Canzi P, Cacciola S, Capaccio P, Pagella F, Occhini A, Pignataro L, Benazzo M
Department of Otorhinolaryngology, University of Pavia, IRCCS Policlinico "San Matteo" Foundation, Pavia, Italy.
Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Acta Otorhinolaryngol Ital. 2017 Apr;37(2):155-159. doi: 10.14639/0392-100X-1606.
Salivary gland toxicity is a common adverse effect of radioactive iodine (I) for the treatment of thyroid cancers with a prevalence ranging from 2% to 67% of the I exposed population. Recently, sialendoscopy has been introduced as an attractive diagnostic and therapeutic tool for management of patients with radioiodine-induced sialadenitis that is unresponsive to standard medical treatments. The objective of the current review was to assess the impact of this procedure on outcomes in patients suffering from radioiodine sialadenitis. Overall, eight studies were included and 122 patients underwent 264 sialendoscopic procedures. Duct stenosis and mucous plugs were observed in 85.7% of endoscopic findings, supporting the role of ductal obstruction in the pathophysiology of radioiodine sialadenitis. In total, 89.3% of patients experienced complete or partial resolution of sialadenitis recurrences without any major adverse events, and parotidectomy was advocated in only 1 case. However, outcomes mainly concerned subjective reports and only two clinical experiences evaluated objective measurement with dissimilar results. Limited to few studies, xerostomia and obstructive symptoms responded differently after sialendoscopy. The optimal timing of salivary gland videoendoscopy needs to be further analysed in order to define the best management of radioiodine-induced obstructive sialadenitis.
唾液腺毒性是放射性碘（I）治疗甲状腺癌的常见不良反应，在接受碘治疗的人群中，其发生率为2%至67%。最近，唾液腺内镜检查已成为一种有吸引力的诊断和治疗工具，用于管理对标准药物治疗无反应的放射性碘诱发的涎腺炎患者。本综述的目的是评估该手术对放射性碘涎腺炎患者治疗结果的影响。总体而言，纳入了八项研究，122例患者接受了264次唾液腺内镜手术。在内镜检查结果中，85.7%观察到导管狭窄和黏液栓，这支持了导管阻塞在放射性碘涎腺炎病理生理学中的作用。总共89.3%的患者涎腺炎复发完全或部分缓解，且无任何重大不良事件，仅1例患者主张进行腮腺切除术。然而，结果主要涉及主观报告，只有两项临床经验评估了客观测量，结果不同。由于研究较少，唾液腺内镜检查后口干症和阻塞性症状的反应有所不同。为了确定放射性碘诱发的阻塞性涎腺炎的最佳管理方法，需要进一步分析唾液腺视频内镜检查的最佳时机。
