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唾液腺内镜在放射性碘诱发的涎腺炎治疗中的应用:一项系统评价

Sialendoscopy in the Management of Radioiodine Induced Sialadenitis: A Systematic Review.

作者信息

Cung Thai-Duong, Lai Wanda, Svider Peter F, Hanba Curtis, Samantray Julie, Folbe Adam J, Shkoukani Mahdi, Raza Syed Naweed

机构信息

1 Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, Michigan, USA.

2 Division of Endocrinology, Diabetes, and Metabolism, Wayne State University School of Medicine, Detroit, Michigan, USA.

出版信息

Ann Otol Rhinol Laryngol. 2017 Nov;126(11):768-773. doi: 10.1177/0003489417732795. Epub 2017 Sep 26.

Abstract

OBJECTIVES

Salivary gland dysfunction as a consequence of radioiodide ablation is present in as many as two-thirds of patients, and unfortunately, many of these individuals do not respond to conservative measures. Sialendoscopy as a minimally invasive therapeutic modality may have utility in the treatment of radioiodide induced sialadenitis (RAIS). Our aim was to explore whether sialendoscopy resulted in clinical improvement in patients with RAIS.

METHODS

A systematic review of studies on sialendoscopy for RAIS was conducted using MEDLINE database, Embase, and Cochrane Library. The outcomes of interest included the proportion of patients demonstrating clinical improvement after intervention, patient demographics, radiation dose, specific procedural variations, specific salivary gland, failure rate, and recurrence.

RESULTS

Eight studies met inclusion criteria. Data reviewed showed an increased predilection of parotid sialadenitis relative to submandibular gland sialadenitis. All but 2 studies employed sialendoscopy only after failure of conservative measures. An overall rate of clinical improvement ranging from 75% to 100% was reported.

CONCLUSION

This systematic review encompassing 122 patients represents the largest pooled sample to date of patients undergoing sialendoscopy for RAIS. Sialendoscopy represents an invaluable minimally invasive modality that may obviate the need for more invasive surgery as intervention was associated with a high success rate.

摘要

目的

放射性碘消融导致的唾液腺功能障碍在多达三分之二的患者中存在,不幸的是,这些患者中的许多人对保守治疗措施无反应。唾液腺内镜检查作为一种微创治疗方式,可能对放射性碘诱发的涎腺炎(RAIS)治疗有用。我们的目的是探讨唾液腺内镜检查是否能使RAIS患者临床症状改善。

方法

使用MEDLINE数据库、Embase和Cochrane图书馆对关于唾液腺内镜检查治疗RAIS的研究进行系统评价。感兴趣的结果包括干预后临床症状改善的患者比例、患者人口统计学特征、辐射剂量、具体操作差异、特定唾液腺、失败率和复发情况。

结果

八项研究符合纳入标准。审查的数据显示,腮腺涎腺炎相对于下颌下腺涎腺炎的发生率更高。除两项研究外,所有研究均仅在保守治疗措施失败后才采用唾液腺内镜检查。报告的总体临床改善率为75%至100%。

结论

这项涵盖122例患者的系统评价是迄今为止接受唾液腺内镜检查治疗RAIS患者的最大汇总样本。唾液腺内镜检查是一种非常有价值的微创方式,由于干预成功率高,可能无需进行更具侵入性的手术。

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