[Clinical and laboratory evaluation of thyroid function following total laryngectomy in laryngeal cancer]

Hypothyroidism is a well-documented complication after treatment of laryngeal cancer and is particularly significant among patients undergoing laryngectomy. We investigated the frequency of hypothyroidism in patients treated with total laryngectomy for laryngeal cancer. We also evaluated the effect of neck radiotherapy on thyroid function after total laryngectomy for laryngeal cancer. In a cross-sectional study, we evaluated 31 patients with laryngeal squamous cell carcinoma [mean age 53.6 years]. Among these patients, 14 were treated with surgery only and 17 were treated with surgery plus radiotherapy. Laboratory evaluation included levels of thyroid stimulating hormone [TSH], free T4, free T3, and antithyroid antibodies both preoperatively and postoperatively at the first day, as well as one and six months after surgery. All patients had normal thyroid function before treatment; however, after 6 months, five patients [16.1%] were hypothyroid. Of these, three patients [9.6%] had subclinical symptoms, including elevated thyroid-stimulating hormone with normal free T4, and two patients [6.5%] showed clinical symptoms of hypothyroidism. Radiotherapy and neck dissection were significantly associated with higher incidences of hypothyroidism. Our data suggest that hypothyroidism occurs in a substantial proportion of patients undergoing surgery for laryngeal cancer. The results indicate that thyroid function studies should be routinely performed in the follow-up care of laryngeal cancer patients, especially if radiotherapy and neck dissection were part of the treatment. We suggest that this approach will improve the patient's quality of life and diminish the co-morbidity associated with this kind of surgery

Diagnosis of pendred syndrome: MRI versus other traditional criteria

Background and purpose: Pendred syndrome, defined traditionally as the constellation of goiter, sensori-neural hearing loss and positive perchlorate discharge test. Since the relatively newer approaches to the diagnosis of this syndrome, as MRI and genetic and/or molecular analysis are much more expensive and complicated than the traditional approaches, we planned to study the value and reliability of MRI as the sole, or adjunctive diagnostic approach to the syndrome

Materials and methods: We presumed the classic triad is still the most widely accepted gold standard, and compared MRI findings in six such defined patients with six seemingly incomplete forms with goiter and hearing loss, but with negative Perchlorate discharge test

Results: There were a sensitivity and specificity of 83.3% and 66.7%, respectively for MRI in patients fulfilling all three criteria and 66.7% and 100% for sensitivity and specificity in the group lacking perchlorate test positivity

Conclusion: Although MRI can not replace the holistic approach, In [partial] cases with equivocal findings, and in the evaluation of relatives of the patients MRI may be considered as a valuable diagnostic adjunct