographic databases from inception to December 2025, complemented by Google Scholar and citation tracking. Studies describing eosinophilic sialodochitis or related entities were included irrespective of language. Data were synthesized descriptively because of marked heterogeneity. Seventy-nine studies involving 387 patients were included, comprising 64 full-text reports and 15 conference abstracts or posters. Most publications were case reports or case series. Recurrent parotid and/or submandibular swelling, eosinophil-rich salivary mucus plugs, ductal dilatation or stenosis, and frequent atopic comorbidity were the most characteristic findings. Eosinophils were identified in salivary mucus in 53 of 58 studies reporting local samples. Full compliance with published diagnostic criteria varied markedly, from 45 of 79 studies using the Baer framework to 2 of 79 using the Carey framework, while no study fully satisfied the Zhao framework. Treatment was usually multimodal and included antihistamines, corticosteroids, intraductal irrigation, sialendoscopy-assisted procedures, and, in selected refractory cases, biologic agents targeting type 2 inflammation. The available evidence supports eosinophilic sialodochitis as a distinct but incompletely standardized clinicopathological entity. Interpretation is limited by heterogeneity, incomplete reporting, and low-certainty evidence. Standardized definitions and minimum reporting items are needed to improve diagnostic certainty and comparability.