The incidence of transient and permanent hypocalcaemia after total thyroidectomy for thyroid cancer

Abstract

Hypocalcaemia is one of the more acute complications of total thyroidectomy and occurs after parathyroid injury during surgery. The aim of this study is to assess the incidence rate and risk factors of transient and permanent hypocalcaemia in patients who had undergone total thyroidectomy, due to malignant thyroid diseases and to determine the value of parathyroid gland autotranplantation in thyroid cancer surgeries. Materials and Methods: Sixty-five patients, diagnosed with thyroid malignancy, who were treated by total thyroidectomy with or without radical neck dissection between 2002 and 2006, were studied retrospectively. Of patients 60% were female (mean age 39.59ط¢آ±10.24 years) and 40% were male (mean age 42.11ط¢آ± 11.93 years). Complications of total thyroidectomy, permanent and transient hypocalcaemia in particular, were studied. In eleven patients, parathyroids were transplanted within fibers of sternocleidomastoid and deltoid muscles. Results: Transient hypocalcaemia occurred in 18 patients and was treated by intravenous and oral calcium supplements. None of patients progressed to permanent hypocalcaemia. Temporary recurrent laryngeal nerve paresis occurred in 2% of patients but there was no case of paralysis. There was a significant difference in hypocalcaemia occurrence between patients, who had just total thyroidectomy and those who underwent thyroidectomyt with neck dissection (p=0.01). Conclusion: Hypocalcaemia after total thyroidectomy is a serious and dangerous complication, requiring prompt diagnosis and proper treatment. Parathyroid gland transplantation for an injured or incidentally removed parathyroid, between fibers of sternocleidomastoid or deltoid muscles, can prevent the occurrence of permanent hypocalcaemia.