How Well Do You Know the 2015 Thyroid Guidelines?

Review “Thyroid Guidelines Had Major Impact on Patient Care, Otolaryngologists Say” in the February 2020 issue of ENTtoday before you answer the question.

Debate continues about the optimal role of radiotherapy in treating HPV-driven oropharyngeal cancers and about whether some patients should have their treatment deescalated, particularly given the relatively young patient population. Though these cancers respond well to radiotherapy combined with chemotherapy and/or surgery, radiotherapy poses some potentially significant side effects and complications. Which of these is NOT a potential issue?

Fibrosis of pharyngeal and cricopharyngeal musculature, leading to long-term swallowing difficulties and increased risk of aspiration pneumonia.

Mucositis, potentially causing pain, dysphagia, and weight loss, which might require narcotics and gastronomy tube placement.

Acute toxicities such as fatigue, nausea, skin breakdown, nephrotoxicity, and ototoxicity, which may necessitate breaks in treatment (and cause suboptimal therapy).

Hyperfunction of organs that had radiotherapy exposure, such as the thyroid, submandibular, and parotid glands.

Question by Ruth Jessen Hickman, MD