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Updated: Jul 9, 2026

Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
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Unintentional parathyroidectomy during total thyroidectomy.

Andreas Manouras1, Haridimos Markogiannakis, Emmanuel Lagoudianakis

  • 1First Department of Propaedeutic Surgery, Hippokration Hospital, Athens Medical School, University of Athens, Athens, Greece.

Head & Neck
|December 7, 2007
PubMed
Summary

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The Parathyroid Glands00:59

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The two pairs of parathyroid glands embedded within the posterior surface of the thyroid gland are restricted by a dense capsule around them. These glands comprise two distinct cell populations—parathyroid oxyphil and parathyroid principal cells- pivotal in calcium homeostasis.
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Unintentional parathyroidectomy during total thyroidectomy is common, occurring in 19.7% of patients. Patient sex, not surgeon experience or technique, influences its occurrence, with no lasting clinical consequences observed.

Area of Science:

  • Endocrine Surgery
  • Surgical Outcomes
  • Thyroid Cancer Management

Background:

  • Unintentional parathyroidectomy during thyroidectomy is a known complication.
  • Limited data exists on surgeon experience and operative technique's impact.
  • The study aimed to determine incidence, consequences, and influencing factors of unintentional parathyroidectomy during total thyroidectomy.

Purpose of the Study:

  • To identify the incidence of unintentional parathyroidectomy during total thyroidectomy.
  • To evaluate the clinical consequences of unintentional parathyroidectomy.
  • To determine factors influencing the occurrence of unintentional parathyroidectomy, including surgeon experience and operative technique.

Main Methods:

  • A retrospective review of total thyroidectomies performed over a 2-year period.

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  • Patients were divided into two groups: unintentional parathyroidectomy and no unintentional parathyroidectomy.
  • Comparison of demographic, clinical, and operative variables between the groups.
  • Main Results:

    • Incidental parathyroidectomy occurred in 19.7% (100/508) of patients.
    • No significant differences were found in age, thyroid characteristics, operative time, surgeon experience, or operative technique between groups.
    • Patient sex was the only factor significantly associated with unintentional parathyroidectomy (p=.002), with men being less likely to experience it.

    Conclusions:

    • Unintentional parathyroidectomy is a frequent occurrence following total thyroidectomy.
    • Despite its commonality, unintentional parathyroidectomy did not lead to permanent hypocalcemia or other significant clinical consequences in this study.
    • Patient sex is a significant factor influencing unintentional parathyroidectomy, whereas surgeon experience and operative technique were not found to be predictive.