World Journal of Endocrine Surgery

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VOLUME 3 , ISSUE 1 ( January-April, 2011 ) > List of Articles

RESEARCH ARTICLE

Hypocalcemia and Hoarseness Following Total Thyroidectomy for Benign Disease: Relationship of Incidence to the Size of the Gland

R Fernando, PC Chandrasinghe, M Bandara

Citation Information : Fernando R, Chandrasinghe P, Bandara M. Hypocalcemia and Hoarseness Following Total Thyroidectomy for Benign Disease: Relationship of Incidence to the Size of the Gland. World J Endoc Surg 2011; 3 (1):7-9.

DOI: 10.5005/jp-journals-10002-1046

Published Online: 01-04-2011

Copyright Statement:  Copyright © 2011; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction

Total thyroidectomy is considered as the standard surgical procedure for most malignancies and benign disease involving both lobes of the thyroid gland. Postoperative complications are likely to be commoner when the thyroid gland is large in size due to the alteration of structural anatomy.

Methods

Postoperative complications of 102 patients who underwent total thyroidectomy for benign disease, by the same surgeon, were analyzed. Patients were prospectively followed up and presence of hoarseness and hypocalcemia, both transient and temporary, were compared with the weight of the gland.

Results

Fourteen patients developed hypocalcemia of which 12 (11.7%) had transient and 2 (1.96%) had permanent deficiencies. Eight patients developed hoarseness following surgery of which seven (6.86%) had transient and only one (0.98%) had permanent hoarseness. A mean thyroid weight of 91.78 gm was observed in the uncomplicated group. Those who developed postoperative hypocalcemia and transient hoarseness had a mean thyroid weight over 100 gm. One patient, who had a thyroid weighing 195 gm developed permanent hoarseness due to RLN injury.

Conclusion

There is no statistically significant difference in the incidence of transient RLN and transient or permanent hypocalcemia. With increased size of the thyroid gland increased rate of complications was observed with a mean thyroid weight above 100 gm. There may be a significant risk of permanent RLN injury when the thyroid gland is enlarged over 10 times (closer to 200 gm) its normal size.


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  1. Total Thyroidectomy for management of thyroid disease. World Journal of Surg 2000;24(8);962-65.
  2. Total thyroidectomy: Indications, technique and training. Aust NZ J Surg 1992;62:87-89.
  3. Assessment of the morbidity and complications of total thyroidectomy. Arch Otolaryngol Head Neck Surg 2002;128:389-92.
  4. Incidental parathyroidectomy during thyroid surgery does not cause transient symptomatic Hypocalcemia. Arch Otolaryngol Head Neck Surg 2001;127:304-08.
  5. Endocrine disease and anaesthesia. Anaesthesia 1970;25: 232-52.
  6. Multivariate analysis of risk factors for postoperative complications in benign goiter surgery: Prospective multicenter study in Germany. World Journal of Surgery 2000;24(11):1335-41.
  7. Recovery of parathyroid function after total thyroidectomy: Long-term follow-up study. ANZ J Surg 2005;75:532-36.
  8. The relation between preoperative ultrasonographic thyroid volume analysis and thyroidectomy complications. Endocr Regul Apr 2009;43(2):83-87.
  9. Thyroidectomy in patients with marked thyroid enlargament: Airway management, morbidity and outcome. Am J Surg 1994;60:586-91.
  10. Prospective study of postoperative complications after total thyroidectomy for multinodular goiters by surgeons with experience in endocrine surgery. Annals of Surgery July 2004;240(1).
  11. Hypomagnesemia and hypocalcemia after thyroidectomy: Prospective study. World Journal of Surgery 2000;24(6):722-26.
  12. Parathyroid risk in total thyroidectomy for bilateral, benign, multinodular goitre: Report of 351 surgical cases. J Laryngol Otol Mar 2007;121(3):237-41. Epub 2006 Oct 23.
  13. Complications and risk factors related to the extent of surgery in thyroidectomy: Results from 2,043 procedures. Hormones (Athens) Oct 2010;9(4):318-25.
  14. Safety and efficacy of total thyroidectomy for differentiated thyroid carcinoma: A 20-year review. Am Surg 1993;59:110-14.
  15. Total thyroidectomy: The preferred option for multinodular goiter. Ann Surg 1988;208:244-45.
  16. Total thryoidectomy for bilateral benign multinodular goiter: Effect of changing practice. Arch Surg 1999;134:1389-93.
  17. Multivariate analysis of risk factors for postoperative complications in benign goiter surgery: Prospective multicenter study in Germany. World Journal of Surgery 2000;24:1335-41.
  18. Total thyroidectomy in management of 909 patients with thyroid disease. Surgery 1998;123:2-7.
  19. Complications of thyroid Surgery; eMedicine Specialties;otolaryngology and facial plastic surgery; Head and Neck Surgery. http://emedicine.medscape.com/article/852184-overview.
  20. Recurrent laryngeal palsy rate in thyroid gland surgery related to operations and nerves at risk. Arch Surg 1985;120:475-77.
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