Obongo Anga Raïs, Abbaci Muriel, Guerlain Joanne, Breuskin Ingrid, Casiraghi Odile, Marhic Alix, Benmoussa-Rebibo Nadia, de Kermadec Héloïse, Moya-Plana Antoine, Temam Stéphane, Gorphe Philippe, Hartl Dana M
Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, 94805 Villejuif, France.
Department of Head and Neck Cancer and ENT Surgery, Henri Becquerel Cancer Center, 76038 Rouen, France.
Cancers (Basel). 2023 Jan 31;15(3):875. doi: 10.3390/cancers15030875.
Hypoparathyroidism is a known complication of total laryngectomy, although parathyroid preservation and/or reimplantation are not routine. Autofluorescence is a new technique for identifying parathyroid glands intraoperatively. The aim of this study was to evaluate the feasibility of autofluorescence in this context.
A retrospective study of patients undergoing total laryngectomy/pharyngectomy with concomitant thyroidectomy using the Fluobeam (Fluoptics, Grenoble, France) and frozen section of a parathyroid fragment in case of reimplantation. The rates of identification using autofluorescence, reimplantation, and hypoparathyroidism were evaluated.
Eighteen patients (16 males, median age 67) underwent total laryngectomy/pharyngectomy with total thyroidectomy (n = 12) or hemithyroidectomy (n = 6). A median of 2 parathyroid glands were identified per patient. Ninety-two percent were identified by autofluorescence before visualisation. All parathyroids were reimplanted due to devascularization. Temporary hypoparathyroidism occurred in nine patients, and was permanent in one patient. After 34 months of median follow-up (range 1-49), no tumor recurrence was observed in the reimplantation sites.
To our knowledge, this is the largest study to evaluate autofluorescence during total laryngectomy with thyroidectomy. No tumor recurrence occurred in the sites of parathyroid reimplantation.
甲状旁腺功能减退是全喉切除术已知的并发症，尽管甲状旁腺保留和/或再植术并非常规操作。自体荧光是一种术中识别甲状旁腺的新技术。本研究的目的是评估在此背景下自体荧光的可行性。
对接受全喉切除术/咽切除术并同期行甲状腺切除术的患者进行回顾性研究，术中使用法国格勒诺布尔的 Fluoptics 公司生产的 Fluobeam 设备，并在再植时对甲状旁腺碎片进行冰冻切片检查。评估自体荧光识别率、再植率和甲状旁腺功能减退发生率。
18 例患者（16 例男性，中位年龄 67 岁）接受了全喉切除术/咽切除术及全甲状腺切除术（n = 12）或半甲状腺切除术（n = 6）。每位患者平均识别出 2 个甲状旁腺。92%的甲状旁腺在肉眼观察前通过自体荧光识别。由于血管化受损，所有甲状旁腺均进行了再植。9 例患者出现暂时性甲状旁腺功能减退，1 例患者为永久性减退。中位随访 34 个月（范围 1 - 49 个月）后，再植部位未观察到肿瘤复发。
据我们所知，这是评估全喉切除术联合甲状腺切除术时自体荧光的最大规模研究。甲状旁腺再植部位未出现肿瘤复发。
