Donnelly M J, O'Meara N, O'Dwyer T P
Department of Otolaryngology/Head and Neck Surgery, Mater Misericordiae Hospital, Dublin, Ireland.
Clin Otolaryngol Allied Sci. 1995 Jun;20(3):254-7. doi: 10.1111/j.1365-2273.1995.tb01861.x.
The thyroid function of 27 patients who previously had carcinoma of the larynx treated by total laryngectomy with thyroid lobectomy was studied by measuring levels of thyroxine (T4) and thyroid stimulating hormone (TSH). Twenty-two of these patients also received external beam radiotherapy. Abnormal results were found in 45% (10 patients) of those who received combined therapy. Clinical hypothyroidism developed in two patients (9%) and subclinical hypothyroidism (elevated TSH) was seen in eight patients (36%). Eighty-eight per cent of those patients with subclinical hypothyroidism had low or low normal T4 levels. All the patients treated with surgery only had normal thyroid function. To prevent hypothyroidism and identify those at risk of developing hypothyroidism, post-operative testing of thyroid function should be carried out on a routine basis in patients receiving combined therapy for laryngeal cancer. In addition we recommend that patients with subclinical hypothyroidism who have had combined treatment should be treated with thyroxine to prevent the complications of this condition.
通过测量甲状腺素（T4）和促甲状腺激素（TSH）水平，对27例先前接受全喉切除术加甲状腺叶切除术治疗的喉癌患者的甲状腺功能进行了研究。其中22例患者还接受了外照射放疗。接受联合治疗的患者中有45%（10例）出现异常结果。2例患者（9%）出现临床甲状腺功能减退，8例患者（36%）出现亚临床甲状腺功能减退（TSH升高）。亚临床甲状腺功能减退的患者中88%的T4水平低或正常下限。所有仅接受手术治疗的患者甲状腺功能均正常。为预防甲状腺功能减退并识别有发生甲状腺功能减退风险的患者，对于接受喉癌联合治疗的患者，术后应常规进行甲状腺功能检测。此外，我们建议接受联合治疗的亚临床甲状腺功能减退患者应接受甲状腺素治疗，以预防该疾病的并发症。
