Post-Operative Complications after Thyroid Gland Surgery due to Different Pathologic Condition: A Prospective Study

Background: The outcome and complication rates of post-operative cases are largely dependent on different factors. Objective: The objective of this study was to determine the risk factors responsible for major postoperative complications after thyroid surgery. Methodology: This was a prospective cohort study which was carried out at the Department of Surgery, Bangabandhu Shiekh Mujib Medical University, Dhaka, Bangladesh. Adult patients undergoing elective surgery for various thyroid disorders were selected as study population. This study was carried out from March 2009 to June 2011 for a period of two years. The study was included patients of various thyroid disorders that required surgical intervention of different magnitude. They were evaluated by history, physical examination, biochemical tests, ultrasound scan and FNAC where indicated. Histopathology was done and patients were followed up for subsequent outcome. Results: Among 2(2%) of them developed reactionary haemorrhage. The most common immediate surgical complication following thyroidectomy is hypocalcaemia and 12 patients (12%) experiencing this problem. 11(11%) patients developed transient tetany (hypocalcaemia) on 2nd post-operative day which was improved later on and 1(1%) patient developed permanent hypoparathyroidism and the patient supplemented by vitamin-D more than 6 months follow-up . In this study the mortality rate is 0% and complication rate is acceptable in comparison to other study. Conclusion: Hypoparathyroidism is a relatively common complication after thyroid surgery. Journal of Current and Advance Medical Research, July 2021;8(2):119-124

Current concepts in thyroid gland surgery: transoral endoscopic and robotic surgical procedures

The increased incidence of thyroid cancer in young females may raise concerns about visible hypertrophic scarring on the center of the neck after thyroid gland surgery. Therefore, endoscopic surgical procedures have attracted significant interest from patients with thyroid cancer, leading to the development of various endoscopic and robotic approaches. Although the cosmetic outcomes of current endoscopic and robotic thyroid surgeries have been excellent, all the procedures still require a large incision and extensive flap elevation. Transoral endoscopic thyroid surgery is a newly developed surgical method performed by inserting an endoscope through a mucosal opening created in the mouth, obviating the need for a skin incision. Additionally, the dissection area is relatively small and no dressings are required. Showering or shaving may resume the day after surgery and the port created within the oral mucous membrane generally heals within one week. Importantly, this approach is markedly less invasive than other endoscopic approaches. Although transoral endoscopic thyroid surgery has not yet been universally accepted, it may emerge as the preferred method for thyroid surgery in the near future.

Anterior Cervical Discectomy and Fusion combined with thyroid gland surgery, a tailored case and literature review

Background Nowadays, Anterior Cervical Discectomy and Fusion (ACDF) is considered a routine procedure. However, unexpected difficulties do occasionally arise, especially when anterior neck pathologies or anatomical variations are encountered. In such cases, proactive thinking will allow surgeons to tailor appropriately their approach and eliminate surgical risks. Case presentation We present the case of a 50-year-old male patient suffering from left upper limb radiculopathy that underwent a C7-T1 ACDF combined with a hemithyroidectomy. Excision of the right thyroid lobe was offered to the patient because of a goiter found during the preoperative work-up. Furthermore, the hemithyroidectomy provided a wide surgical field so the ACDF performed without excreting excessive traction to the adjacent neck structures. Conclusions The patient had an uncomplicated post-operative. To our knowledge this is the first report of a planned hemithyroidectomy being carried out as the first step towards an ACDF procedure.

Bilateral hypocalcemic cataract after total thyroidectomy in a young woman: case report

Background Hypocalcemia is a derangement in serum calcium level due to a vast spectrum of disorders, but the most common cause is surgery, usually thyroid gland surgery. Symptoms of hypocalcemia can be due to increased neuromuscular excitation resulting in tetany, paresthesia or seizure. It can also be because of deposition of calcium in soft tissues producing reduced vision /cataract or calcification of basal ganglia. Cataract is the most common ocular symptom of hypocalcemia. Case report A twenty-six years old Ethiopian female patient presented with painless reduction of vision of both eyes. Five years prior to the reduction of vision she was diagnosed to have hypocalcemia. The serum calcium level was very low (3 mg/dl) due to damage to the parathyroid gland during total thyroidectomy for toxic goiter. She has been on supplemental calcium gluconate twice daily. She had typical bilateral symmetrical posterior sub capsular cataract with punctate iridescent opacities in the anterior and posterior cortex of the lens. Systemic examination revealed horizontal surgical scar on the anterior neck and positive Chvostek sign.

