Hypothyroidism in surgically treated T4 hypopharyngeal and laryngeal cancers

Deepak Janardhan; Bipin T. Varghese; Elizabeth Mathew Iype; Shaji Thomas

doi:10.18203/issn.2454-5929.ijohns20174316

Authors

Deepak Janardhan Department of Surgical Oncology, Head and Neck Division, RCC, Trivandrum, Kerala
Bipin T. Varghese Department of Surgical Oncology, Head and Neck Division, RCC, Trivandrum, Kerala
Elizabeth Mathew Iype Department of Surgical Oncology, Head and Neck Division, RCC, Trivandrum, Kerala
Shaji Thomas Department of Surgical Oncology, Head and Neck Division, RCC, Trivandrum, Kerala

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20174316

Keywords:

Hypothyroidism, Total laryngectomy/pharyngolaryngectomy, Chemotherapy, Radiotherapy

Abstract

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 6^th 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 6^th 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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Author Biography

Deepak Janardhan, Department of Surgical Oncology, Head and Neck Division, RCC, Trivandrum, Kerala

Deepak Janardhan,[MS ENT, Fellowship in Head and Neck surgery (2yrs)]

Senior Resident ,

Department of Head and Neck Surgical Oncology , Regional Cancer Centre , Trivandrum,Kerala, India

695011

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