Assessment of thyroid and parathyroid function in patients treated for laryngeal carcinoma

Abstract

Background The close proximity of both thyroid and parathyroid glands to the larynx puts them at high risk to develop hypofunction from the treatment of cancer larynx. Aim Thyroid and parathyroid function evaluation after treatment modalities of cancer larynx. Patients and methods Thyroid and parathyroid function was evaluated in 60 patients treated from laryngeal carcinoma. Patients were classified into three groups based on treatment type. Group 1 included patients with primary radiotherapy while group 2 included patients with total laryngectomy and group 3 involved patients with combined total laryngectomy and postoperative radiotherapy. Laboratory assessment of thyroid function included thyroid-stimulating hormone (TSH), free T4, while parathyroid function included corrected serum calcium and parathormone levels. The association of gland hypofunction was studied against tumor and treatment characteristics. Results Among the 60 patients; group 1 included 27 patients, group 2 included 21 patients, and group 3 included 12 patients. Twenty-five (41.7%) patients showed high TSH level and low FT4 level indicating clinical hypothyroidism while 12 (20%) patients showed high TSH level with normal FT4 level indicating subclinical hypothyroidism. Twenty-three (38.3%) patients showed normal levels of both TSH and FT4 being euthyroid. Concerning parathyroid function; 19 (31.7%) showed hypoparathyroidism diagnosed by low corrected serum calcium level and confirmed by low parathyroid hormone level. Conclusion The study detects the occurrence of hypothyroidism with or without hypoparathyroidism after treatment modalities of cancer larynx emphasizing the need of high clinical suspicion and routine evaluation for early detection of any post treatment thyroid or parathyroid gland hypofunction.