Bilateral hypocalcemic cataract after total thyroidectomy in a young woman: Case report

Background: Hypocalcemia is a derangement in serum calcium level due to a vast spectrum of disorders, but the most common cause is surgery, usually thyroid gland surgery. Symptoms of hypocalcemia can be due to increased neuromuscular excitation resulting in tetany, paresthesia or seizure. It can also be because of deposition of calcium in soft tissues producing reduced vision /cataract or calcification of basal ganglia. Cataract is the most common ocular symptom of hypocalcemia. Case report: A twenty-six years old Ethiopian female patient presented with painless reduction of vision of both eyes. Five years prior to the reduction of vision she was diagnosed to have hypocalcemia. The serum calcium level was very low (3mg/dl) due to damage to the parathyroid gland during total thyroidectomy for toxic goiter. She has been on supplemental calcium gluconate twice daily. She had typical bilateral symmetrical posterior sub capsular cataract with punctate iridescent opacities in the anterior and posterior cortex of the lens. Systemic examination revealed horizontal surgical scar on the anterior neck and positive Chvostek sign. Key words: Hypocalcemia, bilateral cataract, total thyroidectomy, hypoparathyroidism, tetany, serum calcium and Ethiopia.

Spectrum of hypocalcaemia after thyroid surgery in Dhaka Medical College Hospital

Hypocalcaemia is not a uncommon complication after thyroid gland surgery. The extent of surgery and expertise are the vital factors to determine the spectrum of hypocalcaemia. This study was done to observe the spectrum of hypocalcaemia after different extent of thyroid gland surgery. A total of 70 consecutive patients were enrolled in the study by purposive sampling who received treatment for thyroid disorder in department of ENT and Head Neck Surgery, Dhaka Medical College Hospital, Dhaka, Bangladesh. They underwent different extent of thyroid surgery from January, 2017 to June, 2017. A prospective study was conducted for this 6 months period. A pre-structured, interview and observation based, peer reviewed data collection sheet was prepared. Data regarding sociodemographic, clinical, surgical and outcome profile were recorded. Data were compiled, edited and analyzed with SPSS version 23. Data were presented as mean and standard deviation, frequency percentage and median with range. The mean age of the respondents was 46.79±6.79 years (age range: 36-73 years.). Male to female ratio was 1:2.3. All the patients underwent total, near total, subtotal and completion thyroidectomy. 35(50%) and 28 (40%) patients underwent surgery due to papillary thyroid carcinoma and multinodular goiter respectively. Total of 30 patients developed hypocalcaemia. Among them, 22(73.33%) developed asymptomatic or mild hypocalcaemia which subsequently developed symptomatic hypocalcaemia (26.67%). Out of these 30 patients,15(50%) and 10 (33.33%) patients developed hypocalcaemia intraoperative (20 minutes after surgery) and after 24 hours after surgery respectively. Serum calcium level significantly decreases after total thyroidectomy and most critical time is the first 24 hours of post thyroidectomy period. Bangladesh Med J. 2018 Jan; 47 (1): 1-5

Bilateral hypocalcemic cataract after total thyroidectomy in a young woman: Case report

Background: Hypocalcemia is a derangement in serum calcium level due to a vast spectrum of disorders, but the most common cause is surgery, usually thyroid gland surgery. Symptoms of hypocalcemia can be due to increased neuromuscular excitation resulting in tetany, paresthesia or seizure. It can also be because of deposition of calcium in soft tissues producing reduced vision /cataract or calcification of basal ganglia. Cataract is the most common ocular symptom of hypocalcemia. Case report: A twenty-six years old Ethiopian female patient presented with painless reduction of vision of both eyes. Five years prior to the reduction of vision she was diagnosed to have hypocalcemia. The serum calcium level was very low (3mg/dl) due to damage to the parathyroid gland during total thyroidectomy for toxic goiter. She has been on supplemental calcium gluconate twice daily. She had typical bilateral symmetrical posterior sub capsular cataract with punctate iridescent opacities in the anterior and posterior cortex of the lens. Systemic examination revealed horizontal surgical scar on the anterior neck and positive Chvostek sign.