Transient hyperthyroidism after total laryngectomy for laryngeal cancer

Area of Science:

• Otolaryngology
• Endocrinology
• Surgical Oncology

Background:

• Thyroid damage is a known complication following total laryngectomy (TL).
• Transient hyperthyroidism (HT) has been anecdotally reported after head and neck surgeries.
• The direct relationship between TL and HT requires further investigation.

Purpose of the Study:

• To determine the frequency of hyperthyroidism (HT) after total laryngectomy (TL).
• To evaluate the association between HT and the surgical procedure in patients undergoing TL.

Main Methods:

• A retrospective cohort study design was employed.
• Forty-four patients were divided into two groups: TL with pharyngectomy and TL with neck dissection.
• Postoperative thyroid function was monitored, and data were analyzed using chi-square tests and odds ratios.

Main Results:

• A high prevalence of HT was observed in 54.6% of patients post-TL.
• Patients undergoing TL with pharyngectomy showed a significantly higher incidence of HT compared to those with TL and neck dissection (p=0.04).
• All affected patients normalized thyroid function before discharge, with a small subset requiring pharmacological intervention.

Conclusions:

• Total laryngectomy (TL) is associated with a significant prevalence of transient hyperthyroidism (HT).
• The surgical approach, specifically the addition of pharyngectomy, appears to influence the occurrence of HT.
• Routine thyroid function monitoring is recommended post-TL, and further research into the metabolic and hemodynamic implications is warranted.