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Journal of Peking University (Health Sciences) ›› 2020, Vol. 52 ›› Issue (3): 586-590. doi: 10.19723/j.issn.1671-167X.2020.03.029

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Inflammation grading and sialoendoscopic treatment of131I radioiodine-induced sialadenitis

Xiao LI1,Jia-zeng SU1,Yan-yan ZHANG1,Li-qi ZHANG2,Ya-qiong ZHANG2,Deng-gao LIU2,△(),Guang-yan YU1,△()   

  1. 1. Department of Oral and Maxillofacial Surgery
    2. Department of Oral Radiology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
  • Received:2019-02-01 Online:2020-06-18 Published:2020-06-30
  • Contact: Deng-gao LIU,Guang-yan YU E-mail:kqldg@bjmu.edu.cn;gyyu@263.net
  • Supported by:
    National Natural Science Foundation of China(81974151)

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Abstract:

Objective: To investigate the inflammation grading of131I radioiodine-induced sialadenitis based upon sialoendoscopic and sialographic appearances, and to evaluate the results of sialoendoscopic intervention.Methods: The patients diagnosed with131I radioiodine-induced sialadenitis and underwent sialoendoscopic exploration and intervention procedures in Peking University Hospital of Stomatology from Nov. 2012 to Oct. 2018 were included in this study. The appearances of sialogaphy and sialoendoscopy were analyzed and classified. The treatment options included irrigation with saline and dexamethasone and mechanical dilatation by sialoendoscope. The patients were followed up after treatment.Results: Forty-two patients with131I radioiodine-induced sialadenitis were included. There were 5 males and 37 females, with a male-to-female ratio of 1 ∶7.4. Symptoms included recurrent swelling and pain in the parotid glands, and dry mouth. Sialography showed stenosis in the main duct,and in some cases nonvisua-lization of the branches. Sialoendoscopy showed narrowing of the main duct, and the branch duct atresia was seen. The appearances of sialogaphy and sialoendoscopy were analyzed and classified into 3 groups: (1) Mild inflammation: stenosis and ectasia occurred in the main duct, whereas the 0.9 mm sialoendoscope could pass through easily. (2) Moderate inflammation: one point of severe stricture could be seen in the main duct where 0.9 mm sialoendoscope could not be passed through. (3) Severe inflammation: two points or more of severe strictures or diffused strictures occurred in the main duct. Thirty-three patients with 65 affected glands were examined by both sialography and sialoendoscopy. Eight glands were classified as mild inflammation, 23 glands moderate inflammation, and 34 glands severe inflammation. The duration of follow-up ranged from 3-72 months. The clinical results were evaluated as good in 22 glands, fair in 22 glands, and poor in 19 glands, with an overall effective rate of 69.8% (44/63).Conclusion: The clinical, sialographic and sialoendoscopic appearances of131I radioiodine-induced sialadenitis showed their characteristics. We proposed an inflammation grading standard for the131I radioiodine-induced sialadenitis based on the appearances of sialography and sialoendoscopy. Sialoendoscopy can significantly alleviate the clinical symptoms, which is an effective therapy, and better for early lesions.

Key words: Sialoendoscopy, Sialadenitis, Iodine radioisotopes, Diagnosis, Treatment outcome

CLC Number: 

  • R781.7

Figure 1

The sialendoscopic appearances of 131I radioiodine-induced sialadenitis A, sialendoscopy showed polypoid proliferation (yellow arrow) in the duct system; B, sialendoscopy showed hyperemia (yellow arrow) and narrowing of the main duct; C, sialendoscopy showed stenosis in the lumen (yellow arrow) and paleness in the ductal wall."

Figure 2

The sialogaphic appearances of 131I radioiodine-induced sialadenitis A, mild inflammation: sialography displayed minor uneven thickness (yellow arrow) in the main duct; B, moderate inflammation: sialography displayed stenosis in the main duct (yellow arrow) and irregular dilation in the branches; C, severe inflammation: sialography displayed severe stenosis in the main duct with rough edge (yellow arrow), nonvisualization of the branches."

