Interventional sialendoscopy for treatment of radioiodine-induced sialadenitis

Authors

  • Steven R. Bomeli MD,

    1. Department of Otolaryngology and Head Neck Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.
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  • Barry Schaitkin MD,

    1. Department of Otolaryngology and Head Neck Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.
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  • Ricardo L. Carrau MD,

    1. Department of Otolaryngology and Head Neck Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.
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  • Rohan R. Walvekar MD

    Corresponding author
    1. Department of Otolaryngology and Head Neck Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, U.S.A.
    2. Department of Otolaryngology and Head Neck Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana, U.S.A
    • Department of Otolaryngology & Head Neck Surgery, LSUHSC, 533 Bolivar St, Suite 566, New Orleans, LA 70112
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  • Conflict of interest: none.

  • Source of funding: none.

Abstract

Objectives/Hypothesis:

The purpose of this study is to review our experience with sialendoscopy for the management of radioiodine-induced sialadenitis.

Methods:

Retrospective chart review of all patients with radioiodine-induced sialadenitis treated with interventional sialendoscopy.

Results:

Twelve female patients with a mean age of 46.5 years (range, 25–77 years) underwent interventional sialendoscopy for the treatment of recalcitrant sialadenitis from radioiodine-induced damage to the major salivary glands. Symptoms arising from the parotid gland were seen in 75% of patients, whereas symptoms arising from the submandibular gland were seen in 50%. Three patients (25%) presented symptoms in both the parotids and the submandibular glands. The mean dose of radioiodine was 143 mCi (range, 101.9–185.7 mCi) received as a single dose prior to their referral. The mean duration from radioiodine ablation therapy to sialendoscopy was 10.4 months (range, 5–16 months). Thirty-two glands (20 parotid, 12 submandibular) were taken to the operating room, with complete endoscopy successful in 27 glands (84.4%). Ductal stenosis (30%) and mucus plugs (44%) were the most common types of ductal pathology. Sialendoscopy improved the symptoms in 75% (9/12) of patients, with no serious complications reported in follow-up ranging from 2 weeks to 33 months (median, 6 months).

Conclusions:

Interventional sialendoscopy is an effective tool for the management of patients with radioiodine-induced sialadenitis that is unresponsive to medical management. Laryngoscope, 2009

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