Evidence‐based management of the thyroid gland during a total laryngectomy

2015 ◽  
Vol 125 (10) ◽  
pp. 2317-2322 ◽  
Author(s):  
Philippe Gorphe ◽  
Aïcha Ben Lakhdar ◽  
Yungan Tao ◽  
Ingrid Breuskin ◽  
François Janot ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Total Laryngectomy ◽  
Evidence Based

Does Thyroid Gland Preserving Total Laryngectomy Affect Oncological Control in Laryngeal Carcinoma?

2019 ◽  
Vol 130 (6) ◽  
pp. 1465-1469 ◽  
Author(s):  
Jessica K. McGuire ◽  
Gerrit Viljoen ◽  
John Rocke ◽  
Siobhan Fitzpatrick ◽  
Sameera Dalvie ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Laryngeal Carcinoma ◽  
Total Laryngectomy

Current trends in antibiotic prophylaxis for laryngectomy in the UK – a national survey

2015 ◽  
Vol 129 (1) ◽  
pp. 63-67 ◽  
Author(s):  
R Harris ◽  
E Ofo ◽  
D Cope ◽  
I Nixon ◽  
R Oakley ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Total Laryngectomy ◽  
Current Practice ◽  
Salvage Surgery ◽  
Pharyngocutaneous Fistula ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Current Trends ◽  
National Guidance ◽  
The Uk

AbstractBackground:With the increasing use of chemoradiotherapy protocols, total laryngectomy carries increasing risks such as pharyngocutaneous fistula. There is little reference to the use of antibiotic prophylaxis in salvage surgery. This study aimed to determine the current practice in antibiotic prophylaxis for total laryngectomy in the UK.Method:A questionnaire was designed using SurveyMonkey software, and distributed to all ENT-UK registered head and neck surgeons.Results:The survey revealed that 19 surgeons (51 per cent) follow a protocol for antibiotic prophylaxis in primary total laryngectomy and 17 (46 per cent) follow a protocol in salvage total laryngectomy. Only 11 (30 per cent) use anti-methicillin-resistant Staphylococcus aureus agents in their antibiotic prophylaxis. The duration of prophylaxis varies considerably. Nineteen surgeons (51 per cent) revealed that their choice of antibiotic prophylaxis reflected non-evidence-based practices.Conclusion:There appears to be little evidence-based guidance on antibiotic prophylaxis in primary and salvage total laryngectomy. The survey highlights the need for more research in order to inform national guidance on antibiotic prophylaxis in primary and salvage total laryngectomy.

scholarly journals Pharyngocutaneous fistulae after total laryngectomy: a systematic review

2008 ◽  
Vol 16 (4) ◽  
pp. 772-778 ◽  
Author(s):  
Mary Elizabeth de Santana ◽  
Namie Okino Sawada
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Nursing Care ◽  
Total Laryngectomy ◽  
Cochrane Library ◽  
Evidence Based ◽  
Wound Treatment ◽  
Research Results ◽  
Pharyngocutaneous Fistulae ◽  
Use Of Research

Nursing care to patients after total laryngectomy should be based on scientific knowledge. Evidence-based practice is a type of approach that stimulates the use of research results in clinical practice. This study presents a systematic review that aimed to identify the main treatments for pharyngocutaneous fistulae after total laryngectomy. Articles were selected from five databases: Pubmed, Cinahl, Biomednet Research Tools, Cochrane Library and Lilacs. The review sample consisted of 37 articles. After analyzing the articles included in the review, results showed that conservative treatment is commonly used for pharyngocutaneous fistulae, recommending intensive hygiene and wound treatment. The use of research results in clinical practice will grant greater consistency to nurses' actions in care for patients with pharyngocutaneous fistulae.

Thyroid gland after total laryngectomy: CT appearance.

Radiology ◽  
1998 ◽  
Vol 207 (2) ◽  
pp. 405-409 ◽  
Author(s):  
J L Weissman ◽  
H D Curtin ◽  
J T Johnson
Keyword(s):  
Thyroid Gland ◽  
Total Laryngectomy

scholarly journals Onset of hypothyroidism after total laryngectomy: Effects of thyroid gland surgery and preoperative and postoperative radiotherapy

Head & Neck ◽  
2020 ◽  
Vol 42 (4) ◽  
pp. 636-644
Author(s):  
Robert E. Plaat ◽  
Boukje A. C. Dijk ◽  
Anneke C. Muller Kobold ◽  
Roel J. H. M. Steenbakkers ◽  
Thera P. Links ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Total Laryngectomy ◽  
Postoperative Radiotherapy ◽  
Thyroid Gland Surgery

Thyroid gland involvement in carcinoma of the hypopharynx

2014 ◽  
Vol 128 (1) ◽  
pp. 64-67 ◽  
Author(s):  
P Joshi ◽  
S Nair ◽  
P Chaturvedi ◽  
D Nair ◽  
T Shivakumar ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Retrospective Analysis ◽  
Total Laryngectomy ◽  
Hypopharyngeal Cancer ◽  
Pyriform Sinus ◽  
Memorial Hospital ◽  
En Bloc ◽  
Tata Memorial Hospital ◽  
Subglottic Extension ◽  
The Mean

