Controversies in thyroid and parathyroid surgery
Courtney Brooke Shires1, Aaron Parsons2, Karuna Dewan2
1Division of Head & Neck Surgical Oncology, West Cancer Institute, Memphis, TN, USA.
American Journal of Otolaryngology
|July 22, 2025
Summary
Common thyroid and parathyroid surgery practices, including nerve monitoring and airway management, were reviewed against evidence. Ten common surgical myths were identified, offering opportunities to improve patient care through evidence-based modifications.
Area of Science:
- Otolaryngology
- Endocrinology
- Surgical Oncology
Background:
- Clinical practices in thyroid and parathyroid surgery are often based on deeply held beliefs.
- Some established practices may be rooted in outdated or inaccurate evidence.
- This can lead to suboptimal patient outcomes.
Purpose of the Study:
- To critically analyze common practices in thyroid and parathyroid surgery.
- To identify and refute clinical practices not supported by current scientific literature.
- To promote evidence-based decision-making in surgical care.
Main Methods:
- Clinical practice patterns were observed and compared with existing literature.
- Practices strongly communicated but lacking evidence were identified.
- A list of "myths" was compiled based on discordance with published evidence.
Main Results:
- Ten common practice patterns in thyroid and parathyroid surgery were identified as "myths."
- Examples include practices related to muscle relaxants, airway management, CT contrast use, and neural monitoring.
- These practices were found to be discordant with high-quality published evidence.
Conclusions:
- Clinicians strive for optimal outcomes in thyroid and parathyroid surgery.
- Strongly held practices may persist despite evidence supporting alternatives.
- Modifying 10 identified practices based on evidence can lead to improved, less complex, or more precise patient care.
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