Alper CEYLAN, Ahmet KÖYBAŞIOĞLU, Metin YILMAZ, Sabri USLU, Korhan ASAL, Erdoğan İNAL

İleri evre larenks ve hipofarenks karsinomlarında tiroid bez tutulumu

Amaç: Total larenjektomi gerektiren ileri evre larenksve hipofarenks karsinomlarında tiroid bezi tutulumuoranını ve tiroidektomi gerekliliğini değerlendirmek.Hastalar ve Yöntemler: Gazi Üniversitesi Kulak BurunBoğaz Bölümü’nde 1994-2001 yılları arasında, 129 olguda ileri evre primer larenks karsinomu nedeniyle total larenjektomi ile beraber ipsilateral hemitiroidektomi, 14 olguda primer ileri evre hipofarenks karsinomu nedeniyletotal larengofarenjektomi ile beraber total tiroidektomiuygulandı. Bu 143 olgunun cerrahi spesimenlerinde, tiroit bezi ve tiroid kıkırdak invazyonunun varlığı, ışık mikroskopik inceleme sonuçları göz önünde bulundurularak,retrospektif olarak değerlendirildi.Bulgular: Larengeal karsinom olgularının hiçbirinde tiroid bez invazyonu saptanmazken, 14 hipofarenks karsinomlu olgunun sekizinde %57 tiroid bez tutulumumevcuttu. Larenks karsinomlu grupta 20 olguda %16 ,hipofarenks karsinomlu grupta ise üç olguda %21 tiroid kıkırdak invazyonu olduğu saptandı.Sonuç: Total lerenjektomi uygulanan tüm olgularda tiroidektomi yapmanın gerekli olmadığını, ancak subglottikuzanım gösteren larenks karsinomlarında ve ileri evre hipofarenks tümörlerinde total larenjektomi ile birlikte tiroidektominin gerekli olduğunu düşünmekteyiz. Bu iki durum dışında, cerrahi sırasında tümörün larenks dışı dokulara uzanım gösterdiğinin saptanmasının ve makroskobik olarak tiroid bezi tutulumu izlenmesinin tiroidektomikararını almamızda yol gösterici olacağı kanısındayız

Anahtar Kelimeler:

Larenjektomi, larengeal neoplaziler/cerrahi, farengeal neoplaziler/cerrahi, tiroid bezi/patoloji/cerrahi, tiroidneoplazileri/tutulum/cerrahi, tiroidektomi, neoplazi tutulum, prognoz, tiroid kıkırdak/patoloji

Thyroid gland invasion in advanced laryngeal and hypopharyngeal carcinoma

Objectives: To assess the rate of thyroid gland inva sion and the need for thyroidectomy in advanced laryn geal and hypopharyngeal carcinomas which require total laryngectomy.Patients and Methods: 129 total laryngectomy with ipsilateral hemithyroidectomy and 14 total laryngopharyn- gectomy with total thyroidectomy were performed for pri- mary squamous celi carcinoma of larynx and hypophar- ynx betvveen 1994-2001 in the ENT Department of Gazi University HospitaL İn the surgical specimens of these 143 patients, the presence of tumor invasion of thyroid cartilage and thyroid gland was evaluated retrospectively according to light microscopic examination.Results: None of the laryngeal carcinoma patients had thyroid gland invasion vvhereas eight 57% hypopha ryngeal carcinoma patients had thyroid gland invasion.Tvventy patients 16% had evidence of thyroid carti lage invasion in laryngeal carcinoma group. There were only 3 21% cases with thyroid cartilage invasion in hypopharyngeal carcinoma patients.Conclusion: There may be no need for performing thy roidectomy in ali total laryngectomy cases. We recommend thyroidectomy during total laryngectomy in laryn geal carcinoma cases with subglottic extension and advanced hypopharyngeal tumors. Except for these two conditions, the assessment of extralaryngeal extension and thyroid gland invasion will guide vvhether thyroidectomy should be performed or not.

Keywords:

Laryngectomy, laryngeal neoplasms/surgery, pharyngeal neoplasms/surgery, thyroid gland/pathology/surgery, thyroid neoplasms/secondary/ surgery, thyroidectomy, neoplasm invasiveness, prognosis, thyroid cartilage/pathology,

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