Hypocalcaemia in pharyngolaryngectomy: Preservation or autotransplantation of parathyroid glands. Issue 5 (28th July 2021)

• Record Type: Journal Article
• Authors: Every, James D.; Sideris, Anders W.; Sarkis, Leba M.; Lam, Matthew E.; Mackay, Stuart G.; Pearson, Stephen J.
• Is Part Of: Laryngoscope investigative otolaryngology. Volume 6:Issue 5(2021)
• Page Start: 1208
• Page End: 1213
• Publication Date: 2021-07-28
• Subjects: hypocalcaemia -- pharyngolaryngectomy -- salvage surgery; Otolaryngology -- Periodicals; Laryngoscopy -- Periodicals; Otolaryngology; Otolaryngology; Periodicals; Periodicals; 617.51
• DOI: 10.1002/lio2.627
• Languages: English
• ISSNs: 2378-8038

Abstract

Abstract: Objective: To describe transient and permanent hypocalcaemia following partial and total pharyngolaryngectomy with parathyroid gland preservation or autotransplantation. Methods: Thirty patients underwent partial or total pharyngolaryngectomy by a single surgeon during the period 2009‐2020. Intraoperative parathyroid gland preservation or autotransplantation (where the gland appeared devascularized) was routinely performed. Calcium levels performed on day 1, 3 months, and at 12 months postoperatively were collected. Rates of transient and permanent hypocalcaemia were calculated. Results: A total of 13% of patients had transient hypocalcaemia, and 10% permanent hypocalcaemia. Rates of transient and permanent hypocalcaemia in total pharyngolaryngectomy were 14% and 14%, respectively. Partial pharyngectomy hypocalcaemia rates were 13% for transient and 0% for permanent. The majority of patients underwent salvage surgery for oncological resection, often following radiotherapy (63%). Ipsilateral hemithyroidectomy was preferred to total (57% vs 7%), with high rates of concurrent neck dissection (67%) and reconstruction (87%). Conclusion: This data supports preservation or autotransplantation of parathyroid glands as a means of reducing permanent postoperative hypocalcaemia. Level of Evidence: Level IV, case series, retrospective.