Changes in hormones of the thyroid axis after tracheostomy and their influence on regeneration in patients with head and neck cancer: A prospective study |
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| Institution: | 1. Christian Albrechts University, Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Kiel, Germany;2. Christian Albrechts University, Division of Endocrinology, Diabetes and Clinical Nutrition, Department of Medicine 1, Institute of Diabetes and Clinical Metabolic Research, University Hospital of Schleswig-Holstein, Campus Kiel, Kiel, Germany;3. University Hospital Münster, Department of Neurosurgery, Münster, Germany;1. University Hospital Augsburg, Department of Otolaryngology, Head and Neck Surgery, Stenglinstrasse 2, 86156, Augsburg, Germany;2. Institute of Mathematics, University of Augsburg, Universitätsstrasse 2, 86159, Augsburg, Germany;1. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China School & Hospital of Stomatology, Sichuan University, No. 14, 3rd Section of Renmin South Road, Chengdu, 610041, China;2. Stomatological Hospital of Chongqing Medical University, Chongqing, 401147, China;3. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral Radiology, West China School & Hospital of Stomatology, Sichuan University, No. 14, 3rd Section of Renmin South Road, Chengdu, 610041, China;1. Department of Cranio-Maxillofacial Surgery, University Hospital Regensburg, Regensburg, Germany;2. Tumor Center — Institute for Quality Management and Health Services Research, University of Regensburg, Regensburg, Germany;3. Department of Internal Medicine 5 — Hematology/Oncology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany;4. Department of Otorhinolaryngology, University Hospital Regensburg, Regensburg, Germany;1. Department of Dentistry, All India Institute of Medical Sciences, AIIMS, Deoghar, Jharkhand, 814152, India;2. GSR Institute of Cranio-Maxillofacial and Facial Plastic Surgery, Vinay Nagar Colony, I S Sadan, Saidabad, Hyderabad, Telangana, 500059, India;3. Department of Dentistry, All India Institute of Medical Sciences, AIIMS, Rishikesh, Uttarakhand, 249203, India;4. Emeritus Consultant, Maxillofacial Surgeon, Poole Hospital, University of Bournemouth, University of Duisburg-Essen, Trinity College Dublin, India;5. Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine/Medical Faculty, University of Bern, Freiburgstrasse 7, CH-3010 Bern, Switzerland;6. Department of Orthodontics, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands;7. Faculty of Dentistry, Universitas Indonesia, Campus Salemba, Jalan Salemba Raya No.4, Jakarta, 10430, Indonesia;1. Department of Oral and Maxillofacial Plastic Surgery, University Hospital Würzburg, Germany;2. Comprehensive Cancer Center Mainfranken, University Hospital Würzburg, Germany;3. Department of Otorhinolaryngology, University Hospital Würzburg, Germany;4. Department of Otorhinolaryngology – Head and Neck Surgery, RWTH Aachen University Hospital, Germany;5. Department of Pathology, University of Würzburg, Germany;6. Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Germany;7. Department of Nuclear Medicine, University Hospital Würzburg, Germany;8. Nuclear Medicine, Medical Faculty, University of Augsburg, Germany |
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| Abstract: | This prospective study aimed to compare and evaluate changes in hormones of the thyroid axis affected by tracheostomy due to surgical treatment in patients with oral cancer.The patients were evaluated with regard to serum levels of the thyroid axis — free T3/triiodothyronine (fT3) and free T4/thyroxine (fT4), as well as thyroid-stimulating hormone (TSH) — at fixed perioperative time points: during the tumor staging about 1 week before operation, immediately before and within 6 h after operation, 2 days after operation, and about 10 days after operation. Additionally, data on the patients’ characteristics (age, gender), relevant secondary diagnoses, duration of ventilation in the intensive care unit, and perioperative complications were obtained and analyzed.In total, 51 patients with an average age of 68.29 years (±11.82) were included. Analyses of thyroid hormones directly before and after tracheostomy showed a significant postoperative decrease in circulating TSH (p = 0.005) and fT3 (p < 0.001), whilst a significant increase in fT4 values (p < 0.001) was found. Nine patients showed perioperative complications, such as infection, emphysema, or requiring a revision operation. Eleven patients were diagnosed with a cardiac problem or suffered from agitation after operation.Within the limitations of the study it seems that hormonal changes following tracheostomy in critically ill patients should be monitored and thyroid hormone adjustment should be taken into account because the latter might lead to lower mortality and morbidity during hospitalization in these patients.Clinical trial registration numberDRKS00023942. |
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| Keywords: | Hormones of the thyroid axis Plastic tracheostoma Tracheostomy Postoperative hormonal changes Perioperative management |
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