{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:39:31Z","timestamp":1792370371991,"version":"4.4.0"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"vor","delay-in-days":89,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Eat Disord"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Self-induced vomiting (SIV) in patients with eating disorders exposes the oral cavity to repeated chemical and mechanical insults, leading to various oral complications. Necrotizing sialometaplasia (NS) is one such complication; however, most cases resolve spontaneously and follow a benign course without requiring surgical intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A woman in her twenties with a long history of an eating disorder characterized by habitual SIV developed NS of the hard palate. Unlike the usual benign course, the lesion failed to heal spontaneously and progressed to a palatonasal fistula. Her clinical course was notable for several behavioral and clinical factors that may have contributed to sustained local irritation of the palatal tissues, such as persistent vomiting, smoking, and dental procedures requiring local anesthesia. Multidisciplinary psychiatric and dental management was provided throughout the clinical course. Since spontaneous closure of the fistula could not be expected, surgical repair was ultimately performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although NS associated with SIV in patients with eating disorders is usually benign and self-limiting, it can rarely progress to severe and irreversible oral complications such as a palatonasal fistula. Despite the fact that NS is not life-threatening, its severe progression can significantly impair quality of life. Accumulating clinical experience with such hidden complications may improve the quality of psychoeducation and advance the treatment of eating disorders.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40337-026-01714-7","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T12:02:57Z","timestamp":1784721777000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Severe necrotizing sialometaplasia progressing to palatonasal fistula in a patient characterized by habitual self-induced vomiting: a case report"],"prefix":"10.1186","volume":"14","author":[{"given":"Haruka","family":"Yamauchi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayaka","family":"Matsumoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiro","family":"Dohi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuta","family":"Inagawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiro","family":"Suda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,22]]},"reference":[{"issue":"1","key":"1714_CR1","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1002\/erv.3178","volume":"33","author":"D Gibson","year":"2025","unstructured":"Gibson D, Watters A, Mehler PS. Medical complications of purging behaviors: an updated review. Eur Eat Disord Rev. 2025;33(1):123\u201335. https:\/\/doi.org\/10.1002\/erv.3178.","journal-title":"Eur Eat Disord Rev"},{"issue":"4","key":"1714_CR2","doi-asserted-by":"publisher","first-page":"e70087","DOI":"10.1111\/scd.70087","volume":"45","author":"ME Mota","year":"2025","unstructured":"Mota ME, Tomo S, Moreira MS, Villa A, Alves FA. Palatal nodule in bulimia patient: an early sign of necrotizing sialometaplasia. Spec Care Dentist. 2025;45(4):e70087. https:\/\/doi.org\/10.1111\/scd.70087.","journal-title":"Spec Care Dentist"},{"issue":"1","key":"1714_CR3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.5935\/2525-5711.20230232","volume":"9","author":"JSV N\u00e9ri","year":"2024","unstructured":"N\u00e9ri JSV, Silva VP, Ara\u00fajo NS, Gomes TAO, Nascimento MB, Cangussu MCT, Ramalho LMP, Santos JN. Necrotizing sialometaplasia: systematic review and meta-analyses over the past 46 years. J Oral Diagn. 2024;9(1):1\u201310.","journal-title":"J Oral Diagn"},{"issue":"5","key":"1714_CR4","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1016\/j.oooo.2012.02.020","volume":"114","author":"I Kaplan","year":"2012","unstructured":"Kaplan I, Alterman M, Kleinman S, Reiser V, Shuster A, Dagan Y, Shlomi B. The clinical, histologic, and treatment spectrum in necrotizing sialometaplasia. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;114(5):577\u201385. https:\/\/doi.org\/10.1016\/j.oooo.2012.02.020.","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol"},{"key":"1714_CR5","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1007\/978-3-031-36797-7_56","volume-title":"Oral Medicine \u2013 A Clinical Guide","author":"H Clark","year":"2024","unstructured":"Clark H. Necrotising sialometaplasia. In: Balasubramaniam R, Yeoh SC, Yap T, Prabhu S, editors. Oral Medicine \u2013 A Clinical Guide. Cham: Springer; 2024. pp. 231\u20133. https:\/\/doi.org\/10.1007\/978-3-031-36797-7_56."},{"issue":"2","key":"1714_CR6","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1016\/S1348-8643(18)30002-8","volume":"15","author":"K Yagihara","year":"2018","unstructured":"Yagihara K, Ishii J, Katsurano M, Tsuchida E, Okamura T, Ishikawa A. A case of necrotizing sialometaplasia clinically mimicking a malignant tumor of the palate. Oral Sci Int. 2018;15(2):73\u20137. https:\/\/doi.org\/10.1016\/S1348-8643(18)30002-8.","journal-title":"Oral Sci Int"},{"key":"1714_CR7","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1016\/j.jpsychres.2017.09.022","volume":"96","author":"R Panico","year":"2018","unstructured":"Panico R, Piemonte E, Lazos J, Gilligan G, Zampini A, Lanfranchi H. Oral mucosal lesions in anorexia nervosa, bulimia nervosa and EDNOS. J Psychiatr Res. 2018;96:178\u201382. https:\/\/doi.org\/10.1016\/j.jpsychres.2017.09.022.","journal-title":"J Psychiatr Res"},{"key":"1714_CR8","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1186\/s40337-024-01050-8","volume":"12","author":"L Valeriani","year":"2024","unstructured":"Valeriani L, Frigerio F, Piciocchi C, Piana G, Montevecchi M, Donini LM, Mocini E. Oro-dental manifestations of eating disorders: a systematic review. J Eat Disord. 2024;12:87. https:\/\/doi.org\/10.1186\/s40337-024-01050-8.","journal-title":"J Eat Disord"},{"key":"1714_CR9","doi-asserted-by":"publisher","first-page":"105619","DOI":"10.1016\/j.neubiorev.2024.105619","volume":"160","author":"E Rossi","year":"2024","unstructured":"Rossi E, Cassioli E, Dani C, Marchesoni G, Monteleone AM, Wonderlich SA, Ricca V, Castellini G. The maltreated eco-phenotype of eating disorders: a new diagnostic specifier? A systematic review. Neurosci Biobehav Rev. 2024;160:105619. https:\/\/doi.org\/10.1016\/j.neubiorev.2024.105619.","journal-title":"Neurosci Biobehav Rev"},{"key":"1714_CR10","doi-asserted-by":"publisher","unstructured":"Asselin L, Laforgue EJ, Duval M, Revol B, Veyrac G, Grall-Bronnec M, Victorri-Vigneau C. Drugs associated with behavioral addictions: real world analysis using the WHO pharmacovigilance database. Therapies. 2025;In Press. https:\/\/doi.org\/10.1016\/j.therap.2025.07.002","DOI":"10.1016\/j.therap.2025.07.002"}],"container-title":["Journal of Eating Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40337-026-01714-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40337-026-01714-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40337-026-01714-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T23:47:57Z","timestamp":1792367277000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40337-026-01714-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,22]]},"references-count":10,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["1714"],"URL":"https:\/\/doi.org\/10.1186\/s40337-026-01714-7","relation":{},"ISSN":["2050-2974"],"issn-type":[{"value":"2050-2974","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,22]]},"assertion":[{"value":"10 May 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 July 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Written informed consent was obtained from the patient for publication of this case report. According to the policy of Jichi Medical University, ethical approval for single case reports is not required.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Written informed consent for publication of clinical details and images was obtained from the patient.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"242"}}