Post-thyroidectomy Hypocalcemia - Risk Factors and Management

Păduraru, Dan Nicolae; Ion, Daniel; Cârșote, Mara; Andronic, Octavian; Bolocan, Alexandra

doi:10.21614/chirurgia.114.5.564

Cited by 45 publications

(60 citation statements)

References 38 publications

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“…Despite being oncologically sound, HT or TT comes at costs of transient or permanent hypocalcemia and/or permanent hypothyroidism [8,16]. The incidence of such complications is variable according to different reports [19,20].…”

Section: Discussionmentioning

confidence: 99%

“…Treatment requires multiple pills and doses throughout the day which is always inconvenient to both patients and surgeons. Each effort should be exercised to prevent the development of such complications [3,8,16]. The management of clinically negative thyroid gland in non-thyroid head and neck cancer has been a subject of ongoing debate.…”

Section: Discussionmentioning

confidence: 99%

“…Others prefer to perform total thyroidectomy (TT) if the tumor is crossing the midline [1,4,5]. TT can be complicated with temporary or permanent hypocalcemia, while permanent hypothyroidism is an inevitable consequence [6][7][8]. Hemithyroidectomy is not associated with the risk of hypocalcemia; however, the incidence of hypothyroidism remains to be a significant risk.…”

Section: Introductionmentioning

confidence: 99%

“…Treatment requires lifelong thyroid stimulation hormone (TSH) monitoring and thyroid hormone replacement therapy [13][14][15]. On the other hand, postoperative hypocalcemia, can be very agonizing to both the patient and the surgeon with the inconvenience of replacement therapy which includes multiple pills and doses throughout the day with the associated symptoms and morbidity that can be temporary or permanent [8,16].…”

Section: Introductionmentioning

confidence: 99%

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Incidence and predictors of thyroid gland invasion by laryngeal carcinoma: a 7-year experience review

Eltelety¹,

Nassar²,

Batawi³

et al. 2020

Egypt J Otolaryngol

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Background Study the incidence of thyroid gland invasion by laryngeal carcinoma and the risk factors that may predispose to this condition. Aiding surgeons develop an evidence-based plan for the management of the thyroid gland during total laryngectomy. Results Retrospective analysis of the available medical records for patients who had total laryngectomy together with total thyroidectomy or hemithyroidectomy in the same procedure. Associated pathological features were also investigated. Patients who had laryngeal carcinoma managed by total laryngectomy with total thyroidectomy or hemithyroidectomy between January 1, 2011, and December 31, 2017. Three hundred seventy-seven records were retrieved. The incidence of thyroid gland invasion by the laryngeal carcinoma was 24 (6.4%). Three patients showed microscopic extension (3/356; 0.8%). Six patients had malignant pathology other than squamous cell carcinoma (SCC). Two over six had invasion of the thyroid gland; OR (95% CI): 7.9 (1.4-45.4). Patients who had primary tumor stage of T4a were 244. 23/244 had thyroid gland invasion, 13.7 (1.8-102.9). Poorly differentiated tumors had significant incidence of thyroid gland invasion (4/15), 6.2 (1.8-21.3). Patients who had subglottic extension by the primary tumor were 177 with 20 patients having thyroid gland invasion (20/177), 6.2 (2.1-18.6). Conclusion Several risk factors are associated with higher incidence of invasion of the thyroid gland by laryngeal carcinoma. Identification of these factors can help surgeons develop a surgical strategy for the management of the thyroid gland during total laryngectomy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Incidence and predictors of thyroid gland invasion by laryngeal carcinoma: a 7-year experience review

Eltelety¹,

Nassar²,

Batawi³

et al. 2020

Egypt J Otolaryngol

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“…Hyper-function and even electrolytes anomalies must be treated before surgery due to high cardiovascular risk (9,10,11,12). Post-thyroidectomy complications are described in 0-4% of cases, an average of 1% (except for iatrogenic hypothyroidism) (13,14). Among them we mention hypoparathyroidism-related hypocalcemia, edema, neck hematoma, anesthesia and cardiovascular risk during surgery especially if prior cardiac co-morbidities or dys-electrolytemia are presented.…”

Section: The Post-operatory Complicationsmentioning

confidence: 99%

Hypertrofic scar – associated ultrasound aspects after thyroidectomy

Şandru¹,

Valea²,

Albu³

et al. 2020

Ro J Med Pract.

