Inflammation grading and sialoendoscopic treatment of131I radioiodine-induced sialadenitis

  • Xiao LI ,
  • Jia-zeng SU ,
  • Yan-yan ZHANG ,
  • Li-qi ZHANG ,
  • Ya-qiong ZHANG ,
  • Deng-gao LIU ,
  • Guang-yan YU
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  • 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 date: 2019-02-01

  Online published: 2020-06-30

Supported by

National Natural Science Foundation of China(81974151)

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.

Cite this article

Xiao LI , Jia-zeng SU , Yan-yan ZHANG , Li-qi ZHANG , Ya-qiong ZHANG , Deng-gao LIU , Guang-yan YU . Inflammation grading and sialoendoscopic treatment of131I radioiodine-induced sialadenitis[J]. Journal of Peking University(Health Sciences), 2020 , 52(3) : 586 -590 . DOI: 10.19723/j.issn.1671-167X.2020.03.029

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