Clinical Effectiveness of Sialendoscopy in Radioactive Iodine-induced Sialadenitis: A Systematic Review and Meta-analysis.

Abstract

To systematically review and synthesize outcomes following sialendoscopy in patients with salivary gland dysfunction and a history of radioactive iodine (RAI). A comprehensive search of Medline, Embase, and Cochrane Library was conducted from database inception through December 26, 2025. Two reviewers independently screened studies in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Eligible studies reported outcomes of sialendoscopy in patients with a history of RAI therapy. Case reports, reviews, meta-analyses, letters, conference abstracts, and non-English or non-French publications were excluded. Risk of bias was assessed using the Risk of Bias Assessment tool for Nonrandomized Studies (RoBANS). Twenty-two studies encompassing 387 patients and 626 salivary glands treated with sialendoscopy for RAI-induced sialadenitis were included. The most common intraoperative findings were ductal stenosis (52.2%; 95% CI, 33.1-71.4) and mucous plugs (31.0%; 95% CI, 18.6-43.4). Overall, 87.9% of patients (95% CI, 82.6-93.2) experienced partial to complete symptomatic improvement following sialendoscopy. At the gland level, partial to complete improvement was observed in 71.2% of glands (95% CI, 56.4-86.0). The pooled recurrence rate was 7.4% (95% CI, 2.1-12.7). No major complications were reported. Among reported complications, 17 of 22 were associated with cases of severe ductal stenosis. Sialendoscopy is an effective, minimally invasive treatment for RAI-induced sialadenitis. Most patients experience meaningful symptomatic improvement with a low recurrence rate and minimal morbidity.