FUNCTIONAL MANAGEMENT OF THE PARATHYROID GLANDS IN SURGERY FOR ADVANCED MALIGNANCY OF THE LARYNX AND HYPOPHARYNX

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  • 両側頸部郭清術を併施した喉頭・下咽頭癌手術における副甲状腺温存術式の成功率

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Abstract

To better understand ways to improve the preservation of function of the parathyroid glands in surgery for advanced malignancy of the larynx and hypopharynx, we did a retrospective analysis of 59 patients. These patients underwent total laryngectomy or total pharyngo-laryngectomy and bilateral neck dissection with preservation of the contnalateral thyroid gland and parathyroid glands. Results of preserving the parathyroid function were evaluated at 3 months after surgery based on the necessity of calcium replacement.<BR>The rates of successful preservation of the function of the parathyroid glands post-operatively were not significantly different between those who underwent surgery for laryngeal cancer and hypopharyngeal cancer. There were also no significant differences based on the surgery of the primary sites. T-stage and N-stage were not useful indicators. Most importantly for discriminating between success and failure, were the findings during surgery. Our analysis demonstrated that the function of the parathyroid glands was preserved in only 44.4% of the patients with insufficient preservation of the superior thyroid vein and 20.0% of the patients with congestion of the preserved thyroid glands.<BR>These results indicate that sufficient preservation of the superior thyroid vein and avoidance of congestion of the preserved thyroid gland were crucial for the post-operative functional management of the parathyroid glands in surgery for advanced malignancy of the larynx and hypopharynx.

Journal

  • Toukeibu Gan

    Toukeibu Gan 32 (4), 515-518, 2006

    Japan Society for Head and Neck Cancer

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