AI Article Synopsis

  • - This study explores the rates of hypocalcemia (low calcium levels) in patients who underwent total laryngectomy (TL), with comparisons between those who also had thyroid surgery and those who did not.
  • - Researchers analyzed data from 870 patients who had TL alone, 158 who had a hemithyroidectomy, and 123 who had a total thyroidectomy, finding significantly higher rates of hypocalcemia and low parathyroid hormone (PTH) levels in those who had total thyroidectomy.
  • - The findings suggest that patients receiving total thyroidectomy alongside TL have a heightened risk of hypocalcemia, indicating a need for careful monitoring of PTH levels and possibly enhanced supplemental treatments after surgery.

Article Abstract

Objective: Hypoparathyroidism and associated hypocalcemia are well-established complications following laryngectomy. This study further characterizes the rates of hypocalcemia in patients undergoing total laryngectomy (TL) with and without thyroidectomy and hemithyroidectomy.

Study Design: Retrospective cohort study.

Setting: TriNetX.

Methods: We queried TriNetX, a deidentified patient database, to identify patients who underwent TL with and without thyroidectomy and hemithyroidectomy. Rates of hypocalcemia, low parathyroid hormone (PTH), calcium, and calcitriol supplementation were compared between groups with multivariable repeated measures logistic regression.

Results: We identified 870 patients in the TL without thyroidectomy cohort, 158 patients in the hemithyroidectomy cohort, and 123 in the total thyroidectomy cohort. Rates of hypocalcemia differed between patients receiving total thyroidectomy versus TL alone for 0 to 1 month (odds ratio [OR]: 2.88 [1.95-4.26]) 1 to 6 months (OR: 5.08 [2.29-11.3]), and 6 to 12 months (OR: 2.63 [1.003-6.88]) postoperatively, with adjustment for age at laryngectomy, race, ethnicity, and gender. Results were similar among those who received calcium supplementation. The rate of low PTH levels differed in these groups for 0 to 1 month (OR: 5.13 [3.10-8.51]), 1 to 6 months (OR: 3.47 [1.46-8.22]), and 6 to 12 months (OR: 3.63 [1.40-9.38]) following surgery. Rates of postoperative calcium supplementation were increased for patients receiving total thyroidectomy versus TL for 1 to 6 months (OR: 2.44 [1.62-3.68]), and 6 to 12 months following surgery (OR: 1.79 [1.18-2.72]).

Conclusion: Patients undergoing TL with total thyroidectomy have a higher risk of postoperative hypocalcemia compared to patients receiving TL alone. Risk of parathyroid injury in these patients may warrant further emphasis on PTH measurement after surgery and a multidisciplinary approach to management.

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Source
http://dx.doi.org/10.1002/ohn.804DOI Listing

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