Savage Mack W, Sobel Rachel K, Hoffman Henry T, Carter Keith D, Finkelstein Michael W, Shriver Erin M
*Carver College of Medicine, University of Iowa, Iowa City; †Department of Ophthalmology, Boston University, Boston, Massachusetts; and Departments of ‡Otolaryngology-Head and Neck Surgery, §Ophthalmology and Visual Sciences, and ‖Oral Pathology, University of Iowa, Iowa City, Iowa, U.S.A.
Ophthalmic Plast Reconstr Surg. 2015 May-Jun;31(3):e50-2. doi: 10.1097/IOP.0000000000000066.
Radioactive iodine has long been used in the treatment of cancers of the thyroid. While salivary complications secondary to I-131 therapy in association with xerophthalmia are well documented, there is little in the literature addressing simultaneous nasolacrimal duct obstruction with salivary gland dysfunction. The authors present 2 patients with epiphora from bilateral nasolacrimal duct obstruction and concurrent sialadenitis following I-131 ablation therapy for papillary thyroid carcinoma. These cases highlight the lacrimal and salivary duct complications resulting from I-131 therapy, introduce the possibility of a shared mechanism of damage, and demonstrate the availability of effective treatments for both conditions. Ophthalmologists see patients with epiphora from I-131 therapy and should be aware of the possible concurrent symptoms caused by salivary duct stenosis to make timely and appropriate referrals.
放射性碘长期以来一直用于治疗甲状腺癌。虽然I - 131治疗继发唾液腺并发症并伴有干眼症已有充分记录，但文献中很少提及同时发生鼻泪管阻塞和唾液腺功能障碍的情况。作者报告了2例因双侧鼻泪管阻塞导致溢泪且在接受I - 131消融治疗乳头状甲状腺癌后并发涎腺炎的患者。这些病例突出了I - 131治疗引起的泪道和唾液腺导管并发症，提出了共同损伤机制的可能性，并证明了这两种情况都有有效的治疗方法。眼科医生会诊治因I - 131治疗而溢泪的患者，应意识到唾液腺导管狭窄可能引起的并发症状，以便及时进行适当的转诊。
