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Related Concept Videos

The Parathyroid Glands00:59

The Parathyroid Glands

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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.
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by...
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Hypothyroidism II: Pathophysiology01:23

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Hypothyroidism is a disorder characterized by insufficient production of thyroid hormones, which regulate metabolism, energy balance, and multiple organ systems.TypesHypothyroidism is classified based on the level of dysfunction. Primary hypothyroidism results from intrinsic thyroid gland dysfunction, causing reduced hormone production despite normal or increased stimulation. Secondary hypothyroidism arises from inadequate thyroid-stimulating hormone (TSH) secretion by the pituitary. Tertiary...
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Hyperthyroidism II: Pathophysiology01:27

Hyperthyroidism II: Pathophysiology

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Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH...
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Hormones and Bone Tissue01:17

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The endocrine system produces and secretes hormones, which interact with the skeletal system. These hormones control bone growth, maintain bone once it is formed, and remodel it.
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
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Graves Disease II: Pathophysiology01:24

Graves Disease II: Pathophysiology

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Graves’ disease is an autoimmune disorder characterized by the production of thyroid-stimulating immunoglobulins (TSI) that activate TSH receptors, leading to excessive synthesis and release of thyroid hormones (T3 and T4) and resulting in hyperthyroidism.Among all causes of hyperthyroidism, Graves’ disease is the most common and can happen at any age, though it is more frequent in women. It produces a hypermetabolic state with features such as weight loss, tachycardia, tremor,...
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Skeleton and Calcium Homeostasis01:21

Skeleton and Calcium Homeostasis

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Calcium is not only the most abundant mineral in bone but also the most abundant mineral in the human body. Calcium ions are needed for bone mineralization, tooth health, heart rate regulation and strength of contraction, blood coagulation, the contraction of smooth and skeletal muscle cells, and the regulation of nerve impulse conduction. The average calcium level in the blood is about 10 mg/dL. When the body cannot maintain this level, a person will experience hypo or hypercalcemia.
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Dynamic Risk Assessment Using Unstimulated Serum Thyroglobulin Level and Thyroglobulin Doubling Rate after Total Thyroidectomy for Papillary Thyroid Carcinoma.

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Permanent hypoparathyroidism after completion total thyroidectomy as a second surgery: How do we avoid it?

Yasuhiro Ito1, Minoru Kihara, Kaoru Kobayashi

  • 1Department of Surgery, Kuma Hospital, Kobe 650-0011, Japan.

Endocrine Journal
|January 31, 2014
PubMed
Summary
This summary is machine-generated.

Permanent hypoparathyroidism after total thyroidectomy is a risk. Careful parathyroid gland management during initial hemithyroidectomy and avoiding bilateral central dissection in the first surgery can prevent permanent hypoparathyroidism.

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Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Head and Neck Surgery

Background:

  • Permanent hypoparathyroidism is a significant complication following total thyroidectomy.
  • Completion thyroidectomy after initial hemithyroidectomy presents unique challenges for parathyroid preservation.

Purpose of the Study:

  • To investigate the incidence of permanent hypoparathyroidism after completion total thyroidectomy.
  • To identify strategies for avoiding permanent hypoparathyroidism in this patient group.

Main Methods:

  • Retrospective analysis of patients undergoing completion total thyroidectomy.
  • Comparison of outcomes based on parathyroid autotransplantation and extent of lymph node dissection (central dissection).

Main Results:

  • Permanent hypoparathyroidism occurred in 5% of patients undergoing completion total thyroidectomy.
  • Patients without parathyroid autotransplantation had a higher risk.
  • Bilateral central dissection during initial hemithyroidectomy increased the risk of permanent hypoparathyroidism in the two-surgery group (8% vs. 2% in one-time total thyroidectomy).

Conclusions:

  • Parathyroid gland identification and autotransplantation during initial hemithyroidectomy are crucial for preventing permanent hypoparathyroidism in subsequent surgeries.
  • Bilateral central neck dissection during hemithyroidectomy should be avoided to minimize the risk of permanent hypoparathyroidism; ipsilateral dissection is preferred when total thyroidectomy is not initially performed.