Department of Otorhinolarygology, Medical Faculty of Ataturk University, Erzurum, 25240, Turkey.
Department of Internal Medicine, Medical Faculty of Ataturk University, Erzurum, Turkey.
Eur Arch Otorhinolaryngol. 2024 Dec;281(12):6579-6584. doi: 10.1007/s00405-024-08857-w. Epub 2024 Jul 31.
The aim of this study is to investigate the relationship between the use of high doses of levothyroxine (L-T4) and hearing loss in patients who have undergone surgery for thyroid cancer.
After total thyroidectomy for thyroid cancer, patients were divided into two groups according to L-T4 dose below 150 µg and above 150 µg. Demographic characteristics, postoperative duration, radioactive iodine treatment, bone densitometry scans with LDxa and FDxa, and right and left ear hearing levels were statistically compared in both groups.
The study included 62 patients, 85.5% (n = 53) of whom were female, with a mean age of 48.8 ± 11.7 years. While 56.45% (n = 35) of the patients were taking L-T4 below 150 µg 43.55% (n = 27) were taking L-T4 above 150 µg. The mean postoperative duration of the participants was 4.1 ± 2.7 years, osteopenic 30.7% and osteoporotic 16.13% according to LDxa, osteopenic 29.0% and osteoporotic 1.6% according to FDxa. Hearing loss in both right and left ears was 41.9% and sensorineural hearing loss in both ears was 22.6%. Age, LDxa, FDxa, hearing loss in the right and left ear were found to be significantly different in the two groups above and below 150 µg according to the dose of L-T4 used (p < 0.05). However, no differences were found according to sex, height, weight, body mass index, postoperative period, or radioactive iodine treatment (p > 0.05). Both osteopenia and osteoporosis, as well as hearing loss in both the right and left ear, were significantly higher in the group taking L-T4 150 µg or more (p < 0.05).
In our study, we found that patients taking 150 µg or more of L-T4 daily were more osteopenic and osteoporotic and had more hearing loss in both ears.
本研究旨在探讨甲状腺癌手术后使用大剂量左甲状腺素（L-T4）与听力损失之间的关系。
甲状腺癌全甲状腺切除术后，根据 L-T4 剂量分为 150μg 以下和 150μg 以上两组。比较两组患者的一般资料、术后时间、放射性碘治疗、骨密度测定（LDxa 和 FDxa）、右耳和左耳听力水平。
本研究共纳入 62 例患者，85.5%（n=53）为女性，平均年龄 48.8±11.7 岁。56.45%（n=35）的患者服用 L-T4 剂量<150μg，43.55%（n=27）服用 L-T4 剂量>150μg。参与者的平均术后时间为 4.1±2.7 年，根据 LDxa，骨量减少者占 30.7%，骨质疏松者占 16.13%；根据 FDxa，骨量减少者占 29.0%，骨质疏松者占 1.6%。双耳均有听力损失者占 41.9%，双耳均为感音神经性听力损失者占 22.6%。根据 L-T4 剂量，发现两组间年龄、LDxa、FDxa、右耳和左耳听力损失差异有统计学意义（p<0.05）。但性别、身高、体重、体重指数、术后时间和放射性碘治疗无差异（p>0.05）。L-T4 剂量 150μg 或以上组骨量减少和骨质疏松、双耳听力损失的发生率明显高于 L-T4 剂量<150μg 组（p<0.05）。
在本研究中，我们发现每天服用 150μg 或以上 L-T4 的患者更易出现骨量减少和骨质疏松，双耳听力损失更多。
