The intraoperative management of the thyroid gland during laryngectomy

Brennan, Joseph; Meyers, Arlen D.; Jafek, Bruce W.

doi:10.1288/00005537-199109000-00003

Cited by 48 publications

(90 citation statements)

References 36 publications

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“…In their study, Brennan and Dadas confirmed that routine thyroid gland removal during (pharyngo) laryngectomy is not indicated for the majority of (pharyngo) laryngeal cancers that do not meet the aforementioned criteria [5,6].…”

Section: Discussionmentioning

confidence: 90%

The Role of Thyroidectomy in Advanced Laryngeal and Pharyngolaryngeal Carcinoma

Dequanter

Shahla

Paulus

et al. 2012

Indian J Otolaryngol Head Neck Surg

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Total thyroidectomy or hemithyroidectomy together with a total laryngectomy (TL) or pharyngo laryngectomy (TPL) for (pharyngo) laryngeal cancer often renders the patient hypothyroid and commits them to life-long thyroid hormone replacement. To determine the incidence of thyroid gland invasion (TG) in patients undergoing TL or TPL with total thyroidectomy (TThy) or lobectomy (HThy) for advanced laryngeal or hypo pharyngeal cancer and to assess predicative factors. Retrospective analysis of 35 patients from 2007 to 2010. Specimens were examined to determine the incidence of TG invasion and relevant predicative factors such as histological grade and subglottic extension. Pre-operative imaging was reviewed to assess for radiological evidence of TG invasion. TL and TThy was performed in 13 patients. TL and HThy was performed in four patients and TPL and TThy was performed in 18 patients. Surgery was performed for primary and recurrent cancer in 29 and six patients, respectively. Histological evidence of invasion of the TG was found in three patients. Relationship was found between TG invasion and subsite of primary carcinoma and the presence of subglottic extension. No relationship was found between TG invasion and patient's sex, stage of primary disease at surgery, degree of differentiation. In addition, no significant relationship was found between the presence of TG invasion and recurrent disease. Invasion of the TG in patients undergoing a TL or TPL is a rare event and limits the need for a TTHy in most cases.

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Section: Discussionmentioning

confidence: 90%

The Role of Thyroidectomy in Advanced Laryngeal and Pharyngolaryngeal Carcinoma

Dequanter

Shahla

Paulus

et al. 2012

Indian J Otolaryngol Head Neck Surg

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“…However the incidence of thyroid involvement was noted to be around 10%. 3 This was noted, especially when anterior comissure, cricothyroid membrane was involved. Probably due to the stretching of collagen bundles by the tumour and creating direct pathway towards extralaryngeal space.…”

Section: Discussionmentioning

confidence: 99%

“…4 Similarly subglottic extension of more than 1cm and paraglottic extension also have been reported as a predictor for extralaryngeal spread and thyroid involvement. 3,[5][6][7][8][9] Subglottic extension more than 1.5 cm has been reported to have 100% chance of thyroid gland involvement as against 8% when its 0.5 cm into subglottis. 3,6 One of the main reasons for treatment failure has been attributed to, inadequate level 6 clearance in subglottic extension cases.…”

Section: Discussionmentioning

confidence: 99%

“…3,[5][6][7][8][9] Subglottic extension more than 1.5 cm has been reported to have 100% chance of thyroid gland involvement as against 8% when its 0.5 cm into subglottis. 3,6 One of the main reasons for treatment failure has been attributed to, inadequate level 6 clearance in subglottic extension cases. 10,11 Extralaryngeal spread via thyroid cartilage is directly proportional to the calcification status of the thyroid cartilage.…”

Section: Discussionmentioning

confidence: 99%

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Hypothyroidism in surgically treated T4 hypopharyngeal and laryngeal cancers

Janardhan

Varghese

Iype

et al. 2017

Int J Otorhinolaryngol Head Neck Surg

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Background: Total laryngectomy in laryngohypopharyngeal cancers, both in primary setting and salvage scenario, include variable amounts of thyroid resection. Although considerable proportion of these cases undergo total thyroidectomy, with an intention of wider surgical clearance, histopathological examination for thyroid infiltration, very often indicate that such resections are generally out of proportion to the actual oncological requirement.Methods: Forty three patients undergoing total laryngectomy with no prior thyroid dysfunction, from April 2014 to 2016, at our centre, were prospectively studied for post treatment, thyroid function with tests done at 6th month. Overt and occult hypothyroidism was correlated with extent of thyroid preserved intraoperatively. Results: Of 43 patients studied, 82% had extralaryngeal spread, and 16% of them showed thyroid gland infiltration. Only 7% were patholog1ically correlated for gland infiltration. Among those who had hemithyroidectomy, clinical hypothyroidism was seen in 20% primary and 85% salvage cases by 6th month of post treatment period.Conclusions: In clinicoradiologically favourable scenarios, thyroid preservation attempt helps to augment the neopharynx closure line and to preserve the parathyroids. Anatomical preservation however doesnot guarantee thyroid function, which needs regular follow up to avoid post-operative complications and better QOL.

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“…En effet, en période postopératoire, 10 à 25 % d'hypothyroïdie sont retrouvées chez des patients traités par radiothérapie seule. Ce chiffre atteint 45 % après chirurgie et radiothérapie et 70 % après chirurgie avec thyroïdectomie et radiothé-rapie complémentaire [3][4][5][6][7][8]. Concernant le métabolisme phosphocalcique, une hypoparathyroïdie postopératoire est retrouvée dans 25 % des cas après chirurgie et radiothérapie [9].…”

Section: Introductionunclassified