scholarly journals Incidence and predictors of thyroid gland invasion by laryngeal carcinoma: a 7-year experience review

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Ahmad M. Eltelety ◽  
Ahmed A. Nassar ◽  
Ahmed M. El Batawi ◽  
Sherif G. Ibrahim
Keyword(s):  
Risk Factors ◽  
Thyroid Gland ◽  
Total Thyroidectomy ◽  
Primary Tumor ◽  
Laryngeal Carcinoma ◽  
Total Laryngectomy ◽  
Tumor Stage ◽  
Significant Incidence ◽  
Poorly Differentiated ◽  
Subglottic Extension

Abstract Background Study the incidence of thyroid gland invasion by laryngeal carcinoma and the risk factors that may predispose to this condition. Aiding surgeons develop an evidence-based plan for the management of the thyroid gland during total laryngectomy. Results Retrospective analysis of the available medical records for patients who had total laryngectomy together with total thyroidectomy or hemithyroidectomy in the same procedure. Associated pathological features were also investigated. Patients who had laryngeal carcinoma managed by total laryngectomy with total thyroidectomy or hemithyroidectomy between January 1, 2011, and December 31, 2017. Three hundred seventy-seven records were retrieved. The incidence of thyroid gland invasion by the laryngeal carcinoma was 24 (6.4%). Three patients showed microscopic extension (3/356; 0.8%). Six patients had malignant pathology other than squamous cell carcinoma (SCC). Two over six had invasion of the thyroid gland; OR (95% CI): 7.9 (1.4-45.4). Patients who had primary tumor stage of T4a were 244. 23/244 had thyroid gland invasion, 13.7 (1.8-102.9). Poorly differentiated tumors had significant incidence of thyroid gland invasion (4/15), 6.2 (1.8-21.3). Patients who had subglottic extension by the primary tumor were 177 with 20 patients having thyroid gland invasion (20/177), 6.2 (2.1-18.6). Conclusion Several risk factors are associated with higher incidence of invasion of the thyroid gland by laryngeal carcinoma. Identification of these factors can help surgeons develop a surgical strategy for the management of the thyroid gland during total laryngectomy.

Thyroid Gland Management in Total Laryngectomy: Meta-analysis

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P46-P47
Author(s):  
Asher Aron Mendelson ◽  
Talal Ahmed Al-Khatib ◽  
Marilyse Julien ◽  
Michael P Hier
Keyword(s):  
Thyroid Gland ◽  
Total Thyroidectomy ◽  
Squamous Cell ◽  
Laryngeal Carcinoma ◽  
Total Laryngectomy ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Total N ◽  
Laryngeal Tumors ◽  
Subglottic Extension

Objective 1. Review the incidence of thyroid gland invasion by squamous cell laryngeal carcinoma in the literature. 2. Correlate thyroid gland invasion with anatomical characteristics of the laryngeal tumor. Do laryngeal tumors which invade the thyroid gland share certain characteristics which can aid in determing the management of the thyroid gland during total laryngectomy? Methods Systematic review of MEDLINE (1967–2007) and EMBASE (1980–2007) for all total laryngectomy series which commented on thyroid gland invasion according to tumor subsite and pathological characteristics. These results were supplemented with 61 patients from our centers who underwent total laryngectomy with hemi- or total thyroidectomy. Eleven series in total (n = 535) were included in the meta-analysis (fixed effects model). Results Thyroid gland invasion was present in 47 laryngectomy specimens (9%); the main method of invasion of the gland was by direct extralaryngeal extension. Subglottic extension > 10mm (OR 6.27 [2.16 to 18.19]; p = 0.0007), subglottic subsite (OR 4.32 [1.53 to 12.19]; p = 0.006), and transglottic subsite (OR 4.10 [1.75 to 9.57]; p = 0.001) were significantly correlated with thyroid gland invasion. Cartilagenous invasion by tumor was not a significant predictor of thyroid gland invasion (p>0.05). Conclusions Thyroid gland invasion is not a general feature of squamous cell laryngeal carcinoma. When present, it is strongly associated with anteroinferior spread of laryngeal tumors. Thyroidectomy should only be performed during total laryngectomy for transglottic tumors, subglottic tumors, and tumors with subglottic extension >10mm. In these cases, total thyroidectomy is warranted to maximize locoregional control.

