J Korean Thyroid Assoc.  2012 May;5(1):60-64. 10.11106/jkta.2012.5.1.60.

Usefulness of Sialendoscopy for Sialadenitis after Radioactive Iodine Therapy

Affiliations
  • 1Department of Otorhinolaryngology, Inha University School of Medicine, Incheon, Korea. ymk416@inha.ac.kr

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).
CONCLUSION
Therapeutic interventional sialendoscopy appears to provide symptom improvement in most patients. Sialendoscopy is effective tool for improving symptoms due to RI-induced sialadenitis in patients who are unresponsive to conservative managements.

Keyword

Radioiodine; Sialadenitis; Sialendoscopy; Thyroid; Salivary gland

MeSH Terms

Constriction, Pathologic
Female
Follow-Up Studies
Humans
Iodine
Mucus
Parotid Gland
Retrospective Studies
Salivary Glands
Sialadenitis
Submandibular Gland
Thyroid Gland
Thyroid Neoplasms
Iodine

Reference

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.
Article
2. Nahlieli O, Nazarian Y. Sialadenitis following radioiodine therapy - a new diagnostic and treatment modality. Oral Dis. 2006. 12(5):476–479.
Article
3. Mandel SJ, Mandel L. Persistent sialadenitis after radioactive iodine therapy: report of two cases. J Oral Maxillofac Surg. 1999. 57(6):738–741.
Article
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.
Article
7. Kim JW, Han GS, Lee SH, Lee DY, Kim YM. Sialoendoscopic treatment for radioiodine induced sialadenitis. Laryngoscope. 2007. 117(1):133–136.
Article
8. Mandel SJ, Mandel L. Radioactive iodine and the salivary glands. Thyroid. 2003. 13(3):265–271.
Article
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.
Article
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.
Article
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.
Article
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.
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