Interventional sialendoscopy for radioiodine-induced sialadenitis: quo vadis?

Research output: Contribution to journalArticle

Abstract

Salivary gland toxicity is a common adverse effect of radioactive iodine ((131)I) for the treatment of thyroid cancers with a prevalence ranging from 2% to 67% of the (131)I exposed population. Recently, sialendoscopy has been introduced as an attractive diagnostic and therapeutic tool for management of patients with radioiodine-induced sialadenitis that is unresponsive to standard medical treatments. The objective of the current review was to assess the impact of this procedure on outcomes in patients suffering from radioiodine sialadenitis. Overall, eight studies were included and 122 patients underwent 264 sialendoscopic procedures. Duct stenosis and mucous plugs were observed in 85.7% of endoscopic findings, supporting the role of ductal obstruction in the pathophysiology of radioiodine sialadenitis. In total, 89.3% of patients experienced complete or partial resolution of sialadenitis recurrences without any major adverse events, and parotidectomy was advocated in only 1 case. However, outcomes mainly concerned subjective reports and only two clinical experiences evaluated objective measurement with dissimilar results. Limited to few studies, xerostomia and obstructive symptoms responded differently after sialendoscopy. The optimal timing of salivary gland videoendoscopy needs to be further analysed in order to define the best management of radioiodine-induced obstructive sialadenitis.
Original languageEnglish
Pages (from-to)155-159
Number of pages5
JournalActa Otorhinolaryngologica Italica
Volume37
Issue number2
DOIs
Publication statusPublished - Apr 1 2017

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Sialadenitis
Salivary Glands
Xerostomia
Thyroid Neoplasms
Iodine
Pathologic Constriction
Therapeutics
Recurrence
Population

Keywords

  • Radioiodine
  • Salivary glands
  • Sialadenitis
  • Sialendoscopy

Cite this

@article{89666815f30e41ea8c6f34b099593c58,
title = "Interventional sialendoscopy for radioiodine-induced sialadenitis: quo vadis?",
abstract = "Salivary gland toxicity is a common adverse effect of radioactive iodine ((131)I) for the treatment of thyroid cancers with a prevalence ranging from 2{\%} to 67{\%} of the (131)I exposed population. Recently, sialendoscopy has been introduced as an attractive diagnostic and therapeutic tool for management of patients with radioiodine-induced sialadenitis that is unresponsive to standard medical treatments. The objective of the current review was to assess the impact of this procedure on outcomes in patients suffering from radioiodine sialadenitis. Overall, eight studies were included and 122 patients underwent 264 sialendoscopic procedures. Duct stenosis and mucous plugs were observed in 85.7{\%} of endoscopic findings, supporting the role of ductal obstruction in the pathophysiology of radioiodine sialadenitis. In total, 89.3{\%} of patients experienced complete or partial resolution of sialadenitis recurrences without any major adverse events, and parotidectomy was advocated in only 1 case. However, outcomes mainly concerned subjective reports and only two clinical experiences evaluated objective measurement with dissimilar results. Limited to few studies, xerostomia and obstructive symptoms responded differently after sialendoscopy. The optimal timing of salivary gland videoendoscopy needs to be further analysed in order to define the best management of radioiodine-induced obstructive sialadenitis.",
keywords = "Radioiodine, Salivary glands, Sialadenitis, Sialendoscopy",
author = "P. Canzi and S. Cacciola and P. Capaccio and F. Pagella and A. Occhini and L. Pignataro and M. Benazzo",
note = "LR: 20170615; CI: (c) Copyright by Societa Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.; JID: 8213019; OTO: NOTNLM; 2016/09/15 00:00 [received]; 2016/12/12 00:00 [accepted]; 2017/05/19 06:00 [entrez]; 2017/05/19 06:00 [pubmed]; 2017/05/19 06:00 [medline]; ppublish",
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T1 - Interventional sialendoscopy for radioiodine-induced sialadenitis: quo vadis?

AU - Canzi, P.

AU - Cacciola, S.

AU - Capaccio, P.

AU - Pagella, F.

AU - Occhini, A.

AU - Pignataro, L.

AU - Benazzo, M.

N1 - LR: 20170615; CI: (c) Copyright by Societa Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.; JID: 8213019; OTO: NOTNLM; 2016/09/15 00:00 [received]; 2016/12/12 00:00 [accepted]; 2017/05/19 06:00 [entrez]; 2017/05/19 06:00 [pubmed]; 2017/05/19 06:00 [medline]; ppublish

PY - 2017/4/1

Y1 - 2017/4/1

N2 - Salivary gland toxicity is a common adverse effect of radioactive iodine ((131)I) for the treatment of thyroid cancers with a prevalence ranging from 2% to 67% of the (131)I exposed population. Recently, sialendoscopy has been introduced as an attractive diagnostic and therapeutic tool for management of patients with radioiodine-induced sialadenitis that is unresponsive to standard medical treatments. The objective of the current review was to assess the impact of this procedure on outcomes in patients suffering from radioiodine sialadenitis. Overall, eight studies were included and 122 patients underwent 264 sialendoscopic procedures. Duct stenosis and mucous plugs were observed in 85.7% of endoscopic findings, supporting the role of ductal obstruction in the pathophysiology of radioiodine sialadenitis. In total, 89.3% of patients experienced complete or partial resolution of sialadenitis recurrences without any major adverse events, and parotidectomy was advocated in only 1 case. However, outcomes mainly concerned subjective reports and only two clinical experiences evaluated objective measurement with dissimilar results. Limited to few studies, xerostomia and obstructive symptoms responded differently after sialendoscopy. The optimal timing of salivary gland videoendoscopy needs to be further analysed in order to define the best management of radioiodine-induced obstructive sialadenitis.

AB - Salivary gland toxicity is a common adverse effect of radioactive iodine ((131)I) for the treatment of thyroid cancers with a prevalence ranging from 2% to 67% of the (131)I exposed population. Recently, sialendoscopy has been introduced as an attractive diagnostic and therapeutic tool for management of patients with radioiodine-induced sialadenitis that is unresponsive to standard medical treatments. The objective of the current review was to assess the impact of this procedure on outcomes in patients suffering from radioiodine sialadenitis. Overall, eight studies were included and 122 patients underwent 264 sialendoscopic procedures. Duct stenosis and mucous plugs were observed in 85.7% of endoscopic findings, supporting the role of ductal obstruction in the pathophysiology of radioiodine sialadenitis. In total, 89.3% of patients experienced complete or partial resolution of sialadenitis recurrences without any major adverse events, and parotidectomy was advocated in only 1 case. However, outcomes mainly concerned subjective reports and only two clinical experiences evaluated objective measurement with dissimilar results. Limited to few studies, xerostomia and obstructive symptoms responded differently after sialendoscopy. The optimal timing of salivary gland videoendoscopy needs to be further analysed in order to define the best management of radioiodine-induced obstructive sialadenitis.

KW - Radioiodine

KW - Salivary glands

KW - Sialadenitis

KW - Sialendoscopy

U2 - 10.14639/0392-100X-1606 [doi]

DO - 10.14639/0392-100X-1606 [doi]

M3 - Article

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JO - Acta Otorhinolaryngologica Italica

JF - Acta Otorhinolaryngologica Italica

SN - 0392-100X

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