Postoperative Hypocalcemia After Thyroidectomy for Graves' Disease

Pesce, Catherine; Shiue, Zita; Tsai, Hua Ling; Umbricht, Christopher B.; Tufano, Ralph P.; Dackiw, Alan P.B.; Kowalski, Jeanne; Zeiger, Martha A.

doi:10.1089/thy.2010.0047

Cited by 88 publications

(75 citation statements)

References 13 publications

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“…The Chovstek sign is elicited by tapping the facial nerve in the preauricular area and observing for facial contractions; Trousseaus sign by induction of carpal spasm upon inflation of blood pressure cuff above the systolic value. 8,9 The best way to reserve the PT function is the deliberate identification of them and safeguarding its blood supply. In a cadaveric study, 77% of the superior PT was at the cricothyroid junction, intimately associated with the RLN.…”

Section: Resultsmentioning

confidence: 99%

Hypoparathyroidism, an innate risk of thyroidectomy

2017

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Background: The identification and preservation of parathyroid glands (PT) with its intact blood supply is of utmost importance during thyroid surgery. To preserve the PT with intact blood supply, a medial to lateral dissection is advocated, with plane of dissection along the thyroid capsule. One of the earliest and feared complications of thyroidectomy is hypoparathyroidism (HPT). Aim was to study the incidence of temporary and permanent hypoparathyroidism during thyroidectomy.Methods: This was a hospital based prospective study, from 2008 to 2015. 472 cases who underwent thyroidectomy (182 near total and 290 total thyroidectomies) for any indications in general surgery department of a tertiary care centre were included.Results: The incidence of permanent and transient HPT after total thyroidectomy was 3.8 and 09%, where as it was 2.75 and 3.85% after near total thyroidectomy. The results of present study were comparable with other studies.Conclusions: Meticulous dissection, absolute hemostasis, and a thorough knowledge of neck anatomy are the key in reducing the post thyroidectomy complications. Transient or permanent hypo parathyroidism is due to inadvertent gland removal or injury to its vascular pedicle. Dissection close to the thyroid capsule and ligation of capsular branches of thyroid avoiding the main trunk of inferior thyroid artery holds the key.

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Section: Resultsmentioning

confidence: 99%

Hypoparathyroidism, an innate risk of thyroidectomy

2017

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“…[12][13][14][15] The old literature, in fact, described some cohorts as "normocalcemic", while more careful inspection has shown that these patients were intermittently normocalcemic. [16][17][18][19][20] The incidence of permanent hypocalcaemia which required calcium supplementation was more accurate with serial calcium estimation than the intact parathyroid hormone (iPTH) levels obtained after total thyroidectomy. The serial calcium level estimations are more predictable and coast effective than intact parathyroid hormone (i PTH) estimation in predicting long term postoperative hypocalcaemia after total/near total thyroidectomy.…”

Section: Discussionmentioning

confidence: 99%

Identification of patients at high risk for hypocalcemia after total thyroidectomy with serial calcium estimation and intact parathyroid hormone levels-a comparative study

Pauly

Santhosh

et al. 2016

Int J Res Med Sci

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“…A major cause of postoperative hypoparathyroidism is inadvertent injury during surgery, such as mechanical or thermal trauma, gland devascularization or incidental parathyroidectomy (23)(24)(25). There have been many studies that have reported the surgical risk factors of postthyroidectomy hypocalcemia, such as re-operation, large goiter (25), Graves' disease (27), and thyroid cancer (28). There have also been reports of clinical predictors of postoperative hypocalcemia, such as calcium levels being less than 1.88 mmol/L (reading taken 24 h after surgery), and the inability to identify more than one PTG during surgery (25).…”

Section: Syndromes Of Hypoparathyroidism After Total Thyroidectomymentioning

confidence: 99%