title: Free Thyroid Transfer: A Novel Procedure to Prevent Radiation-induced Hypothyroidism.
abstract: The incidence of hypothyroidism after radiation therapy for head and neck cancer (HNC) has been found to be ≤53%. Medical treatment of hypothyroidism can be costly and difficult to titrate. The aim of the present study was to assess the feasibility of free thyroid transfer as a strategy for the prevention of radiation-induced damage to the thyroid gland during radiation therapy for HNC.
  
  
  
  A prospective feasibility study was performed involving 10 patients with a new diagnosis of advanced HNC undergoing ablative surgery, radial forearm free-tissue transfer reconstruction, and postoperative adjuvant radiation therapy. During the neck dissection, hemithyroid dissection was completed with preservation of the thyroid arterial and venous supply for implantation into the donor forearm site. All patients underwent a diagnostic thyroid technetium scan 6 weeks and 12 months postoperatively to examine the functional integrity of the transferred thyroid tissue.
  
  
  
  Free thyroid transfer was executed in 9 of the 10 recruited patients with advanced HNC. The postoperative technetium scans demonstrated strong uptake of technetium at the forearm donor site at 6 weeks and 12 months for all 9 of the transplanted patients.
  
  
  
  The thyroid gland can be transferred as a microvascular free transfer with maintenance of function. This technique could represent a novel strategy for maintenance of thyroid function after head and neck irradiation.
authors: Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.
authors: Jeffrey
authors: J
authors: Harris
authors: Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada; Department of Otolaryngology-Head and Neck Surgery, King Abdulaziz University, Jeddah, Saudi Arabia.
authors: Hani
authors: H
authors: Almarzouki
authors: Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada. Electronic address: brittanybarber0@gmail.com.
authors: Brittany
authors: B
authors: Barber
authors: Division of Radiation Oncology, Department of Oncology, University of Alberta, Edmonton, Alberta, Canada.
authors: Rufus
authors: R
authors: Scrimger
authors: Division of Endocrinology and Metabolism, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
authors: Jacques
authors: J
authors: Romney
authors: Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.
authors: Daniel
authors: D
authors: O'Connell
authors: Institute for Head and Neck and Thyroid Cancers, Icahn School of Medicine, Mount Sinai Hospital, New York, New York.
authors: Mark
authors: M
authors: Urken
authors: Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.
authors: Hadi
authors: H
authors: Seikaly
mesh_terms: D005260:Female; D058752:Free Tissue Flaps; D006258:Head and Neck Neoplasms / Q000150:complications / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D007037:Hypothyroidism / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011832:Radiation Injuries / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D013961:Thyroid Gland / Q000637:transplantation*; D016896:Treatment Outcome