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. 2023 Jan;105(1):62-67.
doi: 10.1308/rcsann.2021.0276. Epub 2022 Feb 8.

Evaluation of hypoparathyroidism following laryngectomy

O Edafe  1 , E T Tan  1 , R Jackson  1 , S Sionis  1 , S P Balasubramanian  1   2 , N Beasley  1
Affiliations

Evaluation of hypoparathyroidism following laryngectomy

O Edafe et al. Ann R Coll Surg Engl. 2023 Jan.

Abstract

Background: Hypoparathyroidism is a recognised complication following laryngectomy; it is associated with significant short-and long-term morbidity. This study aimed to further characterise this condition, identify risk factors and describe preventative and management strategies in a large cohort.

Materials and methods: This was a retrospective study at a tertiary referral centre for head and neck cancers. All consecutive patients who had total laryngectomy over an eight-year period were included.

Results: A total of 140 patients were included. Rates of transient and long-term hypoparathyroidism were 14.3% and 10.1%, respectively. The following factors were significantly associated with transient post-surgical hypocalcaemia or hypoparathyroidism: total thyroidectomy (relative risk, RR, 4.33; 95% confidence interval, CI, 1.86-10.10), oesophagectomy (RR 6.05; 95% CI 2.92-12.53) and female sex (RR 3.23; 95% CI 1.45-7.19). In addition, total thyroidectomy (RR 5.89; 95% CI 1.94-17.86), central neck dissection (RR 3.97; 95% CI 1.42-11.10), oesophagectomy (RR 9.38; 95% CI 4.13-21.3), pharyngectomy (RR 7.14; 95% CI 2.08-24.39) and female sex (RR 5.52; 95% CI 1.95-15.63) were risk factors for long-term hypoparathyroidism. There was variability in the use of preventative measures, monitoring and management of hypocalcaemia and hypoparathyroidism following total laryngectomy.

Conclusions: Transient hypocalcaemia and long-term hypoparathyroidism occur in a significant proportion of patients after laryngectomy. A standard protocol is required to improve care.

Keywords: Hypocalcaemia; Hypoparathyroidism; Laryngectomy; Thyroidectomy.

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Figures

Figure 1
Figure 1
Protocol for management of hypocalcaemia and/or hypoparathyroidism after thyroid resection as part of radical laryngectomy/pharyngectomy
See this image and copyright information in PMC

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