{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T05:02:47Z","timestamp":1790226167630,"version":"4.1.0"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:00:00Z","timestamp":1790208000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Nasal symptoms after radioactive iodine (RAI) therapy in differentiated thyroid cancer have received less attention than salivary or lacrimal toxicity. Nasal saline irrigation is a simple supportive-care measure, but its association with post-RAI nasal symptom burden remains insufficiently evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This single-center retrospective cohort study included patients with differentiated thyroid cancer who received\n                      <jats:sup>131<\/jats:sup>\n                      I remnant ablation or therapy at Qingdao Municipal Hospital between April 2024 and March 2025. Patients received either standard care alone or standard care plus stepped nasal irrigation with 0.9% saline. Nasal symptoms were assessed using a 0\u201310 visual analog scale at discharge and at 2 weeks, 1 month, and 2 months after discharge. Propensity score matching was used to construct the matched cohort. Post-therapy imaging on days 3 and 7 was used to explore nasal mucosa target-to-background (T\/B) ratios.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 185 eligible patients, 92 received standard care and 93 received nasal irrigation. After matching, 148 patients were included in the primary analysis. Symptoms meeting the prespecified VAS \u22653 threshold occurred in 27 of 74 patients (36.5%) in the standard-care group and 13 of 74 patients (17.6%) in the irrigation group (risk difference, \u221220.27 percentage points; 95% CI, \u221234.32 to \u22126.22; P\u00a0=\u00a00.005). Rescue medication was required in 25 of 74 patients (33.8%) and 11 of 74 patients (14.9%), respectively. Nasal dryness showed the most consistent between-group difference. The day-7 T\/B ratio was lower in the irrigation group (2.24 \u00b1 0.76 vs. 2.56 \u00b1 0.81; P\u00a0=\u00a00.012), whereas the day-3 ratio was similar.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this retrospective cohort, stepped nasal saline irrigation was associated with fewer early post-RAI nasal symptoms and less rescue medication use. The imaging findings were exploratory and should not be interpreted as direct evidence of enhanced radioiodine clearance. Prospective studies are needed to confirm these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2026.1897010","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T04:37:42Z","timestamp":1790224662000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of nasal irrigation with reduced nasal symptoms after radioiodine ablation in differentiated thyroid cancer: a retrospective cohort study with propensity score matching"],"prefix":"10.3389","volume":"17","author":[{"given":"Juan","family":"Ren","sequence":"first","affiliation":[{"name":"Department of Nuclear Medicine, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital)","place":["Qingdao, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuiyuan","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital)","place":["Qingdao, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanfei","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital)","place":["Qingdao, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yueyun","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital)","place":["Qingdao, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feibo","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital)","place":["Qingdao, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shasha","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital)","place":["Qingdao, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zongping","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital)","place":["Qingdao, China"]},{"name":"Qingdao Medical College of Qingdao University","place":["Qingdao, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuai","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital)","place":["Qingdao, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1089\/thy.2015.0020","article-title":"2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer","volume":"26","author":"Haugen","year":"2016","journal-title":"Thyroid"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2015.09.001","article-title":"Intermediate and long-term adverse effects of radioiodine therapy for differentiated thyroid carcinoma--a systematic review","volume":"41","author":"Clement","year":"2015","journal-title":"Cancer Treat Rev"},{"key":"B3","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1007\/s12020-018-1720-3","article-title":"Routine thyroglobulin, neck ultrasound and physical examination in the routine follow up of patients with differentiated thyroid cancer-Where is the evidence","volume":"62","author":"Gray","year":"2018","journal-title":"Endocrine"},{"key":"B4","article-title":"Intermediate and long-term side effects of high-dose radioiodine therapy for thyroid carcinoma","volume":"39","author":"Alexander","year":"1998","journal-title":"J Nucl Med"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2012.0106","article-title":"Salivary gland function 5 years after radioactive iodine ablation in patients with differentiated thyroid cancer: direct comparison of pre- and postablation scintigraphies and their relation to xerostomia symptoms","volume":"23","author":"Jeong","year":"2013","journal-title":"Thyroid"},{"key":"B6","article-title":"Salivary and lacrimal gland dysfunction (sicca syndrome) after radioiodine therapy","volume":"42","author":"Solans","year":"2001","journal-title":"J Nucl Med"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1053\/j.semnuclmed.2024.05.002","article-title":"Radioactive iodine therapy in differentiated thyroid cancer: An update on dose recommendations and risk of secondary primary Malignancies","volume":"54","author":"Nguyen","year":"2024","journal-title":"Semin Nucl Med"},{"key":"B8","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1159\/000432397","article-title":"Radioiodine treatment and thyroid hormone suppression therapy for differentiated thyroid carcinoma: Adverse effects support the trend toward less aggressive treatment for low-risk patients","volume":"4","author":"Klein Hesselink","year":"2015","journal-title":"Eur Thyroid J"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2009.1611","article-title":"The