Interventional Sialendoscopy for Treatment of Radioiodine-Induced Sialadenitis

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.