scholarly journals Thyroid Gland Invasion in Laryngeal Carcinoma

2018 ◽  
Vol 32 (2) ◽  
pp. 22-24 ◽  
Author(s):  
Maria Concepcion F. Vitamog ◽  
Samantha S. Castañeda
Keyword(s):  
Thyroid Gland ◽  
Total Thyroidectomy ◽  
Laryngeal Carcinoma ◽  
Total Laryngectomy ◽  
Thyroid Cartilage ◽  
Case Series ◽  
Government Hospital ◽  
Retrospective Case ◽  
Cartilage Invasion ◽  
Poorly Differentiated

Objective: To determine the prevalence of, and describe transglottic cancer with thyroid cartilage invasion as a possible risk for, thyroid gland invasion in a series of patients with laryngeal carcinoma who underwent total laryngectomy with thyroidectomy. Methods Study Design:            Retrospective case series Setting:                       Tertiary government hospital Subjects:                    61 laryngeal carcinoma patients who underwent total laryngectomy with hemi- or total thyroidectomy from January 2010 to August 2017. Results Out of 61 patients with laryngeal carcinoma, 11 patients had supraglottic, 11 glottic, 2 subglottic and 37 had transglottic involvement. Eleven had thyroid cartilage invasion, all of whom had transglottic tumors. Of these 11 patients, only 1 had thyroid gland invasion. This was a case of a 78 year-old male patient, with poorly differentiated SCC stage IVa transglottic tumor with thyroid cartilage invasion. Conclusion Thyroid gland invasion was uncommon in our sample of laryngeal carcinoma patients who underwent laryngectomy and thyroidectomy. Although transglottic involvement with thyroid cartilage invasion may increase the risk of thyroid gland invasion, it could not be confirmed by our series. Perhaps thyroidectomy should not be routinely performed on all patients with laryngeal carcinoma who undergo total laryngectomy, but more rigorous studies are needed to establish this.   Keywords: laryngeal carcinoma, transglottic, thyroid cartilage invasion, thyroid gland invasion, thyroidectomy  

Does Thyroid Gland Preserving Total Laryngectomy Affect Oncological Control in Laryngeal Carcinoma?

2019 ◽  
Vol 130 (6) ◽  
pp. 1465-1469 ◽  
Author(s):  
Jessica K. McGuire ◽  
Gerrit Viljoen ◽  
John Rocke ◽  
Siobhan Fitzpatrick ◽  
Sameera Dalvie ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Laryngeal Carcinoma ◽  
Total Laryngectomy

Hypocalcaemia following laryngectomy: prevalence and risk factors

2018 ◽  
Vol 132 (11) ◽  
pp. 969-973 ◽  
Author(s):  
A S Harris ◽  
E Prades ◽  
C D Passant ◽  
D R Ingrams
Keyword(s):  
Risk Factors ◽  
Confidence Interval ◽  
Total Thyroidectomy ◽  
Odds Ratio ◽  
Total Laryngectomy ◽  
Retrospective Cohort ◽  
Parathyroid Surgery ◽  
Exclusion Criteria ◽  
Time Frames

AbstractObjectivesTo establish the prevalence of hypocalcaemia following laryngectomy and demonstrate that total thyroidectomy is a risk factor.MethodsA retrospective cohort study was conducted that included all patients who underwent total laryngectomy from 1st January 2006 to 1st August 2017. Exclusion criteria were: pre-operative calcium derangement, previous thyroid or parathyroid surgery, concurrent glossectomy, pharyngectomy, or oesophagectomy.ResultsNinety patients were included. Sixteen patients had early hypocalcaemia (18 per cent), seven had protracted hypocalcaemia (8 per cent) and six had permanent hypocalcaemia (10 per cent). Exact logistic regression values for hypocalcaemia following total thyroidectomy compared to other patients were: early hypocalcaemia, odds ratio = 15.5 (95 per cent confidence interval = 2.2–181.9; model p = 0.002); protracted hypocalcaemia, odds ratio = 13.3 (95 per cent confidence interval = 1.5–117.1; model p = 0.01); and permanent hypocalcaemia, odds ratio = 22.7 (95 per cent confidence interval = 1.9–376.5; model p = 0.005).ConclusionThis is the largest study to investigate the prevalence of hypocalcaemia following laryngectomy and the first to include follow up of longer than three months. Total thyroidectomy significantly increased the risk of hypocalcaemia at all time frames and independent of other variables.

