Parathyroid Insufficiency After Thyroidectomy

Thyroidectomy and the parathyroids

“…Girling and Murley (1963) similarly were unable to confirm the postoperative sequelae of hypoparathyroidism, despite an inadvertent parathyroidectomy rate of g per cent.…”

Vocal Cord Paralysis and Voice Changes in Patients with Surgical Hypoparathyroidism

“…This would imply that numbers of hypoparathyroid subjects are present in the community who are unrecognized because of a lack of laryngeal pathology. This is not borne out by several studies (Thoren and Wijnbladh, 1956;Girling and Murley, 1963) in which serum calcium was estimated in large numbers of patients after thyroidectomy, regardless of symptoms, and in which only about 1% of the subjects were found to be hypocalcaemic. A further objection may be raised against the arbitrary placement of a patient in one or the other group on the basis of a serum calcium estimation, rather than on the basis of symptoms, such as tetany.…”

Parathyroid Growth

“…203 Except when all four glands are removed, which almost never happens with neck surgery for non-malignant disease, there is no relationship between the development of hypocalcemia and the amount of parathyroid tissue in the surgical specimen. 206 Rather than simple removal of some parathyroid tissue, there is interference with the blood supply of all four glands as the result of the surgical dissection and hemostasis. 207 This occurs only in a small minority of patients, presumably because of individual differences in the precise location of the parathyroid glands and in the detailed anatomy of their blood supply.…”