Predictors of response to sialendoscopy for patients with chronic non-obstructive Sialadenitis versus radioiodine induced Sialadenitis

Abstract

Objective

Radioiodine therapy, commonly used post-thyroidectomy to eliminate residual affected tissue in thyroid cancer patients, can lead to the development of radioiodine induced sialadenitis (RIS). Chronic idiopathic sialadenitis (CIS) is characterized by intermittent and often painful swelling of the salivary glands, not attributed to salivary duct stones. Sialendoscopy is used to treat sialadenitis when conservative management fails. Our objective is to assess patient factors that may predict treatment success, which could help guide expectations on treatment outcomes.

Methods

We reviewed 315 patients who underwent sialendoscopy between January 2010 and June 2022. Utilizing the electronic medical record, patient demographics, comorbidities, and post-operative outcomes were reviewed in our REDCap database.

Results

We identified 22 patients with RIS and 116 patients with CIS. 28 % of patients with CIS and 41 % of patients with RIS were male. There was no significant difference in mean age (p = 0.37) or gender (p = 0.24) between the two groups. The parotid glands were the primary site of disease in both groups (56 % in CIS group, 73 % in RIS). Age, gender, previous salivary gland surgery, prior radiation, a history of autoimmune disease, and procedures performed during sialendoscopy were not significantly associated with clinical improvement in the CIS group (p > 0.05). 80 % of patients with CIS and 82 % of patients with RIS reported complete resolution or minimal residual symptoms following sialendoscopy.

Conclusion

A multitude of predisposing factors can affect a patient's post-operative outcome after sialendoscopy. Sialendoscopy is an effective treatment for patients with RIS or CIS refractory to conservative management.