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Peripheral Facial Nerve Palsy after High-Dose Radioiodine Therapy in Patients with Papillary Thyroid Carcinoma
- David Levenson, MD;
- Seza Gulec, MD;
- Martin Sonenberg, MD, PhD;
- Eseng Lai, MD, PhD;
- Stanley J. Goldsmith, MD; and
- Steven M. Larson, MD
- From the Memorial Sloan-Kettering Cancer Center, New York, New York. Requests for Reprints: David Levenson, MD, Department of Medicine, Endocrinology Service, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021-6094. Grant Support: By the Endocrine and Metabolic Research Training Program, National Institutes of Health grant DK07313.
Sialoadenitis is a frequent complication of radioiodine treatment, occurring clinically in 10% of patients [1], although biochemical alterations of saliva are present 100% of the time [2]. This is caused by the similar iodine avidity of the salivary gland and thyroid tissue, each achieving a tissue-to-serum ratio of approximately 50 [3]. Administration of thyroid-stimulating hormone can cause a tenfold increase in thyroid iodine uptake [4].
May [5] listed 81 distinct causes of peripheral facial nerve palsies, including traumatic, infectious, and metabolic. Idiopathic Bell palsy accounted for 57% of the 1575 cases he himself reported. Peripheral facial nerve palsy is associated with nonmalignant parotitis. Andrews and colleagues [6] found only 10 reported cases and presented three more. Our extensive MEDLINE search failed to reveal any previously reported associations between facial nerve palsy and radioiodine treatment. We present two cases of facial nerve palsies in patients who developed parotitis after radioiodine therapy.
Case Reports
Patient 1
A 51-year-old man had locally invasive (stage 2) papillary thyroid carcinoma, for which he was treated with …
