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Numéro 50 ORIGINAL ARTICLE

PRIMARY HYPERPARATHYROIDISM: CONTRIBUTION OF ULTRASOUND AND MIBI SCINTIGRAPHY IN THE PREOPERATIVE DETECTION OF PARATHYROID GLANDS

Hyperparathyroïdie primaire : Apport de l’échographie et de la scintigraphie MIBI dans la détection préopératoire des glandes parathyroïdes

F. Maalej (1), M. Sellami (1), Y. Hbaieb (1), M. Mnejja (1), K. ben Mahfoudh (2), F.Germazi (3) I.lhem Charfeddine (1)
1- ENT Department and Head and Neck Surgery, Habib Bourguiba University and Hospital Center, Sfax, Tunisia
2- Radiology department, Habib Bourguiba University and Hospital Center, Sfax, Tunisia
3- Department of nuclear medicine, Habib Bourguiba University and Hospital Center, Tunisia

Objectives: to specify the indications of reconstructive frontal anterior laryngectomy (RFAL) with epiglottoplasty in the treatment of glottic laryngeal cancers and to evaluate the functional and oncological findings of this surgical procedure.
Methods: A retrospective study of 32 patients who had undergone RFAL over a period of 17 years between 2002 and 2018. We included patients who had a RFAL with epiglottoplasty for T1 and T2 glottic squamous cell carcinoma.
Results: twenty five patients were in stage T1a/T1b (78%) and seven patients were in stage T2 (22%). All patients were operated with Tucker Technique. Surgical excision was enlarged to one arytenoid unit in 9 cases (28.1 %).
The median decannulation delay was 19 days [11-52 days]. The first oral feeding tests began between the 8th and 20th postoperative days; with a median refeeding per os delay of 14 days. Median removal time of nasogastric tube and hospital stay was significantly decreased in patients who were decannulated early (J11-J15). Preservation of both arytenoids did not significantly reduce these functional parameters. Median follow-up time was 30.7 months [6-120 months].
Conclusion: RFAL with epiglottoplasty is a valuable technique in selected glottic carcinomas. Based on our results, this procedure’s local control and survival rates are high with satisfying functional results.
Key-words: Glottic carcinoma; Partial laryngectomy; Epiglottoplasty;Tucker.

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