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Introduction: Hypocalcemia is a common sequela of total thyroidectomy and is usually transient (30%), only a few develop permanent hypoparathyroidism. Till date, no effective risk stratification score to predict hypocalcemia is available that can predict postoperative hypocalcemia. Materials and Methods: This was a prospective observational study including all patients who underwent total or completion thyroidectomy with initial parathormone (PTH) within the normal range in our institution during a 1 year period. Postoperative 6th h PTH fall was noted in all patients and cutoff point for the prediction of long-term hypocalcemia (LTHP) was determined using a paired t-test. Results: Postoperatively, calcium supplementation was initiated in 52% of patients. In 7.6% of patients who had a fall in PTH to more than 80% of preoperative value, calcium supplementation could not be tapered even after 3 months postoperatively. About 66% of patients <20 years of age developed hypocalcemia in the postoperative period. Patients who developed delayed hypocalcemia with initial normal calcium levels had fall in PTH of at least 45%. For individuals below 20 years, a PTH fall of 56% or more required calcium supplementation. The various variables studied failed to attain statistical significance. Conclusions: More than 82% fall in 6th h postoperative PTH predicts long-term hypocalcemia. Post total thyroidectomy, adolescent individuals are at a higher risk of developing hypocalcemia; hence, early calcium supplementation is recommended based on fall in PTH. Weighted score to predict LTHP could not be developed, as none of the risk factors evaluated were statistically significant. [ABSTRACT FROM AUTHOR]

A prospective observational study was done at the Regional Cancer Centre, Thiruvananthapuram, a tertiary referral center for cancer care in India with an aim to assess the surgical outcomes of CO2 laser resection of oral lesions in terms of operative time, blood loss, hospital stay, postoperative pain, time to re-epithelization, pathological margins achieved and the postoperative scar. The excision was performed in 30 patients with a diagnosis of either potentially malignant lesions (leucoplakia, erythroplakia) or early cancers, i.e., carcinoma in situ or T1/T2 squamous cell carcinoma of the anterior oral cavity (tongue, buccal mucosa), adhering to standard oncological principles, and the resultant defect was left for secondary healing. [ABSTRACT FROM AUTHOR]

A 40-year-old female was evaluated for left thyroid swelling and, after left hemithyroidectomy (p T2 N0M0) with intermediate risk as per the American Thyroid Association Guidelines, was referred for completion thyroidectomy as the final histology was papillary carcinoma. A contrast-enhanced computed tomography evaluation of the neck was done, which revealed a suspicious nodule in the right lower pole of the thyroid gland, and a mention of anomalous right subclavian artery was reported. Intraoperative findings were confirmed. [ABSTRACT FROM AUTHOR]

Background: Reconstruction of laryngopharngeal defects with pedicled flaps especially with Myocutaneous pectoralis major flap remains to be the workhorse in most high volume tertiary centres against free flaps, even in the present era. SCF is an equally viable alternative with advantages of either. Aim: To assess the reliability of Supraclavicular flap in augmentation of neopharngeal reconstruction with Patch Supraclavicular flap. Methods : Primary Hypopharyngeal cancers undergoing Total laryngectomy with partial pharyngectomy at our institution from June 2017 was included in the study. SCF was harvested from contralateral side in view of need for ipsilateral Selective neck dissection. Results: A total of 4 cases were selected for the study. All were T4a lesions of Pyriform fossa.Following laryngectomy, the pharyngeal defect was reconstructed with patch SCAIF . The average dimension of the flap used 7.8x5.2cm, that was harvested in median duration of 48 minutes.The average length of hospital stay was 4 days.Prophylactic neck strapping with crepe bandage was initiated on POD-4 till 2 weeks post op followed by oral soft diet. Adjuvant Radiation was initiated around 4-5 weeks postop. One patient had post op medical complication of PSVT, that was managed. No Pharyngocutaneous leaks, stomal stenosis or aspiration were noted . Conclusion: Patch Supraclavicular flap is a reasonably versatile and reliable flap when utilized for neopharyngeal reconstruction in view of sminimal learning curve and ease to harvest without affecting the oncolcogical safety. [ABSTRACT FROM AUTHOR]

Purpose-The indication for surgical intervention in laryngeal and hypopharyngeal cancers have narrowed down to T4a SCC and treatment failures . Radiation still remains the treatment in other case scenarios. But unlike the morbid procedure of total laryngectomy, near total laryngectomy whenever feasible is a better alternative in view of better speech quality without prosthesis. Aim- To retrospectively analyse the oncological safety of NTL in the setting of a tertiary care centre, after extensive resections and for salvage surgeries with regard to oncological outcome, morbidity, complications, recurrence and survival Methods-Retrospective study of 29 patients who underwent near total laryngectomy from Jan 2003 to Jan 2017 at our institution. Results- Of 29 patients, 48% were salvage cases.58% underwent near total laryngectomy alone followed by 24% with partial pharyngectomy also. Excellent communicable speech was attained in 24%.Completion laryngectomy was done in 10% due to shunt failure, shunt stenosis or local recurrence. Locoregional failure was noted in 27% in a median follow up 8 years. Survival was plotted with Kaplan mier curves. Conclusions- Near total laryngectomy remains to be a maintenance free, oncologically safe when carefully opted and well tolerated option for both primary and salvage scenarios of laryngectomy. [ABSTRACT FROM AUTHOR]