Abstract
The objective of this study is to investigate thyroid and parathyroid functions in patients with laryngeal carcinoma after total laryngectomy with hemithyroidectomy with or without irradiation, and to determine if irradiation when following surgery has an additive effect contributing to either or both glands hypo function. This study included 17 patients with laryngeal squamous cell carcinoma who were subjected to surgery. Nine of them were further justified for postoperative radiotherapy as well. All patients were subjected to Clinical assessment, including adequate history taking and physical examination, to detect the presence of hypothyroidism or hypoparathyroidism. Laboratory assessment of thyroid function included TSH and T4 assay, and parathyroid function included corrected serum calcium and parathormone levels. Eight (48 %) patients were treated with surgery alone, and 9 (52 %) patients received postoperative radiotherapy. In this study, 13 out of the 17 patients (78 %) were found to be hypothyroid and 4 (22 %) were euthyroid, while 7 (42 %) were found to have hypoparathyroidism. The study showed; among the 8 patients who were treated by surgery only, 5 (62.5 %) of them developed hypothyroidism and 3 (37.5 %) were euthyroid and 3 (37.5 %) developed hypoparathyroidism and 5 (62.5 %) were normal. Among the 9 patients who were treated by surgery and radiotherapy, 8 (88.9 %) developed hypothyroidism and 1 (11.1 %) was euthyroid and 4 (44.4 %) developed hypoparathyroidism and 5 (55.6 %) were normal. The study confirms the development of hypothyroidism with or without hypoparathyroidism after total laryngectomy with a higher incidence in those treated by combined surgery and radiotherapy and in supraglottic tumors.
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Cooper JS, Pajak TF, Forastiere AA et al (2004) Postoperative concurrent radiotherapy and chemotherapy for high risk squamous cell carcinoma of the head and neck. N Engl J Med 350:1937–1944
Pfister DG, Laurie SA, Weinstein GS et al (2006) American Society of Clinical Oncology clinical practice guideline for the use of larynx-preservation strategies in the treatment of laryngeal cancer. J Clin Oncol 24:3693–3704
Kleinsasser O (1988) Tumors of the larynx and hypopharynx. Thieme, New York
Brennan AJ, Meyers AD, Jafek BW (1991) The intra-operative management of the thyroid gland during laryngectomy. Laryngoscope 101:929–934
Tami TA, Gomez P, Parker GS et al (1992) Thyroid dysfunction after radiation therapy in head and neck cancer patients. Am J Otolaryngol 13(6):357–362
Pallotti F, Seregni E, Ferrari L et al (2003) Diagnostic and therapeutic aspects of iatrogenic hypoparathyroidism. Tumori 89:547–549
Galbo AML, Kuik DJ, Lips P, von Blomberg BME et al (2013) A prospective longitudinal study on endocrine dysfunction following treatment of laryngeal or hypopharyngeal carcinoma. Oral Oncol 49(9):950–955
Weissler MC, Berry BW (1991) Thyroid-stimulating hormone levels after radiotherapy and combined therapy for head and neck cancer. Head Neck 13:357–362
Lo Galbo AM, De Bree R, Kuik DJ et al (2007) The prevalence of hypothyroidism after treatment for laryngeal and hypopharyngeal carcinomas: are autoantibodies of influence? Acta Otolaryngol 127:312–317
Stell PM, Jones AS, Ravi M (1993) The treatment of primary recurrence following laryngectomy for laryngeal carcinoma. J Laryngol Otol 107(7):611–613
Fagan JJ, Kaye PV (1997) Management of the thyroid gland with laryngectomy for T2 glottic carcinomas. Clin Otolaryngol 22:7–12
Graney DO, Hamaker RC (1993) Anatomy of the thyroid and parathyroid glands. In: Cummings CW, Frederickson JM, Harker LA et al (eds) Otolaryngology: head and neck surgery, vol 3, 2nd edn. Mosby Year Book, Saint Louis, pp 2403–2407
Norris AA, Amdur RJ, Morris CG et al (2006) Hypothyroidism when the thyroid is included only in the low neck field during head and neck radiotherapy. Am J Clin Oncol 29:442–445
Garcia-Serra A, Amdur RJ, Morris CG et al (2005) Thyroid function should be monitored following radiotherapy to the low neck. Am J Clin Oncol 28:255–258
Leon X, Gras JR, Perez A et al (2002) Hypothyroidism in patients treated with total laryngectomy. A multivariate study. Eur Arch Otorhinolaryngol 259:193–196
Ledger GA (1994) Hypocalcaemia and hypoparathyroidism. Curr Ther Endocrinol Metabol 5:508–510
Isaacson SR, Snow JB (1978) Etiologic factors in hypocalcaemia secondary to operations for carcinoma of the pharynx and larynx. Laryngoscope 88:1290–1297
Bhandare N, Kennedy L, Malyapa R et al (2007) Primary and central hypothyroidism after radiotherapy for head-and-neck tumors. Int J Radiat Oncol Biol Phys 68:1131–1139
Tell R, Lundell G, Nilsson B et al (2004) Long-term incidence of hypothyroidism after radiotherapy in patients with head-and-neck cancer. Int J Radiat Incol Biol Phys 60:395–400
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Negm, H., Mosleh, M., Fathy, H. et al. Thyroid and parathyroid dysfunction after total laryngectomy in patients with laryngeal carcinoma. Eur Arch Otorhinolaryngol 273, 3237–3241 (2016). https://doi.org/10.1007/s00405-016-4105-3
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DOI: https://doi.org/10.1007/s00405-016-4105-3