Sialendoscopy for Dysfunction of Salivary Gland after Radioactive Iodine Therapy

Abstract

Objectives:

Ablation of the thyroid remnants using radioactive iodine (RI) after total thyroidectomy of well differentiated thyroid cancer could induce dysfunction of salivary gland. The purpose of this study is to review our experience with sialendoscopy for dysfunction of salivary gland after RI therapy.

Methods:

We reviewed medical charts of all patients treated with sialendoscopy due to RI induced salivary dysfunction. The study included 30 patients who underwent sialendoscopy for the treatment of RI induced salivary dysfunction after failing conservative management.

Results:

30 patients (23 women, 7 men) with a mean age of 45.2 years (range, 25~71) underwent sialendoscopy for the treatment of RI-induced salivary dysfunction that is unresponsive to conservative management. Symptoms arising from the parotid gland were seen in 26 (87%) of patients, whereas symptoms arising from the submandibular gland were seen in 4 (13%). Fifteen patients (50%) presented symptoms in bilateral parotid or submandibular glands. The mean dose of RI was 203.5 mCi (range, 150 ~ 500) received as a single dose. The mean duration from RI ablation therapy to sialendoscopy was 13.2 months (range, 0.5 ~ 32). Sialendoscopy was possible in all patients. Ductal stenosis and mucous plugs and debris were the most common types of ductal pathology. Sialendoscopy improved the symptoms in 80% (24/30) of patients, with no serious complications reported in mean follow-up of 12 months(range, 1 ~ 24).

Conclusions:

Sialendoscopy is an effective tool for improving symptoms due to RI-induced salivary dysfunction in patients who are unresponsive to conservative managements.