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Does thyroid-sparing total laryngectomy decrease the risk of hypothyroidism?
G Viljoen1, J K McGuire1, A Alhadad1
1Division of Otorhinolaryngology, Faculty of Health Sciences, University of Cape Town, South Africa.
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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