Effect of controlled dynamic sialometry on the secretory function of the parotid glands

Background. It is noted that patients with xerostomia after sialometry may notice a decrease in xerostomia.

Aim. To study the effect of stimulated sialometry on the quantitative parameters of salivation, to explain the mechanism and reason for such an effect.

Material and methods. Controlled dynamic parotid sialometry was performed in 22 patients with xerostomia. Saliva was taken with a Lashley capsule (n=44) and a catheter (n=44), stimulated with 1% pilocarpine solution. At the 1st stage, the capsule was on the right, the catheter was on the left, a week later (2nd stage) the catheter was on the right, the capsule was on the left. The amount of saliva (ml) obtained with a capsule was taken as a control indicator, with a catheter — as a test indicator, the difference between them determined the rheological state of saliva. The study was approved by the ethical committee. The analysis of indicators in dynamics was carried out separately in the group with a capsule, separately in the group with a catheter. Significance of differences was assessed using Student's t-test. The results were considered significant at p ≤0.05.

Results. By the 2nd stage of the study, the sialometry values (ml) obtained using the capsule increased in 13 (69.1%) cases, did not change (n=2; 9.1%) or decreased (n=7; 31.8%) in 9 (40.9%) cases. By the 2nd stage of the study, sialometry values (ml) obtained using a catheter increased in 16 (72.7%) cases, did not change (n=2; 9.1%) or decreased (n=4; 18.2%) in 6 (27.3%) cases. The number of cases with increased secretion was significantly higher than other cases (t=3.385; p <0.001). The dynamics of the rheological state was as follows. A week later, in 7 (31.8%) cases, the indicators of the rheological state of saliva (the difference between the control and test sialometry values of 0.5 ml or more) returned to normal (the difference between the control and test sialometry values of 0.5 ml or less), in 2 (9.1%) cases, the norm was not achieved (t=1.947; p <0.05). Thus, sialometry in the short term can positively influence the secretory function of the salivary glands. However, parasympathetic stimulation of secretory function depletes the number of secretory granules in glandulocytes, which limits the effect of pilocarpine in reducing xerostomia.

Conclusion. Simultaneous sampling of saliva from the parotid glands with a Lashley capsule (control) and a catheter as a capillary viscometer makes it possible to determine the rheological properties of saliva; the improvement in the rheological properties of saliva after stimulated sialometry is associated with the use of the m-cholinomimetic pilocarpine.