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Hypocalcaemia after subtotal thyroidectomy for thyrotoxicosis.

N I Ramus

    The British Journal of Surgery
    |August 1, 1984
    PubMed
    Summary
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    Subtotal thyroidectomy for thyrotoxicosis resulted in low rates of symptomatic hypocalcaemia and recurrent laryngeal nerve palsy. Lateral ligation of inferior thyroid arteries is recommended for recurrent laryngeal nerve protection.

    Area of Science:

    • Endocrinology and Thyroid Surgery
    • Surgical Outcomes and Complications

    Background:

    • Thyrotoxicosis management often involves subtotal thyroidectomy.
    • Surgical techniques aim to minimize complications such as hypocalcaemia and recurrent laryngeal nerve palsy.

    Purpose of the Study:

    • To evaluate the incidence of symptomatic and prolonged hypocalcaemia after subtotal thyroidectomy.
    • To assess the rate of recurrent laryngeal nerve palsy following the procedure.
    • To analyze the efficacy of lateral ligation of inferior thyroid arteries in preventing nerve injury.

    Main Methods:

    • Retrospective analysis of 81 patients undergoing subtotal thyroidectomy for thyrotoxicosis.
    • Monitoring of symptomatic hypocalcaemia (corrected calcium < 2.0 mmol/l) and prolonged hypocalcaemia.

    Related Experiment Videos

  • Assessment for transient recurrent laryngeal nerve palsy.

    • Main Results:

    • A 10% incidence of symptomatic hypocalcaemia was observed.
    • Only 1.2% of patients experienced prolonged hypocalcaemia.
    • A single case (1.2%) of transient right-sided recurrent laryngeal nerve palsy occurred.

    Conclusions:

    • Lateral ligation of inferior thyroid arteries is effective in protecting the recurrent laryngeal nerve during subtotal thyroidectomy.
    • The study supports continuing this technique, refuting claims that it compromises parathyroid function.
    • Careful handling of parathyroid tissue remains paramount to prevent injury, devascularization, or removal.