Defi nitive anatomopathological fi ndings in thyroidectomized patients with preoperative diagnosis of follicular neoplasm Background: The fi nding of follicular neoplasm, using a FNAP, is an indication for partial or total thyroidectomy, to obtain the defi nitive malignant or benign histology. Frequently, it is possible to identify signifi cant additional histological diagnosis. Aim: To obtain the defi nitive histological fi ndings in patients with follicular neoplasm by FNAP. Patients and Method: Transversal analysis of 133 patients that underwent to total thyroidectomy between 2003 and 2009, that fi lled de requirements for adequate histological assessment. Results: In 33.1% of the treated patients the fi nal diagnosis was indeed a follicular neoplasm (adenoma in 26.3% and cancer in 6.8%). In the 51.9% the fi nding was follicular colloidal hyperplasia and other thyroid cancer in 8.3%. The total malignant prevalence in the whole gland was 29.3%. Conclusions: The thyroidectomy is the treatment of choice and the fi nal diagnostic procedure for these patients. The histological fi ndings of cancer different from follicular not only in the punctioned nodule are a secondary and an additional argument for reinforcing the surgical indication.

Thyroidectomy dysphoniaBackground: Dysphonia is one of the most important and frecuent complication in thyroidectomies. It incidence is between 0 and 20%. The frecuency of this complication depends on factors like the preoperatory diagnosis, goitre volume, surgeon experience and other general factors that theoretically can affect it incidence. Aim: To evaluate a group of preoperatory risk factors usually not considerated that may have relevance in postoperatory dysphonia in thyroidectomies. Patients and Method: Survey and medical records of 56 patients operated between may and july 2009. Results: None of the risk factors included in this study increase de incidence of posthiroidectomy dysphonia. Conclusions: It seems that these theorical risk factors don´t have a great infl uence in the incidence of dysphonia after a thyroidectomy. It can be eventually useful to submit these patients to a direct vocal cord evaluation before surgery, to obtain their real risk.Key words: Thyroidectomy, dysphonia. ResumenIntroducción: La disfonía es una de las complicaciones en tiroidectomías más importante y frecuente. Su incidencia varía entre 0 y 20%. Esta incidencia depende de factores como el tipo de diagnóstico preoperatorio, el volumen del bocio, la experiencia del cirujano y otros factores generales que pueden teóricamente infl uir. Objetivo: Evaluar un grupo no habitualmente considerado de factores de riesgo de disfonía en tiroidectomías. Pacientes y Métodos: Estudio prospectivo con análisis de fi chas clínicas y realización de una encuesta preoperatoria en 56 pacientes consecutivos. Resultados: En este estudio no fue demostrado estadísticamente un mayor riesgo de disfonía en pacientes con los factores de riesgos planteados. Conclusiones: Aunque los factores estudiados en esta muestra pueden teóricamente aumentar la incidencia de disfonía postiroidectomía, parecen no ser los más infl uyentes. Podría ser de utilidad realizar una evaluación dirigida otorrinolaringológica en estos pacientes para objetivar su real riesgo de disfonía postoperatoria.

Postoperative thyroid bed granuloma incidence using ultrasonic knife in total thyroidectomy in cancer patientsBackground: The postoperative thyroid bed granuloma incidence is high and it is an adittional diffi culty for the ultrasound differential diagnosis of eventual local cancer recurrence. The ultrasonic knife utilization eventually can reduce the incidence of these granuloma when is compare with other traditional ligatures methods. Objective: to evaluate the postoperative thyroid bed granuloma incidence with the ultrasonic knife utilization, detected by ultrasound. Methods: retrospective study of 57 evaluable thyroidectomy performed for cancer between March and September 2010. In 46 patients were used traditional ligatures (silk or linen) and in 11, ultrasonic knife. Results: of the 57 patient included, 47 were females. The age average was 44 years old. Postoperative thyroid bed granuloma incidence was 36.3% (CI95%, 7.9%-64.7%) in the group where ultrasonic knife was used and 36.9% (IC95%, 23.0%-50.9%) in which traditional ligatures were used. No statistical difference was found (p = 0.974). Conclusions: The ultrasonic knife utilization had not reduced the postoperative thyroid bed granuloma incidence, when was compared with conventional ligatures. In this sense, this device is probably unable to add benefi ts for the differential diagnosis of thyroid cancer local recurrence.