benefits and risks of 131I therapy in patients with well-differentiated thyroid cancer","volume":"19","author":"Van Nostrand","year":"2009","journal-title":"Thyroid"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2010.0093","article-title":"Thyroid carcinoma","volume":"8","author":"Tuttle","year":"2010","journal-title":"J Natl Compr Canc Netw"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1089\/105072503321582060","article-title":"Radioactive iodine and the salivary glands","volume":"13","author":"Mandel","year":"2003","journal-title":"Thyroid"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2014.0162","article-title":"Nasal symptoms after radioiodine therapy: a rarely described side effect with similar frequency to lacrimal dysfunction","volume":"24","author":"Jonklaas","year":"2014","journal-title":"Thyroid"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26652","article-title":"How does radioactive iodine affect the nose","volume":"127","author":"Server","year":"2017","journal-title":"Laryngoscope"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24895","article-title":"Correlation among ocular surface disease, xerostomia, and nasal symptoms in patients with differentiated thyroid carcinoma subjected to radioiodine therapy: A prospective comparative study","volume":"39","author":"da Fonseca","year":"2017","journal-title":"Head Neck"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2016.30.4384","article-title":"The effects of radioactive iodine therapy on olfactory function","volume":"30","author":"Suat","year":"2016","journal-title":"Am J Rhinol Allergy"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215120002571","article-title":"Does the radioactive iodine dose affect smell, taste sensation and nose function","volume":"135","author":"Tutar","year":"2021","journal-title":"J Laryngol Otol"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-024-03684-2","article-title":"Salivary, lacrimal and nasal (SALANS) measure to assess side effects following radioactive iodine treatment: development, psychometric properties, and factor structure","volume":"33","author":"Jonklaas","year":"2024","journal-title":"Qual Life Res"},{"key":"B18","doi-asserted-by":"publisher","first-page":"48","DOI":"10.1210\/er.2001-0029","article-title":"The sodium\/iodide Symporter (NIS): characterization, regulation, and medical significance","volume":"24","author":"Dohan","year":"2003","journal-title":"Endocr Rev"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.83.5.4839","article-title":"Analysis of human sodium iodide symporter gene expression in extrathyroidal tissues and cloning of its complementary deoxyribonucleic acids from salivary gland, mammary gland, and gastric mucosa","volume":"83","author":"Spitzweg","year":"1998","journal-title":"J Clin Endocrinol Metab"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1097\/IOP.0000000000000603","article-title":"Iodine-131 therapy and lacrimal drainage system toxicity: Nasal localization studies using whole body nuclear scintigraphy and SPECT-CT","volume":"33","author":"Ali","year":"2017","journal-title":"Ophthalmic Plast Reconstr Surg"},{"key":"B21","article-title":"Rhinitis medicamentosa","volume-title":"Statpearls","author":"Zeitlin","year":"2026"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD006394.pub2","article-title":"Nasal saline irrigations for the symptoms of chronic rhinosinusitis","author":"Harvey","year":"2007","journal-title":"Cochrane Database Syst Rev"},{"key":"B23","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1682\/JRRD.2009.08.0116","article-title":"Validity of PTSD diagnoses in VA administrative data: comparison of VA administrative PTSD diagnoses to self-reported PTSD Checklist scores","volume":"48","author":"Gravely","year":"2011","journal-title":"J Rehabil Res Dev"},{"key":"B24","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.otohns.2005.03.002","article-title":"The efficacy of hypertonic saline nasal irrigation for chronic sinonasal symptoms","volume":"133","author":"Rabago","year":"2005","journal-title":"Otolaryngol Head Neck Surg"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.133.11.1115","article-title":"Nasal saline for chronic sinonasal symptoms: a randomized controlled trial","volume":"133","author":"Pynnonen","year":"2007","journal-title":"Arch Otolaryngol Head Neck Surg"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2025.1670372","article-title":"Efficacy of different nasal irrigation treatments versus placebo in allergic rhinitis: a systematic review and network meta-analysis","volume":"16","author":"Hu","year":"2025","journal-title":"Front Pharmacol"},{"key":"B27","article-title":"Peritoneal dialysis fluid (PDF) C++ and 1,25(OH)2D3 modulate peritoneal macrophage (PM0) antimicrobial activity in CAPD patients","volume":"6","author":"Carozzi","year":"1990","journal-title":"Adv Perit Dial"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.541782.AD","article-title":"Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"335","author":"von Elm","year":"2007","journal-title":"BMJ"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2023.1145926","article-title":"Proteasome inhibitors in medullary thyroid carcinoma: time to restart with clinical trials","volume":"14","author":"Fanciulli","year":"2023","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD011995.pub2","article-title":"Saline irrigation for chronic rhinosinusitis","volume":"4","author":"Chong","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"B31","doi-asserted-by":"publisher","first-page":"CD012597","DOI":"10.1002\/14651858.Cd012597","article-title":"Saline irrigation for allergic rhinitis","volume":"6","author":"Head","year":"2017","journal-title":"Cochrane Database Systematic Rev"},{"key":"B32","article-title":"Efficacy of daily hypertonic saline nasal irrigation among patients with sinusitis: a randomized controlled trial","volume":"51","author":"Rabago","year":"2002","journal-title":"J Fam Pract"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1897010\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T04:38:03Z","timestamp":1790224683000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2026.1897010\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,24]]},"references-count":32,"alternative-id":["10.3389\/fendo.2026.1897010"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2026.1897010","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,24]]},"article-number":"1897010"}}