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

Published online by Cambridge University Press:  27 November 2020

G Viljoen ,
J K McGuire ,
A Alhadad ,
S Dalvie  and
J J Fagan
G Viljoen*
Affiliation:
Division of Otorhinolaryngology, Faculty of Health Sciences, University of Cape Town, South Africa
J K McGuire
Affiliation:
Division of Otorhinolaryngology, Faculty of Health Sciences, University of Cape Town, South Africa
A Alhadad
Affiliation:
Division of Otorhinolaryngology, Faculty of Health Sciences, University of Cape Town, South Africa
S Dalvie
Affiliation:
Division of Radiation Oncology, Faculty of Health Sciences, University of Cape Town, South Africa
J J Fagan
Affiliation:
Division of Otorhinolaryngology, Faculty of Health Sciences, University of Cape Town, South Africa
*
Author for correspondence: Dr Gerrit Viljoen, Division of Otorhinolaryngology, Faculty of Health Sciences, University of Cape Town, Cape Town7700, South Africa E-mail: dr.gerrit.viljoen@gmail.com
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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.

Keywords

Laryngeal CancerHead And Neck CancerLaryngectomyThyroidectomyHypothyroidism
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 134 , Issue 12 , December 2020 , pp. 1069 - 1072
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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Footnotes

Dr G Viljoen takes responsibility for the integrity of the content of the paper

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