Metabolic, Radiation, and Medication Induced Sialadenitis

This review will cover clinical presentations for sialadenosis, radiation-related sialadenitis, and medication-induced salivary disorders. 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. 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.