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Hypocalcaemia following laryngectomy: prevalence and risk factors

Published online by Cambridge University Press:  11 October 2018

A S Harris ,
E Prades ,
C D Passant  and
D R Ingrams
A S Harris*
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Aneurin Bevan University Health Board, Royal Gwent Hospital, Newport, Wales, UK
E Prades
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Betsi Cadwaladr University Health Board, Glan Clwyd Hospital, Rhyl, Wales, UK
C D Passant
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Aneurin Bevan University Health Board, Royal Gwent Hospital, Newport, Wales, UK
D R Ingrams
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Aneurin Bevan University Health Board, Royal Gwent Hospital, Newport, Wales, UK
*
Author for correspondence: Mr Andrew S Harris, Department of Otolaryngology Head and Neck Surgery, Aneurin Bevan University Health Board, Royal Gwent Hospital, Cardiff Road, Newport NP20 2UB, Wales, UK E-mail: Andrew.harris3@wales.nhs.uk
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Abstract

Objectives

To establish the prevalence of hypocalcaemia following laryngectomy and demonstrate that total thyroidectomy is a risk factor.

Methods

A retrospective cohort study was conducted that included all patients who underwent total laryngectomy from 1st January 2006 to 1st August 2017. Exclusion criteria were: pre-operative calcium derangement, previous thyroid or parathyroid surgery, concurrent glossectomy, pharyngectomy, or oesophagectomy.

Results

Ninety patients were included. Sixteen patients had early hypocalcaemia (18 per cent), seven had protracted hypocalcaemia (8 per cent) and six had permanent hypocalcaemia (10 per cent). Exact logistic regression values for hypocalcaemia following total thyroidectomy compared to other patients were: early hypocalcaemia, odds ratio = 15.5 (95 per cent confidence interval = 2.2–181.9; model p = 0.002); protracted hypocalcaemia, odds ratio = 13.3 (95 per cent confidence interval = 1.5–117.1; model p = 0.01); and permanent hypocalcaemia, odds ratio = 22.7 (95 per cent confidence interval = 1.9–376.5; model p = 0.005).

Conclusion

This is the largest study to investigate the prevalence of hypocalcaemia following laryngectomy and the first to include follow up of longer than three months. Total thyroidectomy significantly increased the risk of hypocalcaemia at all time frames and independent of other variables.

Keywords

LaryngectomyHypocalcemiaPrevalenceIncidenceThyroidectomy

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 11 , November 2018 , pp. 969 - 973
Copyright
Copyright © JLO (1984) Limited, 2018 

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Footnotes

Mr A S Harris takes responsibility for the integrity of the content of the paper

Preliminary data presented at the ENT Wales Academic Conference, 7 October 2016, Saundersfoot, UK, the British Association of Clinical Otorhinolaryngology Conference, 4–6 July 2018, Manchester, UK, and at the British Association of Head and Neck Oncology Annual Scientific Meeting, 25 May 2018, London, UK

References

1Basheeth, N, O'Cathain, E, O'Leary, G, Sheahan, P. Hypocalcemia after total laryngectomy: incidence and risk factors. Laryngoscope 2014;124:1128–33Google Scholar
2Mourad, M, Saman, M, Sawhney, R, Ducic, Y. Management of the thyroid gland during total laryngectomy in patients with laryngeal squamous cell carcinoma. Laryngoscope 2015;125:1835–8Google Scholar
3Mendelson, AA, Al-Khatib, TA, Julien, M, Payne, RJ, Black, MJ, Hier, MP. Thyroid gland management in total laryngectomy: meta-analysis and surgical recommendations. Otolaryngol Head Neck Surg 2009;140:298–305Google Scholar
4Harris, AS, Passant, CD, Ingrams, DR. How reliably can computed tomography predict thyroid invasion prior to laryngectomy? Laryngoscope 2018;128:1099–102Google Scholar
5Harris, AS, Prades, E, Tkachuk, O, Zeitoun, H. Better consenting for thyroidectomy: who has an increased risk of postoperative hypocalcaemia? Eur Arch Otorhinolaryngol 2016;273:4437–43Google Scholar
6Ritter, K, Elfenbein, D, Schneider, DF, Chen, H, Sippel, RS. Hypoparathyroidism after total thyroidectomy: incidence and resolution. J Surg Res 2015;197:348–53Google Scholar
7Lorente-Poch, L, Sancho, JJ, Muñoz-Nova, JL, Sánchez-Velázquez, P, Sitges-Serra, A. Defining the syndromes of parathyroid failure after total thyroidectomy. Gland Surg 2015;4:82–90Google Scholar
8NHS Health Research Authority. Do I need NHS REC approval? In: http://www.hra-decisiontools.org.uk/ethics/ [30 August 2018]Google Scholar
9Negm, H, Mosleh, M, Fathy, H, Awad, A. Thyroid and parathyroid dysfunction after total laryngectomy in patients with laryngeal carcinoma. Eur Arch Otorhinolaryngol 2016;273:3237–41Google Scholar
10Mortimore, S, Thorp, MA, Nilssen, EL, Isaacs, S. Hypoparathyroidism after the treatment of laryngopharyngeal carcinoma. J Laryngol Otol 1998;112:1058–60Google Scholar
11Thorp, MA, Levitt, NS, Mortimore, S, Isaacs, S. Parathyroid and thyroid function five years after treatment of laryngeal and hypopharyngeal carcinoma. Clin Otolaryngol Allied Sci 1999;24:104–8Google Scholar
12Krespi, YP, Wurster, CF, Wang, TD, Stone, DM. Hypoparathyroidism following total laryngopharyngectomy and gastric pull-up. Laryngoscope 1985;95:1184–7Google Scholar
13Kumar, R, Drinnan, M, Robinson, M, Meikle, D, Stafford, F, Welch, A et al. Thyroid gland invasion in total laryngectomy and total laryngopharyngectomy: a systematic review and meta-analysis of the English literature. Clin Otolaryngol 2013;38:372–8Google Scholar
14Gorphe, P, Ben Lakhdar, A, Tao, Y, Breuskin, I, Janot, F, Temam, S. Evidence-based management of the thyroid gland during a total laryngectomy. Laryngoscope 2015;125:2317–22Google Scholar
15Wiegand, S. Evidence and evidence gaps of laryngeal cancer surgery. GMS Curr Top Otorhinolaryngol Head Neck Surg 2016;15:Doc03Google Scholar
16Mangussi-Gomes, J, Danelon-Leonhardt, F, Moussalem, GF, Ahumada, NG, Oliveira, CL, Hojaij, FC. Thyroid gland invasion in advanced squamous cell carcinoma of the larynx and hypopharynx. Braz J Otorhinolaryngol 2017;83:269–75Google Scholar