Treatment of Radioiodine-Induced Xerostomia in Patients with Differenciated Thyroid Carcinoma

Patients with differentiated thyroid carcinoma (DTC) after radio iodine therapy (RIT) often suffer from severe xerostomia due to an acute or chronic sialadenitis with reduced function of the salivary glands. This loss of function can be visualised in scintigraphic imaging. Furthermore, the resulting xerostomia can lead to a reduced health related quality of life (HRQoL) in these patients. The primary hypothesis of this study was that sialendoscopy can improve salivary gland function and also increase HRQoL.

In total, 12 patients after RIT due to DTC were evaluated. After conservative treatment failed, they were offered a sialendoscopy procedure (dilation, irrigation and instillation of 100 mg prednisolone per gland). Patients who declined this procedure formed the control group. Pre- and three months postoperative salivary gland scintigraphy was performed as well as measurement of HRQoL with two validated questionnaires.

We found that parotid glands were significantly more affected by RIT than submandibular glands. Contrary to our hypothesis sialendoscopy did not change the salivary output measured in the scintigrafies. However, the interventional group did show a significant increase in HRQoL compared to our control group. Sialendoscopy seems to be beneficial in patients suffering from xerostomia after RIT in regards to HRQoL. On the other hand, significant changes in functional parameters measured with salivary gland scintigraphy could not be shown.

Publication History

Publication Date:
23 April 2019 (online)