Survey of Post‐thyroidectomy Parathyroid Hormone (PTH) Assay Use by American vs European Thyroid Surgeons

Abstract

POSTERSdetecting early superficial pharyngeal cancers, which are difficult to detect with a standard endoscopy. In this study, we investigated the usefulness of submucosal dissection for such superficial lesions of pharyngeal cancer retrospectively.Method: Fifty patients with superficial pharyngeal cancer were treated since September 2007. Under general anesthesia, a curved laryngoscope was inserted trans-orally, the extent of the lesion was determined by the NBI endoscope, and the lesion was dissected with an orally inserted curved electric knife.Results: Tracheostomy was performed in 5 cases, which had synchronous multiple lesions in the hypopharynx. Regarding adverse effects, postoperative bleeding occurred in one case, which needed emergency tracheostomy. With a median follow-up period of 20 months, metachronous multiple laryngo-pharyngeal cancer occurred in 4 cases and recurrence occurred in 2 cases. All the metachronous cancer cases and the recurrent case were controlled with additional endoscopic submucosal dissection. The cause-specific survival rates at 2 years were 100%. All the patients retained their pharynx and their speaking, breathing, and swallowing functions.Conclusion: Endoscopic submucosal dissection for early pharyngeal cancer allows excellent survival and preservation of swallowing and voice functions. Early detection of superficial pharyngeal cancer with narrow band imaging technology and treatment with endoscopic submucosal dissection can be a new treatment strategy for head and neck cancer.Objective: 1) Identify differences in PTH assay usage by European vs American physicians. 2) Analyze factors that correlate with these differences.Method: Anonymous surveys of physicians regarding their use of post-thyroidectomy PTH assay were collected in 2009 from members of the American Academies of Otolaryngology and Endocrine Surgery and compared with 2010 survey data from members of the European, Italian, French, Spanish, and British Societies of Endocrine Surgery.Results: European respondents returned 61 surveys that were compared with 356 received from American physicians (11% vs 3% response rate). A total of 40.1% of the European physicians used the PTH assay vs 29.8% of the American physicians (chi-square P = .083). A total of 63% of US respondents were otolaryngologists, compared with 7% of the Europeans, but usage among US physicians was not significantly correlated with specialty. Fewer American physicians were fellowship trained (26.6% vs 44.3% (chi-square P = .003)). Using Mann-Whitney testing, estimates of the rate of temporary hypocalcemia were similar, median 10% to 20% (P = .708), but American respondents provided a lower estimated rate of permanent hypocalcemia (P = .007). Conclusion:We found a trend suggesting that more European physicians obtain PTH levels than US physicians and report higher rates of permanent hypocalcemia among thyroidectomy patients, perhaps accounting for their more frequent use of PTH assays.Objective: American Indians and Alaska Natives (AI/AN) experience poor...