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Abstract
It is well known that the thyroid gland is at risk of invasion in advanced carcinoma of the larynx and hypopharynx, laryngeal squamous cell carcinoma may involve the thyroid gland by direct extension or indirectly via lymphatic or vascular metastasis, there are many methods for evaluation of the thyroid gland invasion in Laryngeal and Hypo- pharyngeal carcinoma; Clinical examination ,ultra sonography (us),fine needle aspiration (FNA),Computed tomography (CT) and Magnetic resonance imaging (MRI).
The aim of this Systematic review is to quantify the risk factors associated with spread of laryngeal and hypo-pharyngeal carcinoma to thyroid gland and estimate the incidence of thyroid gland invasion.
In this study (11 )articles fulfilled the inclusion criteria only one of them was prospective study and the rest were retrospective studies, By collection and analysis of data and by using the review manager(5) software program in pooling data ,With Statistical Method Odds ratios (ORs) were used as summary statistics of data.
The invasion of the thyroid gland was in fact not a common feature of SCC of the larynx, Indeed In our series tumor sub-sites namely the glottic and subglottic were the most useful indicator of TGI ,And the tumour variables as extra-laryngeal spread, Sub glottic extension >10 mm, thyroid cartilage invasion and lymph node metastasis should also raise suspicion for thyroid gland invasion, Surgical management of the gland in these cases should include at least ipsi-lateral lobectomy and isthmectomy even when the thyroid gland looks normal, Total thyroidectomy with preservation of the parathyroid glands is recommended in patients with a bilateral extension of advanced tumors.
Invasion of thyroid gland was less common in carcinoma originating from supra-glottis, trans-glottis and hypo-pharyngeal sub-sites and when subglottic extension is less than 10 mm.The low incidence indicates that the elective surgical management of the gland in these cases may not be required.