[Differenciated thyroid carcinomas with laryngo-tracheal invasion].
OBJECTIVE
Analyze the diagnosis and treatment of differentiated thyroid carcinomas with laryngo-tracheal invasion.


METHODS
Among the 117 patients operated for a differentiated thyroid carcinoma in the ENT department of Tours Hospital (France) between January 1990 and December 2003, seven presented laryngo-tracheal invasion and were included in this retrospective study.


RESULTS
Laryngo-tracheal resection resulted in a thyroid cartilage-shaving in two patients. We performed a resection of one side of the thyroid cartilage in one patient, a thyro-tracheal resection-anastomosis with a partial cricoidectomy in one patient, a partial vertical laryngectomy extended to the first tracheal ring in one patient and a total laryngectomy in one patient. No laryngo-tracheal resection was done in one patient. Early complications were swallowing disorders (n = 2), transitory hypoparathyroidism (n = 1), definitive recurrent nerve paralysis (n = 2), subcutaneous emphysema and hematoma (n = 1) and Claude Bernard-Horner's syndrome (n = 1). Locoregional recurrences (n = 2) and distant metastasis (n = 2) were discovered six months to four years after the laryngo-tracheal resection. With a mean follow-up of 40 month, four patients were alive (two disease free) two patients had died and one was lost of follow-up at three months.


CONCLUSIONS
The frequency of locoregional recurrences and distant metastasis is higher for the differentiated thyroid carcinomas with laryngo-tracheal invasion than the others. In these cases, we performed macroscopic carcinological surgery preserving laryngeal functions as much as possible.
Miloundja
J
J
Service d'ORL et de chirurgie cervico-faciale, Hôpital Bretonneau, CHU de Tours.
Lescanne
E
E
Ouedraogo
B
B
Pondaven
S
S
Beutter
P
P
Morinière
S
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D002277:Carcinoma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011183:Postoperative Complications; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014134:Tracheal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery