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

OBJECTIVE: To systematically review and synthesize outcomes following sialendoscopy in patients with salivary gland dysfunction and a history of radioactive iodine (RAI). DATA SOURCES: A comprehensive search of Medline, Embase, and Cochrane Library was conducted from database inception through December 26, 2025. REVIEW METHODS: 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). RESULTS: 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. CONCLUSION: 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.