喉頭・下咽頭癌手術における甲状腺温存の意義

DOI 被引用文献5件 参考文献13件

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  • Significance of functional management of the thyroid gland in surgery for advanced malignancy of the larynx and the hypopharynx

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To understand the significance of functional management of the thyroid gland in surgery for advanced malignancy of the larynx and the hypopharynx, we analyzed 59 patients who underwent surgery, retrospectively. These patients underwent total laryngectomy or total pharyngo-laryngectomy and bilateral neck dissection with preservation of the ipsilateral lobe of the thyroid and parathyroid glands. The outcome of preserving the thyroid function was evaluated 3 months after surgery based on the need for thyroid hormone replacement. Successful preservation of the function of the thyroid gland postoperatively was possible in only 40.7% of cases (24 of 59 patients). Retrospective analysis of the intraoperative findings suggested that preservation of the superior thyroid vein was most important. In those cases with insufficient preservation of the superior thyroid vein, the rate of successful preservation was significantly lower. We also reported the outcome of functional management of the thyroid gland on the parathyroid glands. In those cases with successful management of the thyroid gland, the rate of successful preservation of the parathyroid glands was significantly higher. These results indicate that appropriate preservation of thyroid function is not easy in advanced malignancy of the larynx and the hypopharynx, but that preservation of the thyroid gland during surgery is crucial for better functional outcomes for both the thyroid and parathyroid glands.

収録刊行物

  • 頭頸部外科

    頭頸部外科 17 (1), 47-50, 2007

    特定非営利活動法人 日本頭頸部外科学会

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