15-years experience of paediatric thyroid and parathyroid surgery: Clinical outcomes and patients' perspective

Thyroid surgery in children is uncommon. This study assessed children's/parents' perception of morbidity after thyroid surgery delivered within an established integrated paediatric endocrine surgery programme involving a high-volume adult thyroid surgeon and a paediatric surgeon.

A retrospective cohort study analysed outcomes in consecutive unselected patients. Patient reported outcomes were collected using standardised questionnaires Voice Handicap Index (VHI-10), Voice-related Quality of Life (VRQoL), Swallowing Impairment Score and Manchester Scar Scale (MSS).

Between 2011 and 2025 93 children had 102 thyroid or parathyroid operations. Total thyroidectomy (n = 53) and thyroid lobectomy (n = 27) was performed with an average 1-day postoperative admission. Of the 20 children with thyroid cancer thyroid, 12 needed radical neck dissection for locally advanced disease and their median hospital stay was 3 days. Temporary (n = 15) and permanent (n = 1) hypoparathyroidism was the most common recorded complication but only one child needed calcium supplements for >12 months. A postal survey received replies from 32 of 40 patients (78%) patients (27 female) at a median of 40 months post-op (range 5-111). VHI-10 scores were normal in 24 (75%) children and increased in 8 (25%). VRQoL was excellent in 24 (75%). Swallowing was normal in nine, slightly affected in 21 and severely affected in two children. Manchester Scar Score ranged from 5 to 16 (median 9) with 4 children scoring the ideal score of 5.

When conducted with a multidisciplinary approach in a specialist paediatric and endocrine centre, paediatric thyroid surgery is safe and has minimal long-term impact on voice.