Bomeli Steven R, Schaitkin Barry, Carrau Ricardo L, Walvekar Rohan R
Department of Otolaryngology and Head Neck Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Laryngoscope. 2009 May;119(5):864-7. doi: 10.1002/lary.20140.
OBJECTIVES/HYPOTHESIS: The purpose of this study is to review our experience with sialendoscopy for the management of radioiodine-induced sialadenitis.
Retrospective chart review of all patients with radioiodine-induced sialadenitis treated with interventional sialendoscopy.
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).
Interventional sialendoscopy is an effective tool for the management of patients with radioiodine-induced sialadenitis that is unresponsive to medical management.
目的/假设:本研究的目的是回顾我们使用唾液腺内镜治疗放射性碘诱发的涎腺炎的经验。
对所有接受介入性唾液腺内镜治疗的放射性碘诱发的涎腺炎患者进行回顾性病历审查。
12名女性患者,平均年龄46.5岁(范围25 - 77岁),接受介入性唾液腺内镜治疗,以处理因放射性碘对主要唾液腺造成损伤而导致的顽固性涎腺炎。75%的患者出现腮腺症状,50%的患者出现颌下腺症状。3名患者(25%)腮腺和颌下腺均出现症状。患者转诊前单次接受的放射性碘平均剂量为143毫居里(范围101.9 - 185.7毫居里)。从放射性碘消融治疗到唾液腺内镜检查的平均时间为10.4个月(范围5 - 16个月)。32个腺体(20个腮腺,12个颌下腺)被送入手术室,27个腺体(84.4%)完成了内镜检查。导管狭窄(30%)和黏液栓(44%)是最常见的导管病变类型。唾液腺内镜改善了75%(9/12)患者的症状,在2周至33个月(中位数6个月)的随访中未报告严重并发症。
介入性唾液腺内镜是治疗对药物治疗无反应的放射性碘诱发的涎腺炎患者的有效工具。