Metabolic, Radiation, and Medication Induced Sialadenitis
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SALIVARY GLAND DISORDERS (HT HOFFMAN, SECTION EDITOR)
Metabolic, Radiation, and Medication Induced Sialadenitis Jacqueline E. Harris 1 & Stephen Y. Lai 2 & Jolie L. Chang 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review This review will cover clinical presentations for sialadenosis, radiation-related sialadenitis, and medicationinduced salivary disorders. Recent Findings Presentation of metabolic disorder–related sialadenosis or gland enlargement is gradual and progressive without obstructive salivary symptoms. In contrast, radioactive iodine therapy can induce acute and chronic sialadenitis due to salivary gland dysfunction and duct damage with subsequent duct stenosis. Obstructive symptoms associated with fluctuating gland swelling and pain can be treated with sialendoscopy and dilation of the main salivary ducts. Further investigation of radioprotective agents to prevent salivary gland damage from radioactive iodine and external beam radiation to the head and neck is necessary. Iodine contrast–induced sialadenitis and medications that may affect salivary function are also described. Summary Metabolic disorders, medications, radiation, and iodine contrast can cause salivary gland dysfunction. Management of salivary gland swelling and obstruction depends on the cause of chronic sialadenitis. Keywords Sialadenosis . Radioactive iodine sialadenitis . Sialendoscopy . Sialadenitis . Sialadenosis . Radioactive iodine– induced sialadenitis . Radiation . Iodine contrast
Introduction Chronic and recurrent salivary gland swelling can be caused by metabolic disorders, medications, or radiation. Pathophysiology of chronic sialadenitis due to metabolic causes differs from disease caused by radiation therapy. Most prior studies have been focused on radioactive iodine– associated sialadenitis including rates of disease, potential
preventative therapies, and outcomes with management using sialendoscopy. In this review, we outline the most salient features in managing patients with chronic and recurrent salivary gland swelling due to medications, metabolic diseases, or radiation.
Sialosis (Sialadenosis) This article is part of the Topical collection on Salivary Gland Disorders * Jolie L. Chang [email protected] Jacqueline E. Harris [email protected] Stephen Y. Lai [email protected] 1
Department of Otolaryngology, Head and Neck Surgery, University of California, San Francisco, San Francisco, CA, USA
2
Department of Head and Neck Surgery and Radiation Oncology, and Molecular and Cellular Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
Sialosis or sialadenosis is a chronic condition associated with salivary gland parenchymal enlargement that is gradually progressive and does not typically fluctuate. Sialadenosis is not associated with typical salivary obstructive symptoms and does not present with worse gland swelling during meal-times [1]. Sialadenosis typically represents painless, non-neoplastic, and non-inflammatory bilateral paro
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