Routine thyroidectomy with total laryngectomy: Is it really indicated? A randomized controlled trial.

Area of Science:

• Otolaryngology
• Surgical Oncology
• Endocrinology

Background:

• Advanced laryngeal carcinoma presents challenges in surgical management.
• Thyroid gland invasion is a potential complication during total laryngectomy.
• Predictors and consequences of thyroid invasion require further investigation.

Purpose of the Study:

• To determine the incidence of thyroid gland invasion in advanced laryngeal carcinoma.
• To identify preoperative and intraoperative predictors of thyroid invasion.
• To evaluate the impact of thyroid gland preservation versus sacrifice on oncologic control and recurrence.

Main Methods:

• A 5-year retrospective study of 100 patients undergoing total laryngectomy for advanced laryngeal carcinoma.
• Patients were categorized into thyroid-sparing and thyroid-sacrificing groups based on surgical protocol.
• Comparison of demographic data, tumor characteristics, hypothyroidism incidence, and recurrence rates between groups.

Main Results:

• Thyroid gland invasion was histopathologically confirmed in only one patient (thyroid-sacrificing group).
• No significant differences in tumor profiles or recurrence rates were observed between the groups.
• The thyroid-sacrificing group had a significantly higher incidence of postoperative hypothyroidism.

Conclusions:

• The incidence of thyroid gland invasion by advanced laryngeal carcinoma is low.
• Thyroid gland preservation during total laryngectomy is oncologically safe and reduces the risk of thyroid dysfunction.