Incidence and complications of hypothyroidism postlaryngectomy: A systematic review and meta‐analysis

• Published in: Head & neck Vol. 46; no. 2; pp. 249 - 261
• Main Authors: Banyi, Norbert, Kwon, Jamie J. Y., Turkdogan, Sena, Milner, Thomas D., Prisman, Eitan
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.02.2024; Wiley Subscription Services, Inc
• Subjects: Humans; hypothyroid; Hypothyroidism; Hypothyroidism - epidemiology; Hypothyroidism - etiology; Incidence; Laryngeal Neoplasms - radiotherapy; laryngectomy; Laryngectomy - adverse effects; Laryngectomy - methods; Meta-analysis; Postoperative Complications - etiology; Radiation therapy; radiotherapy; Retrospective Studies; Risk factors; Systematic review; Thyroidectomy; Thyroidectomy - adverse effects; Thyroidectomy - methods; radiotherapy; thyroidectomy; hypothyroidism; hypothyroid; laryngectomy
• DOI: 10.1002/hed.27573
• ISSN: 1043-3074; 1097-0347

Background Hypothyroidism is common postlaryngectomy and is associated with laryngectomy‐specific complications. The objective of this study is to determine the incidence and predictors of hypothyroidism postlaryngectomy and its associated complications. Methods Systematic review, data extraction, and meta‐analyses were performed following the PRISMA protocol. Six databases were searched for studies reporting on postlaryngectomy thyroid status with incidence, risk factors, management, or complications. Results Fifty‐one studies with 6333 patients were included. The pooled incidence of postlaryngectomy hypothyroidism is 49% (CI 42%–57%). Subgroup analysis showed postlaryngectomy hypothyroidism rates significantly correlated with hemithyroidectomy and radiotherapy. Patients who underwent laryngectomy, hemithyroidectomy, and radiotherapy had a 65% (CI 59%–71%) rate of hypothyroidism; laryngectomy and hemithyroidectomy 46% (CI 33%–60%); laryngectomy and radiotherapy 26% (CI 19%–35%); and laryngectomy alone 11% (CI 4%–27%) (p < 0.001). Conclusions Laryngectomized patients with partial thyroidectomy or radiation therapy are at significant risk of postoperative hypothyroidism. Evidence‐based protocols for early detection and (prophylactic) treatment should be established.