M.t Khorsi Ashtiani, Gh.a Dashti Khavidaki , S.h Samimi Ardestani,
Volume 64, Issue 1 (3-2006)
Abstract
Background and Aim: Total laryngectomy following laryngeal cancer has many sequelae , that loss of voice is the most important of them. Tracheoesophageal puncture (TEP) and prosthesis insertion has evolved into the most widely used and accepted technique for vocal rehabilitation.
Materials and Methods: 10 patients that underwent TEP in Amir Alam and Imam Khomeini hospitals from Feb. 2002 through Nov. 2003 were included in this study. Prosthesis insertion in 4 patients is primary and in 6 patients is secondary and all patients are men.
Results: The age of patients was between 50 to 70. 90% of patients had history of cigarette smoking and 10% of them had history of drinking alcohol. Salivary leakage was seen in 30% of patients that was improved with conservative management. Fluency of speech in 30% of patients and intelligibility of speech & voice quality in 40% of patients is good.
Conclusion: We could conclude that TEP has less complication & better speech results of other vocal rehabilitation methods. Carefully selection of patients & size of prosthesis has important role in results of TEP.
Motasaddi Zarandy M, Khorsandi M T, Senemar A, Shaeri H R,
Volume 65, Issue 3 (6-2007)
Abstract
Background: Hypothyroidism is a well-documented complication after treatment of laryngeal cancer and is particularly significant among patients undergoing laryngectomy. We investigated the frequency of hypothyroidism in patients treated with total laryngectomy for laryngeal cancer. We also evaluated the effect of neck radiotherapy on thyroid function after total laryngectomy for laryngeal cancer.
Methods: In a cross-sectional study, we evaluated 31 patients with laryngeal squamous cell carcinoma (mean age 53.6 years). Among these patients, 14 were treated with surgery only and 17 were treated with surgery plus radiotherapy. Laboratory evaluation included levels of thyroid stimulating hormone (TSH), free T4, free T3, and antithyroid antibodies both preoperatively and postoperatively at the first day, as well as one and six months after surgery.
Results: All patients had normal thyroid function before treatment however, after 6 months, five patients (16.1%) were hypothyroid. Of these, three patients (9.6%) had subclinical symptoms, including elevated thyroid-stimulating hormone with normal free T4, and two patients (6.5%) showed clinical symptoms of hypothyroidism. Radiotherapy and neck dissection were significantly associated with higher incidences of hypothyroidism.
Conclusion: Our data suggest that hypothyroidism occurs in a substantial proportion of patients undergoing surgery for laryngeal cancer. The results indicate that thyroid function studies should be routinely performed in the follow-up care of laryngeal cancer patients, especially if radiotherapy and neck dissection were part of the treatment. We suggest that this approach will improve the patient's quality of life and diminish the co-morbidity associated with this kind of surgery.
