Usefulness of Sialendoscopy for Sialadenitis after Radioactive Iodine Therapy

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 sialendos copy 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 submandibu lar 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. Sialendo scopy improved the symptoms in 79% (11/14) of patients, with no serious complications reported in mean fol low 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.