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Scar is part of wound healing and hypertrophic aspects as well as keloids are pathological formation of a scar. Their appearance is seen post-operatory, post-trauma and the consequences are more than cosmetic depending on location, for instance at joins functional impotence is associated. A scar formation involves activation of matrix enzymes, matrix response, local inflammation and fibroblast intervention as well as local cytokines and growth factors action. Our purpose is to introduce to cases of females who developed hypertrophic scars after thyroidectomy in addition to local swelling as revealed by neck ultrasound. The paper is two cases series report. The hormonal assays and ultrasound aspects are provided. A 30-year female with Basedow disease had one month after thyroidectmy TRAb of 2.4 U/l while TSH was 1 of under daily 100 µg of levothyroxine. The subject presented a post-operatory hypertrophic scar in addition to the following ultrasound aspect: right area with an inhomogeneous structure of 1/1.2/4 cm, left area of 1.4/1.7/4 cm, with multiple images with posterior echo and intense local edema. This is a 44-year female referred for total thyroidectomy (for large goiter). The subject did not develop any peri-operatory complication. The histological report showed chronic autoimmune thyoiditis background of focal type in addition to nodules of colloidal and cystic adenomatosis with hyperplasic epithelium. One month later TSH was normal under levothyroxine. The subject presented a post-operatory hypertrophic scar in addition to ultrasound aspect of edema in association with inflammatory lymph nodes at lateral cervical level of 0.6/0.2 cm maximum diameter. It is still a matter of debate to classify the high risk patients for developing post-thyroidectomy scars.

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Dilated cardiomyopathy in patients with hypoparathyroidism: A narrative review

Abdolmaleki,

Ohadi,

Maleki

2024

Health Science Reports

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BackgroundHypoparathyroidism is a rare endocrine disorder characterized by low blood calcium levels, elevated phosphorus levels, and insufficient parathyroid hormone production. It can lead to dilated cardiomyopathy (DCM), a cardiac condition characterized by enlarged ventricles and reduced heart function. This review aims to explore the relationship between hypoparathyroidism and DCM, the impact of calcium on cardiac function, and the potential for DCM reversal with calcium supplementation.MethodsA comprehensive literature search was conducted using PubMed, Google Scholar, and relevant keywords and Mesh terms. Case reports evaluating dilated cardiomyopathy in patients with Hypoparathyroidism were included in the study. Additionally, references cited in each study were carefully examined to identify relevant reports. The cases included in the review were analyzed, and common cardiac manifestations, diagnostic approaches, and management were identified.ResultsDCM in hypoparathyroidism presents with symptoms of heart failure, reduced ejection fraction, and impaired left ventricular function. Laboratory tests show low serum calcium levels and elevated phosphate levels. Prompt diagnosis and treatment with calcium and vitamin D supplementation can lead to improvements in cardiac function.ConclusionHypoparathyroidism‐induced DCM is reversible with timely calcium and vitamin D supplementation. Patient compliance with prescribed medications and supplements is crucial to prevent and manage cardiac complications. Regular follow‐up check‐ups and monitoring of calcium levels can aid in early detection and improve patient outcomes. Educating patients about the importance of treatment adherence can significantly reduce the risk of developing DCM and other cardiac symptoms associated with hypoparathyroidism. Routine follow‐up of DCM among patients with endocrine disorders is recommended.

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Post-thyroidectomy Hypocalcemia - Risk Factors and Management

Cited by 45 publications

References 38 publications

Incidence and predictors of thyroid gland invasion by laryngeal carcinoma: a 7-year experience review

Incidence and predictors of thyroid gland invasion by laryngeal carcinoma: a 7-year experience review

Hypertrofic scar – associated ultrasound aspects after thyroidectomy

Dilated cardiomyopathy in patients with hypoparathyroidism: A narrative review

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