الفهرس 
Material and methodsOnly 14 pages are availabe for public view
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Abstract
After reviewing our results we concluded that preoperative
diagnosis of thyroid gland invasion couldn’t be reached neither by
thyroid scanning, ultrasound examination of the neck, nor ultrasoundguided
fine needle aspiration biopsy. This could be attributed to the fact
that thyroid gland invasion was less than 5mm in diameter in our study
and such modalities are not capable of detecting thyroid gland invasion
unless it reaches 1-I.5cm in diameter.
Test efficiency of frozen section, which is the percentage of
patients correctly classified as diseased or non-diseased, in detecting
thyroid gland invasion was found to be 95.2%, which was also
emphasized by histopathological examination of the removed
specimens,
Thyroid gland invasion should be suspected in T3 or T4,
moderately or poorly differentiated carcinomas that have the following
characteristics: trans glottic tumors, anterior commissure glottic
carcinomas with evidence of thyroid cartilage invasion or subglottic
extension of more than 1em, or epiglottic tumors with evidence of preepiglottic
or para-glottic spaces invasion.
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Conclusion
As regards the hypopharyngeal tumors, thyroid gland invasion
should be suspected in T3 and T4, moderately or poorly differentiated
carcinomas in the pyriform fossa, or post-cricoid regions.
Hypothyroidism and hypoparathyroidism are more liable in cases
managed with combined treatment of surgery (involving
hemithyroidectomy, especially with radical neck dissection) plus
radiotherapy. In addition, hypothyroidism should be expected to get
worse, while hypoparathyroidism may show some improvement by
time.
We concluded that thyroid gland invasion positively correlates
with local and lymph-nodal recurrences while its correlation to distant
metastases, second primary tumors and positive surgical margins is
insignificant.
We concluded that lymph nodal staging significantly correlates
with all types of recurrences. Moreover, there is a direct relationship
between the nodal stage and the rate of lymph nodal recurrence and
distant metastases.
Finally, we also concluded that positive surgical margins correlate
with high significance to local recurrences. On the other hand, positive
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Conclusion
surgical margins neither correlate to lymph-nodal recurrence nor to
distant metastases.