Thyroid gland involvement in carcinoma of the hypopharynx

2014 ◽  
Vol 128 (1) ◽  
pp. 64-67 ◽  
Author(s):  
P Joshi ◽  
S Nair ◽  
P Chaturvedi ◽  
D Nair ◽  
T Shivakumar ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Retrospective Analysis ◽  
Total Laryngectomy ◽  
Hypopharyngeal Cancer ◽  
Pyriform Sinus ◽  
Memorial Hospital ◽  
En Bloc ◽  
Tata Memorial Hospital ◽  
Subglottic Extension ◽  
The Mean

AbstractObjective:The thyroid gland is removed en bloc during laryngectomy. There are no objective criteria for deciding the extent of thyroid gland resection in primary hypopharyngeal cancer cases. The present study aimed to determine the incidence of thyroid gland involvement in hypopharyngeal cancer and identify the various predictors of this involvement.Method:This paper reports a retrospective analysis of 358 patients with hypopharyngeal cancer, who underwent total laryngectomy with partial or total pharyngectomy at Tata Memorial Hospital, Mumbai between 2004 and 2010.Results:The mean age of this population was 61 years. The pyriform sinus was the most common hypopharyngeal subsite involved (in 89 per cent of cases). Most patients underwent hemi-thyroidectomy as part of their surgery. The thyroid gland was involved in only 13 per cent of cases.Conclusion:Thyroid gland involvement is not common in hypopharyngeal cancer. Cases that involved the post-cricoid area, subglottic extension, extralaryngeal spread or prior tracheostomy were associated with a higher risk of thyroid gland involvement. Ipsilateral thyroidectomy is sufficient in most patients undergoing surgery (laryngectomy with partial or total pharyngectomy) for hypopharyngeal cancers.

Preserving Hemithyroid During Total Laryngectomy: Report of a Disease-Free &Complication- Free Case

2018 ◽  
Vol 2 (3) ◽  
pp. 170
Author(s):  
Kumareysh Vijay V ◽  
Mohd Azizul Fitri Khalid ◽  
Irfan Mohamad
Keyword(s):  
Thyroid Gland ◽  
Total Thyroidectomy ◽  
Total Laryngectomy ◽  
Rare Case ◽  
Signs And Symptoms ◽  
Health Sciences ◽  
High Rate ◽  
Calcium Supplements ◽  
Free Case ◽  
Disease Free

Preserving hemithyroid intraoperatively in a total laryngectomy operation is uncommon, as this procedure normally leads to high rate of hypothyroidism similar to total thyroidectomy. This has caused most of the surgeons to prefer total thyroidectomy when involvement of the thyroid gland is suspected. We report a rare case of total laryngectomy with preservation of one lobe of thyroid gland in a 57-year-old man with left unilateral transglottic laryngeal carcinoma. Post operatively the patient was well without signs and symptoms of hypothyroidism or hypocalcemia. The patient was not started on any hormone or calcium supplements after the surgery.International Journal of Human and Health Sciences Vol. 02 No. 03 July’18. Page : 170-173

Risk factors for the development of hypocalcemia in pediatric patients after total thyroidectomy – A systematic review

2021 ◽  
Vol 143 ◽  
pp. 110666
Author(s):  
Kung-Ting Kao ◽  
Elspeth C. Ferguson ◽  
Geoff Blair ◽  
Neil K. Chadha ◽  
Jean-Pierre Chanoine
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Total Thyroidectomy ◽  
Pediatric Patients

scholarly journals Developing anterior mediastinum mass after orthotopic thyroidectomy: a case report

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Rita Meira Soares Camelo ◽  
José Maria Barros
Keyword(s):  
Thyroid Gland ◽  
Total Thyroidectomy ◽  
Thyroid Tissue ◽  
Anterior Mediastinum ◽  
Ectopic Thyroid ◽  
Ectopic Thyroid Tissue ◽  
Ectopic Tissue ◽  
Thyroid Scan ◽  
Imaging Results ◽  
Adjacent Structures

Abstract Background Ectopic thyroid tissue is a rare embryological aberration described by the occurrence of thyroid tissue at a site other than in its normal pretracheal location. Depending on the time of the disruption during embryogenesis, ectopic thyroid may occur at several positions from the base of the tongue to the thyroglossal duct. Ectopic mediastinal thyroid tissue is normally asymptomatic, but particularly after orthotopic thyroidectomy, it might turn out to be symptomatic. Symptoms are normally due to compression of adjacent structures. Case presentation We present a case of a 66-year-old male submitted to a total thyroidectomy 3 years ago, due to multinodular goiter (pathological results revealed nodular hyperplasia and no evidence of malignancy), under thyroid replacement therapy. Over the last year, he developed hoarseness, choking sensation in the chest, and shortness of breath. Thyroid markers were unremarkable. He was submitted to neck and thoracic computed tomography, magnetic resonance imaging, and radionuclide thyroid scan. Imaging results identified an anterior mediastinum solid lesion. A radionuclide thyroid scan confirmed the diagnosis of ectopic thyroid tissue. The patient refused surgery. Conclusions Ectopic thyroid tissue can occur either as the only detectable thyroid gland tissue or in addition to a normotopic thyroid gland. After a total thyroidectomy, thyroid-stimulating hormone can promote a compensatory volume growth of previously asymptomatic ectopic tissue. This can be particularly diagnosis challenging since ectopic tissue can arise as an ambiguous space-occupying lesion.

