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Management of the thyroid gland during laryngectomy

Published online by Cambridge University Press:  08 June 2017

S X Li ,
M A Polacco ,
B J Gosselin ,
L X Harrington ,
A J Titus  and
J A Paydarfar
S X Li*
Affiliation:
Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA Dartmouth Geisel School of Medicine, Hanover, New Hampshire, USA
M A Polacco
Affiliation:
Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
B J Gosselin
Affiliation:
Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA Dartmouth Geisel School of Medicine, Hanover, New Hampshire, USA
L X Harrington
Affiliation:
Dartmouth School of Graduate and Advanced Studies, Hanover, New Hampshire, USA
A J Titus
Affiliation:
Dartmouth School of Graduate and Advanced Studies, Hanover, New Hampshire, USA
J A Paydarfar
Affiliation:
Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA Dartmouth Geisel School of Medicine, Hanover, New Hampshire, USA
*
Address for correspondence: Dr Shawn X Li, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03766, USA E-mail: [email protected]
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Abstract

Objectives:

This study aimed to: describe the incidence of thyroid gland involvement in advanced laryngeal cancer, analyse patterns of spread to the thyroid and elucidate predictors of thyroid involvement.

Methods:

A retrospective review was performed on patients who underwent laryngectomy from 1991 to 2015 as a primary or salvage treatment for squamous cell carcinoma of the larynx, hypopharynx or base of tongue. The incidence of thyroidectomy during total laryngectomy, type of thyroidectomy, incidence of gland involvement, route of spread, and positive predictors of spread were analysed and reported.

Results:

A total of 188 patients fit the inclusion criteria. Of these, 125 (66 per cent) underwent thyroidectomy. The thyroid was involved in 10 of the 125 patients (8 per cent), 9 by direct extension and 1 by metastasis. Cartilage invasion was a predictor of thyroid gland involvement, with a positive predictive value of 26 per cent.

Conclusion:

There is a low incidence of thyroid gland involvement in laryngeal carcinoma. Most cases of gland involvement occurred by direct extension. Thyroidectomy during laryngectomy should be considered for advanced stage tumours with cartilage invasion.

Keywords

LaryngectomyThyroidectomyThyroid CartilageSquamous Cell Carcinoma
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 131 , Issue 8 , August 2017 , pp. 740 - 744
Copyright
Copyright © JLO (1984) Limited 2017 

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Footnotes

Presented orally at the American Academy of Otolaryngology – Head and Neck Surgery Foundation Annual Meeting, 18–21 September 2016, San Diego, California, USA.

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