Sialoendoscopy: a viable treatment for I131 induced sialoadenitis

Luca, Roberto De; Vicidomini, Antonio; Trodella, Michele; Tartaro, Gian Paolo; Colella, G

doi:10.1016/j.bjoms.2014.01.025

Cited by 19 publications

(27 citation statements)

References 10 publications

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“…Symptom relief in those with RAIS ranges from 50% to 100%, with a major complication rate of less than 2%, making it a safe, effective therapy. [19][20][21][22]24,25,27,38 Our study demonstrated that upfront sialendoscopy was the most costeffective option for managing RAIS, with an ICER of $30,402.30, which is less than the willingness-to-pay threshold of $50,000. The sensitivity analysis demonstrated that sialendoscopy was the most cost-effective option 64.5% of the time.…”

Section: Discussionmentioning

confidence: 70%

“…[6][7][8][9][10][11][12][13][14][15][16][17][18] Over the past 10 years, sialendoscopy has become an alternative in the diagnosis and treatment of patients with RAIS. [19][20][21][22][23][24] The common findings on RAIS salivary endoscopy include blanched ducts, strictures, debris, loss of vascular markings, and diffuse ductal stenosis. [25][26][27] Improvement in patient symptoms has been demonstrated within the literature, but no economic analysis to date has been performed to determine its costeffectiveness when compared to medical therapy alone, particularly in adults.…”

Section: Introductionmentioning

confidence: 99%

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Cost‐effectiveness of sialendoscopy versus medical management for radioiodine‐induced sialadenitis

2018

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Section: Discussionmentioning

confidence: 70%

Section: Introductionmentioning

confidence: 99%

Cost‐effectiveness of sialendoscopy versus medical management for radioiodine‐induced sialadenitis

2018

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“…Overall, 240 sialendoscopies in 122 patients were carried out as primary treatment, consequently it may be assumed that multiple glands were often submitted simultaneously to interventional sialendoscopy in the same patient. The type of anaesthesia was specified in 4 studies: Nahlieli et al 12 and De Luca et al 15 performed all the procedures under local anaesthesia; Prendes et al 10 and Bhayani et al 16 opted for general anaesthesia. Only Prendes et al 10 reported one case of unsuccessful cannulation of the duct.…”

Section: Resultsmentioning

confidence: 99%

Interventional sialendoscopy for radioiodine-induced sialadenitis: quo vadis?

Canzi

Cacciola

Capaccio

et al. 2017

Acta Otorhinolaryngol Ital

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La tossicità delle ghiandole salivari rappresenta un noto effetto indesiderato dello iodio radioattivo (I) utilizzato per il trattamento di neoplasie tiroidee, con una prevalenza che varia dal 2% al 67% della popolazione esposta. Recentemente, la scialoendoscopia è stata introdotta come un interessante strumento diagnostico e terapeutico per la gestione dei pazienti affetti da scialoadenite radioiodio-indotta non responsiva ai trattamenti medici standard. Lobiettivo della presente revisione è stato valutare linfluenza di questa procedura sulla storia clinica di pazienti affetti da scialoadenite conseguente a trattamento con radioiodio. Complessivamente, la revisione ha incluso 8 studi, 122 pazienti e 264 scialoendoscopie. Le stenosi duttali ed i tappi mucosi hanno rappresentato l85.7% dei reperti endoscopici, sostenendo il ruolo dellostruzione duttale nella fisiopatologia della scialoadenite da radioiodio. Circa l89.3% dei pazienti riportarono una risoluzione parziale o completa degli episodi di scialoadenite ricorrente, senza complicanze post-operatorie maggiori. Un solo caso è stato sottoposto a parotidectomia per fallimento del trattamento scialoendoscopico e persistenza dei sintomi. Tuttavia, i risultati della letteratura riguardarono principalmente valutazioni soggettive e solamente in due esperienze cliniche furono prese in considerazione misure oggettive con risultati discordanti. La xerostomia fu analizzata in pochi studi, con benefici differenti rispetto ai sintomi ostruttivi. La tempistica ideale per la videoendoscopia delle ghiandole salivari necessita di ulteriori analisi, al fine di definire la miglior gestione delle scialoadeniti ostruttive radioiodio-indotte.

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“…In general, parotid glands are affected more often than submandibular glands, and bilateral parotitis is more common than unilateral parotitis [14,15,16]. This may be due to a higher saliva clearance rate in submandibular glands, which has been proposed to explain the higher NIS expression, but lower cumulative radioiodine activity found in submandibular versus parotid glands [6].…”

Section: Radioiodine Therapymentioning

confidence: 99%

“…A new development within the field is the application of sialoendoscopy, which allows for the dilatation of duct stenoses, lavage of the ductal system and removal of mucus plugs. A subjective improvement in 23 of 30 patients after one treatment could be achieved using this technique [16]. Furthermore, preparation for radioiodine treatment with recombinant human thyroid-stimulating hormone (rhTSH) instead of thyroid hormone withdrawal (THW) has been proposed to induce less salivary gland toxicity, as THW-induced hypothyroidism causes a transient impairment of renal function, and therefore a slower renal clearance of radioiodine.…”

Section: Radioiodine Therapymentioning

confidence: 99%

Radioiodine Treatment and Thyroid Hormone Suppression Therapy for Differentiated Thyroid Carcinoma: Adverse Effects Support the Trend toward Less Aggressive Treatment for Low-Risk Patients

Hesselink¹,

Links²

2015

Eur Thyroid J

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Over the past decades, the incidence of differentiated thyroid carcinoma (DTC) has steadily increased, with especially a growing number of low-risk patients. Whereas DTC used to be treated rather aggressively, it is now acknowledged that aggressive treatment does not affect outcome for low-risk patients and that it can induce adverse effects. In this review an overview of the most clinically relevant adverse effects of radioiodine treatment and thyroid hormone suppression therapy (THST) is presented, and the trend toward less aggressive treatment for low-risk patients is outlined. Salivary gland dysfunction occurs in roughly 30% of patients, and is probably due to the concentration of radioiodine in the salivary glands by the sodium/iodide symporter. Beta radiation from radioiodine can result in sialoadenitis and eventually fibrosis and loss of salivary function. Furthermore, patients can experience bone marrow dysfunction following radioiodine treatment. Although this is in general subclinical and transient, patients that receive very high cumulative radioiodine doses may be at risk for more severe bone marrow dysfunction. THST can induce adverse cardiovascular effects in patients with DTC, such as diastolic and systolic dysfunction, and also adverse vascular and prothrombotic effects have been described. Finally, the effects of THST on bone formation and resorption are outlined; especially postmenopausal women with DTC on THST seem to be at risk of bone loss. In the past years, advances have been made in preventing low-risk patients from being overtreated. Improved biomarkers are still needed to further optimize risk stratification and personalize medicine.

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Sialoendoscopy: a viable treatment for I131 induced sialoadenitis

Cited by 19 publications

References 10 publications

Cost‐effectiveness of sialendoscopy versus medical management for radioiodine‐induced sialadenitis

Cost‐effectiveness of sialendoscopy versus medical management for radioiodine‐induced sialadenitis

Interventional sialendoscopy for radioiodine-induced sialadenitis: quo vadis?

Radioiodine Treatment and Thyroid Hormone Suppression Therapy for Differentiated Thyroid Carcinoma: Adverse Effects Support the Trend toward Less Aggressive Treatment for Low-Risk Patients

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