Impact of sialendoscopy on improving health related quality of life in patients suffering from radioiodineinduced xerostomia

Abstract

Summary Introduction: Xerostomia following radioiodine therapy (RIT) in patients suffering from differentiated thyroid cancer is a common side effect in 2 % to 67 % of patients treated with radioiodine (I-131). In order to evaluate the impact of sialendoscopy on health related quality of life (HRQOL) in patients suffering from therapy induced sialadenitis and xerostomia, we analyzed findings from two dedicated questionnaires (Xerostomy Questionnaire XQ and Xerostomy Inventory XI) in patients before and three months after sialendoscopy. Procedures: In total, 12 patients suffering from differentiated thyroid carcinoma (10 women and 2 men) were evaluated. All patients had experienced conservative management. Patients were offered a sialendoscopy procedure if no major contradictions were present. Patients who denied the procedure formed the control group. Pre- and (three months) postoperative HRQOL was measured with the Patient Reported Outcome Measures (PROM) Xerostomia Questionnaire (XQ) and the Xerostomia Inventory (XI), as well as by a pre- and post-interventional salivary gland scintigram. Patients were graded according to their sialendoscopical findings. Results: Interventional group presented with significant improvements in HRQOL measurements regarding XQ and XI-scores three months postoperatively. Control group showed no significant changes in the XQ or the XI scores. Number of RIT and cumulative activity of I-131 did not correlate with higher disease grade in regards to sialendoscopical findings nor did it correlate with higher XQand XI scores. Pre- and post-interventional salivary gland scintigram stated that parotid glands are more severely damaged than submandibular glands (SMG), but no significant scintigraphically changes could be detected after sialendoscopy. Conclusion: Sialendoscopy in patients suffering from therapy induced sialadenitis and xerostomia seems to be beneficial when evaluating the impact on HRQOL. Functional parameters measured by salivary gland scintigram did not show significant changes in post-interventional scintigrams.

Validating the Xerostomia Inventory in a radiation‐induced xerostomia population in German language

“…Self-reported health assessment is gaining importance in medical research in recent years and is frequently chosen as a primary endpoint in studies, highlighting the focus on patient's individual impairment (Bhayani et al, 2015;Brettschneider et al, 2011;Eisbruch et al, 2003;Rathke et al, 2019). Studies have shown that objective endpoints of studies such as scintigraphy, with regard to xerostomia, are not always congruent with subjective measurements (Bulut et al, 2018;Eisbruch et al, 2003;Rathke et al, 2019). Therefore, self-report assessments of oral health and functional status are more frequently utilized.…”

“…Fourteen patients underwent the sialendoscopy procedure, all by the same surgeon (OCB). The procedure was performed under local anesthesia using a standard approach as described in the literature (Bulut et al, 2018;Rathke et al, 2019). Three patients received additional sialendoscopies as each cycle of Lu-PSMA had worsened their xerostomia resulting in 23 pre-and postoperative assessments.…”

Ultrasonographic Features of Salivary Glands after Radioiodine Therapy in Patients with Thyroid Cancer

“…6,7 Sialendoscopy is a novel means for alleviating obstructive symptoms of RAI-induced sialadenitis 10 and improving the quality of life of affected patients. 8 Recent studies have shown promising outcomes when the procedure is performed early in the course of the disease. 11 The present study aimed to evaluate the early ultrasonographic features of the major salivary glands following postoperative RAI in patients with PTC.…”

“…Secondarily, soft‐tissue neck ultrasound can help clinicians evaluate the salivary glands. It can detect diffuse and focal lesions, dilated ducts, areas of calcification, and stones within the parotid glands 8 . In a study investigating the prevalence of ultrasound‐detected sialadenitis caused by external beam radiotherapy, Horvath et al 9 found changes in the echotexture, echogenicity, and margins of the major salivary glands and reduced glandular size.…”

“…Sialendoscopy is a novel means for alleviating obstructive symptoms of RAI‐induced sialadenitis 10 and improving the quality of life of affected patients 8 . Recent studies have shown promising outcomes when the procedure is performed early in the course of the disease 11…”