Hypocalcaemia following laryngectomy: prevalence and risk factors

Harris, Andrew; Prades, Eduard; Passant, C; Ingrams, Duncan R.

doi:10.1017/s0022215118001615

Cited by 8 publications

(15 citation statements)

References 13 publications

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“…Twenty-three observational studies published between 1968 and 2019 on 1416 patients were included in this review [6,. The studies were from Europe (n = 11), North America (n = 4), Africa (n = 4), Asia (n = 3), and South America (n = 1).…”

Section: Resultsmentioning

confidence: 99%

“…The definition of transient and long-term PoSH varied between individual studies as seen in Table 2. Some definitions only required reduction in serum calcium levels [6,9,12,14,23,24,26], while others required reduction in both calcium and PTH levels in defining hypocalcaemia [17,18]. Corrected serum calcium levels were generally used but one study used ionised calcium levels [29].…”

Section: Discussionmentioning

confidence: 99%

“…Corrected serum calcium levels were generally used but one study used ionised calcium levels [29]. The duration for the definition of long-term PoSH was specified as 6 months in some studies [8,14] and 12 months in others [6,27]. Some studies reported rates of transient and long-term hypocalcaemia without providing a definition in the manuscript [11,13,15,16,[19][20][21].…”

Section: Discussionmentioning

confidence: 99%

“…PoSH in laryngectomy patients who had total thyroidectomy versus hemithyroidectomy or thyroid preservation [6]. Total thyroidectomy significantly increased the rates of transient (OR 15.5, 95% CI 2.2, 181.9) and long term (OR 22.7, 95% CI 1.9, 376.…”

Section: Harris Et Al Compared the Rates Of Transient And Long-termmentioning

confidence: 99%

“…Patients undergoing laryngectomy usually have concomitant unilateral or bilateral thyroidectomy and, therefore, are 1 3 at risk of developing hypocalcaemia [6]. This is mostly secondary to hypoparathyroidism (risk increased by extent of primary surgery) as other mechanisms of hypocalcaemia such as hungry bone syndrome seen in thyroid surgery do not play a significant role in this scenario.…”

Section: Introductionmentioning

confidence: 99%

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Systematic review of incidence, risk factors, prevention and treatment of post-laryngectomy hypoparathyroidism

Edafe

Sandler

Beasley

et al. 2020

Eur Arch Otorhinolaryngol

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Purpose Post-laryngectomy hypoparathyroidism is associated with significant short- and long-term morbidities. This systematic review aimed to determine incidence, risk factors, prevention and treatment of post-laryngectomy hypoparathyroidism. Methods Medline, EMBASE and the Cochrane library were searched for relevant articles on hypocalcaemia and/or hypoparathyroidism after laryngectomy or pharyngectomy. Two authors independently screened titles and abstracts from the search. Data from individual studies were collated and presented (without meta-analysis). Quality assessment of included studies was undertaken. The review protocol was registered in the PROSPERO database (CRD42019133879). Results Twenty-three observational studies were included. The rates of transient and long-term hypoparathyroidism following laryngectomy with concomitant hemi- or total thyroidectomy ranged from 5.6 to 57.1% (n = 13 studies) and 0 to 12.8% (n = 5 studies), respectively. Higher transient (62.1–100%) and long-term (12.5–91.6%) rates were reported in patients who had concomitant oesophagectomy and total thyroidectomy (n = 4 studies). Other risk factors included bilateral selective lateral neck dissection, salvage laryngectomy and total pharyngectomy. There is a lack of data on prevention and management. Conclusion Hypoparathyroidism occurs in a significant number of patients after laryngectomy. Patients who underwent laryngectomy with concomitant hemithyroidectomy may still develop hypoparathyroidism. Research on prevention and treatment is lacking and needs to be encouraged.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Harris Et Al Compared the Rates Of Transient And Long-termmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Systematic review of incidence, risk factors, prevention and treatment of post-laryngectomy hypoparathyroidism

Edafe

Sandler

Beasley

et al. 2020

Eur Arch Otorhinolaryngol

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Extent of thyroidectomy and paratracheal lymph node dissection in total pharyngolaryngectomy for pyriform sinus cancer, and recurrence, survival, and postoperative hypoparathyroidism: A multicenter retrospective study

Ariizumi,

Hanai,

Asakage

et al. 2023

Head & Neck

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BackgroundTotal pharyngolaryngectomy (TPL) is standard treatment for hypopharyngeal cancer. However, extensive thyroidectomy and paratracheal nodal dissection (PTND) can cause hypoparathyroidism. We sought to determine the optimum extent of resection.MethodsWe analyzed the clinicopathological information of 161 pyriform sinus cancer patients undergoing TPL from 25 Japanese institutions. Rates of recurrence and risk factors for hypoparathyroidism, as well as incidence of pathological contralateral level VI nodal metastasis and stomal recurrence, were investigated.ResultsThe extent of thyroidectomy and nodal dissection were not independent risk factors for recurrence. Incidences of contralateral level VI nodal involvement and stomal recurrence were 1.8% and 1.2%, respectively. Patients undergoing hemithyroidectomy/ipsilateral PTND did not develop stomal recurrence and had the lowest incidence of hypoparathyroidism. Prognosis in patients without tracheostomy prior to hemithyroidectomy/ipsilateral PTND was comparable to that with more extensive resections.ConclusionsHemithyroidectomy/ipsilateral PTND may be sufficient for pyriform sinus cancer cases without tracheostomy.

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Hypocalcaemia in pharyngolaryngectomy: Preservation or autotransplantation of parathyroid glands

Every

Sideris

Sarkis

et al. 2021

Laryngoscope Investig Oto

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Objective: To describe transient and permanent hypocalcaemia following partial and total pharyngolaryngectomy with parathyroid gland preservation or autotransplantation.Methods: Thirty patients underwent partial or total pharyngolaryngectomy by a single surgeon during the period 2009-2020. Intraoperative parathyroid gland preservation or autotransplantation (where the gland appeared devascularized) was routinely performed. Calcium levels performed on day 1, 3 months, and at 12 months postoperatively were collected. Rates of transient and permanent hypocalcaemia were calculated.Results: A total of 13% of patients had transient hypocalcaemia, and 10% permanent hypocalcaemia. Rates of transient and permanent hypocalcaemia in total pharyngolaryngectomy were 14% and 14%, respectively. Partial pharyngectomy hypocalcaemia rates were 13% for transient and 0% for permanent. The majority of patients underwent salvage surgery for oncological resection, often following radiotherapy (63%). Ipsilateral hemithyroidectomy was preferred to total (57% vs 7%), with high rates of concurrent neck dissection (67%) and reconstruction (87%). Conclusion:This data supports preservation or autotransplantation of parathyroid glands as a means of reducing permanent postoperative hypocalcaemia.

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Hypocalcaemia following laryngectomy: prevalence and risk factors

Cited by 8 publications

References 13 publications

Systematic review of incidence, risk factors, prevention and treatment of post-laryngectomy hypoparathyroidism

Systematic review of incidence, risk factors, prevention and treatment of post-laryngectomy hypoparathyroidism

Extent of thyroidectomy and paratracheal lymph node dissection in total pharyngolaryngectomy for pyriform sinus cancer, and recurrence, survival, and postoperative hypoparathyroidism: A multicenter retrospective study

Hypocalcaemia in pharyngolaryngectomy: Preservation or autotransplantation of parathyroid glands

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