Salivary and lacrimal dysfunction after radioactive iodine for differentiated thyroid cancer: American Head and Neck Society Endocrine Surgery Section and Salivary Gland Section joint multidisciplinary clinical consensus statement of otolaryngology, ophthalmology, nuclear medicine and endocrinology

Michael C Singer; Francis Marchal; Peter Angelos; Vic Bernet; Laura Boucai; Samanta Buchholzer; Brian Burkey; David Eisele; Evren Erkul; Frederic Faure; Suzanne K Freitag; Marion Boyd Gillespie; Richard Mack Harrell; Dana Hartl; Megan Haymart; Jonathan Leffert; Susan Mandel; Barbra S Miller; John Morris; Elizabeth N Pearce; Rahmatullah Rahmati; William R Ryan; Barry Schaitkin; Martin Schlumberger; Brendan C Stack; Doug Van Nostrand; Ka Kit Wong; Gregory Randolph

doi:10.1002/hed.26417

Salivary and lacrimal dysfunction after radioactive iodine for differentiated thyroid cancer: American Head and Neck Society Endocrine Surgery Section and Salivary Gland Section joint multidisciplinary clinical consensus statement of otolaryngology, ophthalmology, nuclear medicine and endocrinology

Head Neck. 2020 Nov;42(11):3446-3459. doi: 10.1002/hed.26417. Epub 2020 Aug 19.

Authors

Michael C Singer¹, Francis Marchal², Peter Angelos³, Vic Bernet⁴, Laura Boucai⁵, Samanta Buchholzer⁶, Brian Burkey⁷, David Eisele⁸, Evren Erkul⁹, Frederic Faure², Suzanne K Freitag¹⁰, Marion Boyd Gillespie¹¹, Richard Mack Harrell¹², Dana Hartl¹³, Megan Haymart¹⁴, Jonathan Leffert¹⁵, Susan Mandel¹⁶, Barbra S Miller¹⁷, John Morris¹⁸, Elizabeth N Pearce¹⁹, Rahmatullah Rahmati²⁰, William R Ryan²¹, Barry Schaitkin²², Martin Schlumberger²³, Brendan C Stack²⁴, Doug Van Nostrand²⁵, Ka Kit Wong²⁶, Gregory Randolph²⁷

Affiliations

¹ Department of Otolaryngology - Head and Neck Surgery, Henry Ford Health System, Detroit, Michigan, USA.
² Department of Otolaryngology - Head and Neck Surgery, Geneva University Hospital, Geneva, Switzerland.
³ Department of Surgery, University of Chicago Medical Center, Chicago, Illinois, USA.
⁴ Department of Endocrinology, Mayo Clinic Jacksonville, Jacksonville, Florida, USA.
⁵ Department of Endocrinology, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
⁶ Maxillofacial Surgery and Oral Medicine and Pathology, Geneva University Hospital, Geneva, Switzerland.
⁷ Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio, USA.
⁸ Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
⁹ Department of Otorhinolaryngology, Gulhane Medical School, University of Health Sciences, Istanbul, Turkey.
¹⁰ Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA.
¹¹ Department of Otolaryngology, The University of Tennessee Health Science Center, Memphis, Tennessee, USA.
¹² Memorial Center for Integrative Endocrine Surgery, Memorial Healthcare System, Hollywood, Florida, USA.
¹³ Department of Head and Neck Oncology, Institut de Cancerologie Gustave Roussy, Villejuif, France.
¹⁴ Department of Internal Medicine, Division of Metabolism, Endocrinology and Diabetes, University of Michigan, Ann Arbor, Michigan, USA.
¹⁵ North Texas Endocrine Center, Dallas, Texas, USA.
¹⁶ Department of Endocrinology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
¹⁷ Division of Endocrine Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA.
¹⁸ Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota, USA.
¹⁹ Department of Medicine, Section of Endocrinology, Diabetes, Nutrition & Weight Management, Boston University School of Medicine, Boston, Massachusetts, USA.
²⁰ Division of Otolaryngology, Yale School of Medicine, New Haven, Connecticut, USA.
²¹ Department of Otolaryngology - Head and Neck Surgery, University of California, San Francisco, California, USA.
²² Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
²³ Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy and University Paris-Saclay, Villejuif, France.
²⁴ Department of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, Illinois, USA.
²⁵ Division of Nuclear Medicine, MedStar Washington Hospital Center, Washington, District of Columbia, USA.
²⁶ Department of Radiology, Division of Nuclear Medicine, University of Michigan, Ann Arbor, Michigan, USA.
²⁷ Department of Otolaryngology - Head and Neck Surgery, Harvard Medical School, Boston, Massachusetts, USA.

PMID: 32812307
DOI: 10.1002/hed.26417

Abstract

Background: Postoperative radioactive iodine (RAI) administration is widely utilized in patients with differentiated thyroid cancer. While beneficial in select patients, it is critical to recognize the potential negative sequelae of this treatment. The prevention, diagnosis, and management of the salivary and lacrimal complications of RAI exposure are addressed in this consensus statement.

Methods: A multidisciplinary panel of experts was convened under the auspices of the American Head and Neck Society Endocrine Surgery and Salivary Gland Sections. Following a comprehensive literature review to assess the current best evidence, this group developed six relevant consensus recommendations.

Results: Consensus recommendations on RAI were made in the areas of patient assessment, optimal utilization, complication prevention, and complication management.

Conclusion: Salivary and lacrimal complications secondary to RAI exposure are common and need to be weighed when considering its use. The recommendations included in this statement provide direction for approaches to minimize and manage these complications.

Keywords: lacrimal; radioactive iodine; recommendations; salivary; thyroid cancer.

MeSH terms

Consensus
Humans
Iodine Radioisotopes / adverse effects
Nuclear Medicine*
Ophthalmology*
Otolaryngology*
Salivary Glands
Thyroid Neoplasms* / radiotherapy
Thyroid Neoplasms* / surgery
United States

Substances

Iodine Radioisotopes