Open AccessHypocalcaemia in pharyngolaryngectomy: Preservation or autotransplantation of parathyroid glands
Author(s) -
Every James D.,
Sideris Anders W.,
Sarkis Leba M.,
Lam Matthew E.,
Mackay Stuart G.,
Pearson Stephen J.
Publication year - 2021
Publication title -
laryngoscope investigative otolaryngology
Language(s) - English
Resource type - Journals
ISSN - 2378-8038
DOI - 10.1002/lio2.627
Subject(s) - hypocalcaemia , medicine , autotransplantation , surgery , hypoparathyroidism , parathyroid gland , transplantation , parathyroid hormone , calcium
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.