Post-thyroidectomy bleeding: analysis of risk factors from a national registry

2021 ◽  
Author(s):  
H E Doran ◽  
S M Wiseman ◽  
F F Palazzo ◽  
D Chadwick ◽  
S Aspinall
Keyword(s):  
Risk Factors ◽  
Total Thyroidectomy ◽  
Thyroid Surgery ◽  
Multivariable Analysis ◽  
Significant Risk ◽  
Bleeding Risk ◽  
Redo Surgery ◽  
Day Case ◽  
Increased Risk ◽  
Male Sex

Abstract Background Post-thyroidectomy haemorrhage occurs in 1–2 per cent of patients, one-quarter requiring bedside clot evacuation. Owing to the risk of life-threatening haemorrhage, previous British Association of Endocrine and Thyroid Surgeons (BAETS) guidance has been that day-case thyroidectomy could not be endorsed. This study aimed to review the best currently available UK data to evaluate a recent change in this recommendation. Methods The UK Registry of Endocrine and Thyroid Surgery was analysed to determine the incidence of and risk factors for post-thyroidectomy haemorrhage from 2004 to 2018. Results Reoperation for bleeding occurred in 1.2 per cent (449 of 39 014) of all thyroidectomies. In multivariable analysis male sex, increasing age, redo surgery, retrosternal goitre and total thyroidectomy were significantly correlated with an increased risk of reoperation for bleeding, and surgeon monthly thyroidectomy rate correlated with a decreased risk. Estimation of variation in bleeding risk from these predictors gave low pseudo-R2 values, suggesting that bleeding is unpredictable. Reoperation for bleeding occurred in 0.9 per cent (217 of 24 700) of hemithyroidectomies, with male sex, increasing age, decreasing surgeon volume and redo surgery being risk factors. The mortality rate following thyroidectomy was 0.1 per cent (23 of 38 740). In a multivariable model including reoperation for bleeding node dissection and age were significant risk factors for mortality. Conclusion The highest risk for bleeding occurred following total thyroidectomy in men, but overall bleeding was unpredictable. In hemithyroidectomy increasing surgeon thyroidectomy volume reduces bleeding risk. This analysis supports the revised BAETS recommendation to restrict day-case thyroid surgery to hemithyroidectomy performed by high-volume surgeons, with caution in the elderly, men, patients with retrosternal goitres, and those undergoing redo surgery.

Does thyroid-sparing total laryngectomy decrease the risk of hypothyroidism?

2020 ◽  
pp. 1-4
Author(s):  
G Viljoen ◽  
J K McGuire ◽  
A Alhadad ◽  
S Dalvie ◽  
J J Fagan
Keyword(s):  
South Africa ◽  
Retrospective Study ◽  
Laryngeal Carcinoma ◽  
Adjuvant Radiotherapy ◽  
Total Laryngectomy ◽  
Inclusion Criteria ◽  
Nccn Guidelines ◽  
Thyroid Lobectomy ◽  
Cancer Network ◽  
Advanced Laryngeal Carcinoma

Abstract Background Thyroid lobectomy is recommended with total laryngectomy for laryngeal cancer in the National Comprehensive Cancer Network (‘NCCN’) guidelines. However, it is associated with a 32–89 per cent risk of hypothyroidism, with or without adjuvant radiotherapy. Objective The study aimed to determine whether preserving the whole thyroid, compared to a single lobe, does indeed significantly lower the incidence of hypothyroidism in the setting of total laryngectomy. Method A retrospective study was conducted at Groote Schuur Hospital in Cape Town, South Africa. Results Eighty-four patients met the inclusion criteria. The overall incidence of hypothyroidism was 45.2 per cent. The incidence of hypothyroidism was significantly reduced in patients who underwent thyroid-sparing total laryngectomy compared to hemithyroidectomy (p = 0.037). Adjuvant radiotherapy was associated with a higher incidence of hypothyroidism (p = 0.001). Conclusion Thyroid-preserving laryngectomy should be advocated in carefully selected patients with advanced laryngeal carcinoma, as it reduces the incidence of hypothyroidism.

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