[1] van Nostrand D. The benefits and risks of I-131 therapy in patients with well-differentiated thyroid cancer[J]. Thyroid, 2009,19(12):1381-1391.
[2] Lu L, Shan F, Li W, et al. Short-term side effects after radioiodine treatment in patients with differentiated thyroid cancer[J]. Biomed Res Int, 2016,2016(9):1-5.
[3] De Luca R, Vicidomini A, Trodella M, et al. Sialoendoscopy: A viable treatment for I131 induced sialoadenitis [J]. Br J Oral Maxillofac Surg, 2014,52(7):641-646.
[4] 柳登高, 郭玉娇, 姜岚, 等. 43例慢性阻塞性腮腺炎内镜治疗疗效观察[J]. 中华口腔医学杂志, 2012,47(9):81-84.
[5] Ish-Shalom S, Durleshter L, Segal E, et al. Sialochemical and oxidative analyses in radioactive131I-treated patients with thyroid carcinoma [J]. Eur J Endocrinol, 2008,158(5):677-681.
[6] Badam RK, Suram J, Babu DB, et al. Assessment of salivary gland function using salivary scintigraphy in pre and post radioactive iodine therapy in diagnosed thyroid carcinoma patients[J]. J Clin Diagn Res, 2016,10(1):60-62.
[7] Ali MJ. Iodine-131 therapy and nasolacrimal duct obstructions: What we know and what we need to know[J]. Ophthalmic Plast Reconstr Surg, 2016,32(4):243-248.
[8] Maruoka Y, Baba S, Isoda T, et al. A functional scoring system based on salivary gland scintigraphy for evaluating salivary gland dysfunction secondary to 131I therapy in patients with differentiated thyroid carcinoma [J]. J Clin Diagn Res, 2017, 11(8): TC23-TC28.
[9] Jarzab B, Handkiewicz-Junak D, Wloch J. Juvenile differentiated thyroid carcinoma and the role of radioiodine in its treatment: a qualitative review[J]. Endocr Relat Cancer, 2005,12(4):773-803.
pmid: 16322322
[10] Wu CB, Xi H, Zhou Q, et al. Sialendoscopy-assisted treatment for radioiodine-induced sialadenitis[J]. J Oral Maxillofac Surg, 2015,73(3):475-481.
[11] Allweiss P, Braunstein GD, Katz A, et al. Sialadenitis following131I therapy for thyroid carcinoma: Concise communication [J]. J Nucl Med, 1984,25(7):755-758.
pmid: 6737074
[12] Silberstein EB. Reducing the incidence of131I-induced sialadenitis: the role of pilocarpine [J]. J Nucl Med, 2008,49(4):546-549.
doi: 10.2967/jnumed.107.049411 pmid: 18344428
[13] Ko KY, Kao CH, Lin CL, et al. 131I treatment for thyroid cancer and the risk of developing salivary and lacrimal gland dysfunction and a second primary malignancy: A nationwide population-based cohort study [J]. Eur J Nucl Med Mol Imag, 2015,42(8):1172-1178.
[14] Chow S. Side effects of high-dose radioactive iodine for ablation or treatment of differentiated thyroid carcinoma[J]. J HK Coll Radiol, 2005(8):127-135.
[15] Malpani BL, Samuel AM, Ray S. Quantification of salivary gland function in thyroid cancer patients treated with radioiodine[J]. Int J Radiat Oncol Biol Phys, 1996,35(3):535-540.
pmid: 8655377
[16] Geres AE, Mereshian PS, Fernández S, et al. Sialadenitis after radioiodine therapy: Analysis of factors that influence the response to medical treatment[J]. Endocrinol Nutr, 2015,62(10):493-498.
pmid: 26459118
[17] Wu JQ, Feng HJ, Ouyang W, et al. Systematic evaluation of salivary gland damage following I-131 therapy in differentiated thyroid cancer patients by quantitative scintigraphy and clinical follow-up[J]. Nucl Med Commun, 2015,36(8):819.
doi: 10.1097/MNM.0000000000000325 pmid: 25932534
[18] Nahlieli O, Nazarian Y. Sialadenitis following radioiodine therapy a new diagnostic and treatment modality[J]. Oral Disease, 2006,12(5):476-479.
[19] Gonzalez ME, Muttikkal TJ, Rehm PK. Sialadenitis following low dose I-131 diagnostic thyroid scan with Thyrogen® (recombinant human thyroid stimulating hormone-thyrotropin alfa) [J]. J Radiol Case Rep, 2015,9(6):44-49.
pmid: 26622936
[20] Prendes BL, Orloff LA, Eisele DW. Therapeutic sialendoscopy for the management of radioiodine sialadenitis[J]. Arch Otolaryngol Head Neck Surg, 2012,138(1):15-19.
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