AbstractObjective:The thyroid gland is removed en bloc during laryngectomy. There are no objective criteria for deciding the extent of thyroid gland resection in primary hypopharyngeal cancer cases. The present study aimed to determine the incidence of thyroid gland involvement in hypopharyngeal cancer and identify the various predictors of this involvement.Method:This paper reports a retrospective analysis of 358 patients with hypopharyngeal cancer, who underwent total laryngectomy with partial or total pharyngectomy at Tata Memorial Hospital, Mumbai between 2004 and 2010.Results:The mean age of this population was 61 years. The pyriform sinus was the most common hypopharyngeal subsite involved (in 89 per cent of cases). Most patients underwent hemi-thyroidectomy as part of their surgery. The thyroid gland was involved in only 13 per cent of cases.Conclusion:Thyroid gland involvement is not common in hypopharyngeal cancer. Cases that involved the post-cricoid area, subglottic extension, extralaryngeal spread or prior tracheostomy were associated with a higher risk of thyroid gland involvement. Ipsilateral thyroidectomy is sufficient in most patients undergoing surgery (laryngectomy with partial or total pharyngectomy) for hypopharyngeal cancers.

scholarly journals The Incidence of Thyroid Gland Invasion in Patients with Carcinoma of the Larynx who Underwent Total Laryngectomy

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Mawaddah A ◽  
See-Sze S ◽  
Marina MB ◽  
Pua KC ◽  
Abdullah-Sani M
Keyword(s):  
Thyroid Gland ◽  
Total Laryngectomy ◽  
Total Duration ◽  
Study Data ◽  
Adjuvant Radiation ◽  
Advanced Carcinoma ◽  
Carcinoma Of The Larynx ◽  
Case Documentation ◽  
Central Lymph ◽  
Operative Notes

Introduction: Total thyroidectomy or at least hemithyroidectomy is routinely performed alongside total laryngectomy in patients with advanced carcinoma of the larynx. Life-threatening hypocalcaemia and hypothyroidism are common sequelae especially with adjuvant radiation. The study aims to determine the incidence of microscopic thyroid gland invasion and challenge the idea of routine thyroidectomy in advanced carcinoma of the larynx. Materials and Methods: This study was a retrospective observational study. It was done in two tertiary centres in Malaysia between 2003 and 2013 for a total duration of 11 years. A total of 72 patients were included in this study. Data from medical records, operative notes, and histopathological reports were collected and analysed. Results: Three patients (4.2%) had the presence of microscopic thyroid gland invasion. There were no significant associations between microscopic thyroid gland invasion and tumour subsites, histological types of a tumour nor T staging (p>0.05) Conclusion: The incidence of microscopic thyroid gland invasion in advance carcinoma of the larynx is low, disavowing routine thyroidectomy. Limitations: Some factors such as cartilage invasion on CT imaging and central lymph node treatment were not considered due to limitations in case documentation.

scholarly journals Hypothyroidism in surgically treated T4 hypopharyngeal and laryngeal cancers

2017 ◽  
Vol 3 (4) ◽  
pp. 968
Author(s):  
Deepak Janardhan ◽  
Bipin T. Varghese ◽  
Elizabeth Mathew Iype ◽  
Shaji Thomas
Keyword(s):  
Thyroid Gland ◽  
Thyroid Function ◽  
Total Laryngectomy ◽  
Thyroid Dysfunction ◽  
Histopathological Examination ◽  
Post Treatment ◽  
Considerable Proportion ◽  
Thyroid Resection ◽  
Operative Complications

<p class="abstract"><strong>Background:</strong> Total laryngectomy in laryngohypopharyngeal cancers, both in primary setting and salvage scenario, include variable amounts of thyroid resection. Although considerable proportion of these cases undergo total thyroidectomy, with an intention of wider surgical clearance, histopathological examination for thyroid infiltration, very often indicate that such resections are generally out of proportion to the actual oncological requirement.</p><p class="abstract"><strong>Methods:</strong> Forty three patients undergoing total laryngectomy with no prior thyroid dysfunction, from April 2014 to 2016, at our centre, were prospectively studied for post treatment, thyroid function with tests done at 6<sup>th</sup> month. Overt and occult hypothyroidism was correlated with extent of thyroid preserved intraoperatively.  </p><p class="abstract"><strong>Results:</strong> Of 43 patients studied, 82% had extralaryngeal spread, and 16% of them showed thyroid gland infiltration. Only 7% were patholog1ically correlated for gland infiltration. Among those who had hemithyroidectomy, clinical hypothyroidism was seen in 20% primary and 85% salvage cases by 6<sup>th</sup> month of post treatment period.</p><p><strong>Conclusions:</strong> In clinicoradiologically favourable scenarios, thyroid preservation attempt helps to augment the neopharynx closure line and to preserve the parathyroids. Anatomical preservation however doesnot guarantee thyroid function, which needs regular follow up to avoid post-operative complications and better QOL.</p>

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