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Occurrence After Head and Neck Radiation and Surgery

MAJ Mark V. Alexander, MC; COL Joan T. Zajtchuk, MC; COL Robert L. Henderson, MC

Arch Otolaryngol. 1982;108(5):289-291.

Abstract
• A retrospective five-year review of patients treated for cancer of the larynx disclosed a high prevalence of hypothyroidism after combined therapy. A total of 29 patients were studied. Seven (24%) of the 29 patients had hypothyroidism develop in the posttreatment period (zero to two years). Two (22%) of the nine patients treated with surgery alone and five (25%) of 20 patients treated with a combination of surgery and radiation had hypothyroidism develop. An additional ten patients treated with radiation alone remained clinically euthyroid, and no thyroid function tests were performed. Of the five patients who became hypothyroid after treatment with a combination of surgery and radiation, two had fistulae develop that were resistant to intensive local care. They closed promptly after treatment of the hypothyroidism. Of the two patients who had hypothyroidism develop after surgery alone, one had fistulae develop that were resistant to local care, but responsive to thyroid hormone. These patients should have thyroid function tests done in the early postoperative period, and those found to be hypothyroid should be treated promptly.

(Arch Otolaryngol 1982;108:289-291)

Author Affiliations
USA; USA; USA

From the Otolaryngology Service, Dewitt Army Hospital, Ft Belvoir, Va (Dr Alexander); and the Otolaryngology Service, Walter Reed Army Medical Center, Washington, DC, and the Uniformed Services University of the Health Sciences, Bethesda, Md (Drs Zajtchuk and Henderson).

Footnotes
Accepted for publication Oct 28, 1981.

Read in part before the joint meeting of the Society of Head and Neck Surgeons and the Society of Surgical Oncology, San Francisco, May 13, 1980.

Reprint requests to the Otolaryngology Service, Walter Reed Army Medical Center, Washington DC 20012 (Dr Zajtchuk).

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