Importance of Preserving Parathyroids in Surgery for Hemiagenesis of Thyroid: Analysis with Review of Literature

Abstract

Background/objectives: As congenital anomalies of the thyroid are rare and the pathology associated with it warranting total thyroidectomies is still rare, so the inadvertent parathyroidectomies are rarely reported. Unilateral or bilateral hypoplasia or agenesis of one or both thyroid lobes, with or without isthmic agenesis, is a rare developmental anomaly. Meticulous subcapsular dissection with preserving the vascular twigs to the parathyroid is very important in avoiding complications. Materials and methods:We report two cases of thyroid hemiagenesis in our medical college institution over a period of 10 years. Both were females in the 6th decade with swelling in the neck. One had a right-sided swelling and the second had a left-sided swelling, both measuring about 5 × 5 cm.Conclusion: So the total thyroidectomy surgery in hemiagenesis cases poses a risk to the parathyroids as the altered anatomy. So the time-tested technique of subcapsular dissection and meticulous preservation of the multiple vasculature of the parathyroids in the fascial compartment provides better results with least morbidity.