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The Thyroid Gland01:23

The Thyroid Gland

The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...

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Paratracheal lymph node dissection does not negatively affect thyroid dysfunction in patients undergoing

Annalisa M Lo Galbo1, Remco de Bree, Dirk J Kuik

  • 1Department of Otolaryngology/Head and Neck Surgery, VU University Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.

European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
|November 17, 2009
PubMed
Summary

Paratracheal lymph node dissection in laryngeal cancer surgery did not increase the risk of hypo(para)thyroidism. However, combining laryngectomy with hemithyroidectomy and neck dissection leads to a high incidence of these conditions.

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Area of Science:

  • Otolaryngology
  • Endocrinology
  • Oncology

Background:

  • Laryngeal and hypopharyngeal carcinomas often require extensive surgical treatment.
  • Paratracheal lymph node dissection is a critical component of surgical management.
  • The impact of this dissection on endocrine function, specifically hypo(para)thyroidism, requires evaluation.

Purpose of the Study:

  • To assess the prognostic significance of paratracheal lymph node dissection in the development of hypothyroidism and hypoparathyroidism.
  • To determine if paratracheal dissection increases the risk of endocrine dysfunction post-surgery for laryngeal/hypopharyngeal cancer.

Main Methods:

  • Retrospective analysis of 169 patients with laryngeal or hypopharyngeal carcinoma undergoing paratracheal lymph node dissection (1990-2004).
  • Detailed data collection on patient, tumor, and treatment characteristics.
  • Thyroid function tests performed on 100 patients to evaluate for hypothyroidism and hypoparathyroidism.

Main Results:

  • Seventy percent of tested patients developed hypothyroidism (36% clinical, 34% subclinical).
  • Thirty-three percent of patients experienced hypoparathyroidism.
  • No increased incidence of hypo(para)thyroidism was observed with bilateral paratracheal lymph node dissection alone.
  • High incidence of hypo(para)thyroidism noted when laryngectomy was combined with hemithyroidectomy, neck dissection, and paratracheal lymph node dissection.

Conclusions:

  • Paratracheal lymph node dissection itself does not appear to elevate the risk of developing hypo(para)thyroidism.
  • Combined surgical procedures, including hemithyroidectomy and neck dissection alongside laryngectomy, significantly increase the risk of hypo(para)thyroidism.