Postoperative Parathyroid Function in Hypopharyngeal Carcinoma Undergoing Total Pharyngolaryngectomy

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  • Takahashi Ryosuke
    Department of Head and Neck Surgery, Tokyo Medical and Dental University
  • Kawabe Hiroaki
    Department of Head and Neck Surgery, Tokyo Medical and Dental University
  • Koide Nobuaki
    Department of Head and Neck Surgery, Tokyo Medical and Dental University
  • Ohno Kazuchika
    Department of Head and Neck Surgery, Tokyo Medical and Dental University
  • Ariizumi Yosuke
    Department of Head and Neck Surgery, Tokyo Medical and Dental University
  • Asakage Takahiro
    Department of Head and Neck Surgery, Tokyo Medical and Dental University

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Other Title
  • 下咽頭喉頭全摘出術を施行した下咽頭癌における術後副甲状腺機能の検討
  • シタ イントウ コウトウ ゼン テキシュツジュツ オ シコウ シタ カイントウ ガン ニ オケル ジュツゴ フクコウジョウセン キノウ ノ ケントウ

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Abstract

<p>Total pharyngolaryngectomy (TPL) is one of the standard treatments for locally advanced hypopharyngeal carcinoma. With TPL, postoperative hypoparathyroidism may occur depending on the extent of the concurrent thyroidectomy and paratracheal dissection. However, postoperative parathyroid function has not been studied in detail. We performed a retrospective study of 53 patients with hypopharyngeal carcinoma who underwent TPL between April 2008 and September 2018. We investigated the effect of thyroidectomy and paratracheal dissection on parathyroid function 3 months after TPL. Occurrence of postoperative hypoparathyroidism was 0% for thyroid lobectomy＋unilateral VI dissection (0 of 4 cases), 36% for thyroid lobectomy＋bilateral VI dissection (5 of 14 cases), and 97% for total thyroidectomy＋bilateral dissection (34 of 35 cases), indicating that the frequency of hypoparathyroidism tended to increase as the range of resection increased. In addition, hypercalcemia and renal dysfunction were observed in 20% of cases with parathyroid correction. Adjustment of the correction drug improved the hypercalcemia in all 8 cases, but renal dysfunction remained in 2 cases. Because patients with corrected parathyroid function may have hypercalcemia and renal dysfunction, it is necessary to continue to control oral administration by blood and urine tests.</p>

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