Management of the parathyroids in surgery for advanced malignancy of the larynx and hypopharynx.

A thyroidectomy is required in the surgical management of advanced malignancy of the larynx and hypopharynx when there is direct or potential extension to the thyroid of disease from the primary site or adjacent, involved lymph nodes. The parathyroids are at risk of injury either by inadvertent sacrifice with the en bloc resection, or as a result of surgical devascularization. At times the glands must be resected with the specimen. The incidence of postoperative parathyroid insufficiency may be decreased by re-implantation of the glands into the antecubital fossa. A series of parathyroid re-implantations in patients with advanced malignancy of the larynx and hypopharynx is reviewed.