الفهرس | Only 14 pages are availabe for public view |
Abstract After reviewing our results we concluded that preoperative diagnosis of thyroid gland invasion couldn’t be reached neither by thyroid scanning, ultrasound examination of the neck, nor ultrasoundguided fine needle aspiration biopsy. This could be attributed to the fact that thyroid gland invasion was less than 5mm in diameter in our study and such modalities are not capable of detecting thyroid gland invasion unless it reaches 1-I.5cm in diameter. Test efficiency of frozen section, which is the percentage of patients correctly classified as diseased or non-diseased, in detecting thyroid gland invasion was found to be 95.2%, which was also emphasized by histopathological examination of the removed specimens, Thyroid gland invasion should be suspected in T3 or T4, moderately or poorly differentiated carcinomas that have the following characteristics: trans glottic tumors, anterior commissure glottic carcinomas with evidence of thyroid cartilage invasion or subglottic extension of more than 1em, or epiglottic tumors with evidence of preepiglottic or para-glottic spaces invasion. 173 Conclusion As regards the hypopharyngeal tumors, thyroid gland invasion should be suspected in T3 and T4, moderately or poorly differentiated carcinomas in the pyriform fossa, or post-cricoid regions. Hypothyroidism and hypoparathyroidism are more liable in cases managed with combined treatment of surgery (involving hemithyroidectomy, especially with radical neck dissection) plus radiotherapy. In addition, hypothyroidism should be expected to get worse, while hypoparathyroidism may show some improvement by time. We concluded that thyroid gland invasion positively correlates with local and lymph-nodal recurrences while its correlation to distant metastases, second primary tumors and positive surgical margins is insignificant. We concluded that lymph nodal staging significantly correlates with all types of recurrences. Moreover, there is a direct relationship between the nodal stage and the rate of lymph nodal recurrence and distant metastases. Finally, we also concluded that positive surgical margins correlate with high significance to local recurrences. On the other hand, positive 174 Conclusion surgical margins neither correlate to lymph-nodal recurrence nor to distant metastases. |