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Hypocalcaemia following laryngectomy: prevalence and risk factors

Published online by Cambridge University Press:  11 October 2018

A S Harris ,
E Prades ,
C D Passant  and
D R Ingrams
A S Harris*
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Aneurin Bevan University Health Board, Royal Gwent Hospital, Newport, Wales, UK
E Prades
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Betsi Cadwaladr University Health Board, Glan Clwyd Hospital, Rhyl, Wales, UK
C D Passant
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Aneurin Bevan University Health Board, Royal Gwent Hospital, Newport, Wales, UK
D R Ingrams
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Aneurin Bevan University Health Board, Royal Gwent Hospital, Newport, Wales, UK
*
Author for correspondence: Mr Andrew S Harris, Department of Otolaryngology Head and Neck Surgery, Aneurin Bevan University Health Board, Royal Gwent Hospital, Cardiff Road, Newport NP20 2UB, Wales, UK E-mail: Andrew.harris3@wales.nhs.uk
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Abstract

Objectives

To establish the prevalence of hypocalcaemia following laryngectomy and demonstrate that total thyroidectomy is a risk factor.

Methods

A retrospective cohort study was conducted that included all patients who underwent total laryngectomy from 1st January 2006 to 1st August 2017. Exclusion criteria were: pre-operative calcium derangement, previous thyroid or parathyroid surgery, concurrent glossectomy, pharyngectomy, or oesophagectomy.

Results

Ninety patients were included. Sixteen patients had early hypocalcaemia (18 per cent), seven had protracted hypocalcaemia (8 per cent) and six had permanent hypocalcaemia (10 per cent). Exact logistic regression values for hypocalcaemia following total thyroidectomy compared to other patients were: early hypocalcaemia, odds ratio = 15.5 (95 per cent confidence interval = 2.2–181.9; model p = 0.002); protracted hypocalcaemia, odds ratio = 13.3 (95 per cent confidence interval = 1.5–117.1; model p = 0.01); and permanent hypocalcaemia, odds ratio = 22.7 (95 per cent confidence interval = 1.9–376.5; model p = 0.005).

Conclusion

This is the largest study to investigate the prevalence of hypocalcaemia following laryngectomy and the first to include follow up of longer than three months. Total thyroidectomy significantly increased the risk of hypocalcaemia at all time frames and independent of other variables.

Keywords

LaryngectomyHypocalcemiaPrevalenceIncidenceThyroidectomy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 11 , November 2018 , pp. 969 - 973
Copyright
Copyright © JLO (1984) Limited, 2018 

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Footnotes

Mr A S Harris takes responsibility for the integrity of the content of the paper

Preliminary data presented at the ENT Wales Academic Conference, 7 October 2016, Saundersfoot, UK, the British Association of Clinical Otorhinolaryngology Conference, 4–6 July 2018, Manchester, UK, and at the British Association of Head and Neck Oncology Annual Scientific Meeting, 25 May 2018, London, UK

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