Abstract
Objectives:
Radioiodine (I131) is an effective adjuvant therapy following surgery in patients with high-risk thyroid cancer. Unfortunately, radioiodine treatment may result in significant xerostomia and sialadenitis. We examined outcomes in patients treated for radioiodine-induced sialadenitis with sialendoscopy.
Methods:
Data have been prospectively collected for all patients undergoing sialendoscopy at this institution. Findings of the procedure and the intervention details were recorded. Qualitative data were obtained through patient examination and use of standard quality of life questionnaires (eg, MDASI-HN and Xerostomia Questionnaire). Quantitative data were obtained from patients who underwent sialometry.
Results:
Twenty-six patients (23F/3M) with an average age of 46 yrs (range: 19-57 yrs) underwent interventional sialendoscopy for radioiodine-induced sialadenitis. Sialendoscopy was attempted on 62 glands (45 parotid and 17 submandibular glands). In 2 patients, sialendoscopy could not be completed successfully on submandibular glands. Papillary stenosis was seen in 10 (16%) of the glands treated. Six submandibular glands ducts (9.7%) required sialdochoplasty. Patients subjectively noted the following resolution of symptoms: partial resolution (18; 69.2%), complete resolution (6; 23.1%), no change (1; 3.8%), and worsening of symptoms (1; 3.8%). Preliminary statistical analysis of the sialometry data by Wilcoxon matched pairs test (nonparametric) showed that there was a statistically significant difference in saliva production at 6 months following sialendoscopy for unstimulated saliva production (P = 0.028) but not for stimulated saliva production (P = 0.50) as compared to baseline measurements in patients with subjective improvement.
Conclusions:
Sialendoscopy is an effective treatment option for the management of radioiodine-induced sialadenitis.
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