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Thyroidectomy is a common surgical procedure that has several potential complications or sequelae including: temporary or permanent change in voice, temporary or permanently low calcium, need for lifelong thyroid hormone replacement, bleeding, infection, and the remote possibility of airway obstruction due to bilateral vocal cord paralysis.
The strap muscles are released off of the thyroid gland. Then the thyroid gland is mobilized and the parathyroid arterial blood supply is suture ligated. The entire parathyroid adenoma is identified and dissected out. Intraoperative PTH monitoring can begin at this time and will show falling PTH levels if the entire adenoma has been resected. [5]
One well-conducted study of patients with troublesome general symptoms and with anti-thyroperoxidase (anti-TPO) levels greater than 1000 IU/ml (normal <100 IU/ml) showed that total thyroidectomy caused the symptoms to resolve and median anti-thyroid peroxidase levels to reduce from 2232 to 152 IU/mL, [5] [110] but post-operative complications ...
Post-operative complications at high-volume thyroid surgery centers with experienced surgeons are comparable to that of hemithyroidectomy. Arguments for hemithyroidectomy: Most patients have low-risk cancer with an excellent prognosis, with similar survival outcomes in low-risk patients who undergo total thyroidectomy versus hemithyroidectomy.
Post-surgery radioactive iodine does not reduce recurrence in those with low risk thyroid cancer. [10] Patients with medullary, anaplastic, and most Hurthle-cell cancers do not benefit from this therapy. [14] External irradiation may be used when the cancer is unresectable, when it recurs after resection, or to relieve pain from bone metastasis ...
Determining when patients can be safely discharged from the post-anesthesia care unit. Aldrete's scoring system is a commonly used scale for determining when postsurgical patients can be safely discharged from the post-anesthesia care unit (PACU), generally to a second stage (phase II) recovery area, hospital ward, or home.
Thyroid storm is a rare but severe and life-threatening complication of hyperthyroidism. It occurs when an overactive thyroid leads to hypermetabolism, which can cause death from cardiac arrest or multiple organ failure. [2]
A 51-year-old female patient post total thyroidectomy for PTC with elevated thyroglobulin measurement. an Axial non-enhanced CT scan of the neck at the level of the thyroid bed demonstrates a well-defined, rounded, homogenously dense soft tissue situated between the trachea and left internal jugular vein (white arrow). b Transverse ultrasound ...