Sialography One Year After 156 mCi I131 (Radioiodine)
Tuesday, September 16, 2025

Return to: Sialography - How To and Do I Need To? Contemporary Infusion Digital Sialography

 

Case #1 

Presentation: 36 yo with 6 months of recurrent bilateral parotid swelling and pain with onset of dry mouths beginning for 6 months after receiving 156 Ci radioiodine 1 year ago. Pain with and without meals. 

Exam: soft parotid glands with dry mouth unable to produce saliva with massage

CT: unremarkable salivary glands

Ultrasound (POCUS at time of visit): 

Ultrasound after I131 Right Parotid

 

Ultrasound after I131 Left Parotid

 

Panel Discussion Regarding Management

Sialogram:  

 

Left parotid sialogram I131

 

Right Parotid Sialogram after I131

Management Options Discussed:

a. Observation (anticipated atrophy)

b. Steroid Injection to Parotid Glands

c. Botulinum Toxin Injection to Parotid Glands

Outcome:

  1. Immediately after Sialography: Tolerated well, mild improvement in pain and swelling
  2. 2 months after Sialography: Return to baseline
  3. 6 months after Sialography: In clinic procedure Bilateral Parotid Kenalog 10 Insufflation
  4. 3 months after steroid injection: Pain and swelling episodes were so rare that patient was surprised by any occurrence of symptoms