Elective hemithyroidectomy during total laryngectomy

Introduction: Routine hemithyroidectomy during total laryngectomy in the setting of advanced stage of laryngeal carcinoma without clear thyroid involvement remains a controversial issue. This study was conducted to assess the rate of thyroid gland involvement in the patients without obvious clinical involvement who were candidates for total laryngectomy. Materials and Methods: In this cross-sectional study, between ۱۹۹۴ and ۲۰۰۷, ۱۸۶ patients who underwent total laryngectomy with ipsilateral hemithyroidectomy at Imam Khomeini hospital of Ahwaz Jondishapour university, were investigated for thyroid gland involvement. Results: Of ۱۸۶ patients, ۱۶۹ cases were men and ۱۷ were women, with mean age of ۶۳ years. Microscopic tissue study revealed tumor invasion to thyroid gland in ۷ patients, all of them had clinically advanced disease. Among these patients, ۵ cases had transglottic cancer and ۲ cases had subglottic cancer. Moreover, ۴ patients had thyroid cartilage invasion and in one patient pyriform sinus was involved. Conclusion: There may be no need for thyroidectomy in all total laryngectomy cases. We recommend hemithyroidectomy with isthmectomy during total laryngectomy only in cases with subglottic tumor extension, thyroid cartilage invasion, and pyriform sinus involvement.

Keywords:

Laryngeal carcinoma , Laryngectomy , Thyroid gland invasion , Thyroidectomy