Abstract
Background and Objectives
Ablation of the thyroid remnants using radioiodine (RI) after surgical removal of differentiated thyroid cancer could induce radiation-related salivary gland dysfunction. The purpose of this study is to review our experience with therapeutic sialendoscopy for RI-induced sialadenitis.
Materials and Methods
We reviewed medical charts of all patients with RI-induced sialadenitis treated with sialendoscopy retrospectively. The study included 14 patients who underwent sialendoscopy for the treatment of RI-induced sialadenitis after failing conservative management.
Results
14 patients (11 women, 3 men) with a mean age of 43.8 years (range, 26-60) underwent interventional sialendoscopy for the treatment of RI-induced sialadenitis that is unresponsive to conservative management. Symptoms arising from the parotid gland were seen in 12 (86%) of patients, whereas symptoms arising from the submandibular gland were seen in 2 (14%). 7 patients (50%) presented symptoms in bilateral parotid or submandibular glands. The mean dose of RI was 203.2 mCi (range, 150-500) received as a single dose. The mean duration from RI ablation therapy to sialendoscopy was 11.1 months (range, 0.5-29). Sialendoscopy was possible in all patients. Ductal stenosis and mucus plugs and debris were the most common types of ductal pathology. Sialendoscopy improved the symptoms in 79% (11/14) of patients, with no serious complications reported in mean follow up of 4 months (range, 1-12).
References
1. Prendes BL, Orloff LA, Eisele DW. Therapeutic sialendoscopy for the management of radioiodine sialadenitis. Arch Otolaryngol Head Neck Surg. 2012. 138(1):15–19.
2. Nahlieli O, Nazarian Y. Sialadenitis following radioiodine therapy - a new diagnostic and treatment modality. Oral Dis. 2006. 12(5):476–479.
3. Mandel SJ, Mandel L. Persistent sialadenitis after radioactive iodine therapy: report of two cases. J Oral Maxillofac Surg. 1999. 57(6):738–741.
4. Albrecht HH, Creutzig H. [Salivary gland scintigraphy after radio-iodine therapy. Functional scintigraphy of the salivary gland after high dose radio-iodine therapy (author's transl)]. Rofo. 1976. 125(6):546–551.
5. Allweiss P, Braunstein GD, Katz A, Waxman A. Sialadenitis following I-131 therapy for thyroid carcinoma: concise communication. J Nucl Med. 1984. 25(7):755–758.
6. Bomeli SR, Schaitkin B, Carrau RL, Walvekar RR. Interventional sialendoscopy for treatment of radioiodine-induced sialadenitis. Laryngoscope. 2009. 119(5):864–867.
7. Kim JW, Han GS, Lee SH, Lee DY, Kim YM. Sialoendoscopic treatment for radioiodine induced sialadenitis. Laryngoscope. 2007. 117(1):133–136.
9. Hyer S, Kong A, Pratt B, Harmer C. Salivary gland toxicity after radioiodine therapy for thyroid cancer. Clin Oncol (R Coll Radiol). 2007. 19(1):83–86.
10. Caglar M, Tuncel M, Alpar R. Scintigraphic evaluation of salivary gland dysfunction in patients with thyroid cancer after radioiodine treatment. Clin Nucl Med. 2002. 27(11):767–771.
11. Katz P. [New method of examination of the salivary glands: the fiberscope]. Inf Dent. 1990. 72(10):785–786.
12. Buckenham TM, Page JE, Jeddy T. Technical report: interventional sialography--balloon dilatation of a Stensen's duct stricture using digital subtraction sialography. Clin Radiol. 1992. 45(1):34.
13. Katz P. [Systematic antibiotic therapy after extraction of third molars: should antibiotics be prescribed?]. Mondo Odontostomatol. 1978. 20(1):33–42.
14. McGurk M, MacBean A, Fan KF, Sproat C. Conservative management of salivary stones and benign parotid tumours: a description of the surgical techniques involved. Ann R Australas Coll Dent Surg. 2004. 17:41–44.