DOI: 10.21276/aimdr.2018.4.2.EN4
Original Article ISSN (O):2395-2822; ISSN (P):2395-2814
Annals of International Medical and Dental Research, Vol (4), Issue (2) Page 13
Section: Ear, Nose & Throat
Complications of Thyroid Surgery: Our Experience.
Vinti Jain
1
, Akshay Jain
2
, Probal Chatterji
3
1
Junior Resident, Department of ENT&HNS, TMMC&RC, Moradabad.
2
Assistant Professor, Department of ENT &HNS, TMMC&RC, Moradabad.
3
Professor & Head, Department of ENT &HNS, TMMC&RC, Moradabad.
Received: February 2018
Accepted: February 2018
Copyright: © the author(s), publisher. Annals of International Medical and Dental Research (AIMDR) is an
Official Publication of “Society for Health Care & Research Development”. It is an open-access article distributed
under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-
commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Background: The purpose of this study was to evaluate the complications of thyroid surgery and their management.
Methods: A prospective study was conducted on 50 patients at Teerthankar Mahaveer Medical College and Research
Centre Teerthankar Mahaveer University, Moradabad, Uttar Pradesh over a period of 12 months. Patients undergoing
thyroid surgery in our department were included in this study after taking proper written informed consent. Complete history
was taken and thorough ENT examination was performed. Clinical and laboratory data from the study was recorded as per
the pro forma. Results: Among the patients undergoing surgery, Isthmusectomy was performed in 3 (6.0%) patients, Left
hemithyroidectomy in 5 (10.0%) patients, Right hemithyroidectomy in 28 (56.0%), Subtotal thyroidectomy in 6 (12.0%)
patients, Near total thyroidectomy in 3 (6.0%) patients and Total thyroidectomy in 5 (10.0%) patients. The most common
complication that occurred was hypocalcemia(16%). Other complications observed were permanent hypoparathyroidism
(6%), permanent recurrent laryngeal nerve palsy (4%), superior laryngeal nerve palsy (2%), post-operative haemorrhage
(2%), seroma (8%), hypertrophic scar (8%), keloid (2%), wound infection (6%). Conclusion: The most common
complications generally observed are hypoparathyroidism and recurrent laryngeal nerve injuries.
Keywords: Hemithyroidectomy, subtotal thyroidectomy, subtotal thyroidectomy, total thyroidectomy, hypocalcemia,
hypoparathyroidism, recurrent laryngeal nerve palsy.
INTRODUCTION
The thyroid is a gland of internal secretion and a
unique site of several diseases which may be
managed medically or surgically or by a
combination of both. The association of high
prevalence of thyroid diseases with publications
from diverse regions and different schools of surgery
often results in heterogeneous information that helps
feed the controversy about their best mode of
management.
[1-5]
Thyroid nodules are very frequent. Many patients
present with a palpable enlargement of the thyroid
gland and surgery is commonly performed on these
patients. Numerous complications may arise
following the surgical removal of the thyroid gland.
These problems often result from surgical technique,
aberrant anatomy, infections etc. Although the
incidence of these complications is low, some
problems are seen more frequently than others.
[6]
Thyroid surgery was rarely performed until the late
nineteenth century. Total thyroidectomies were only
performed occasionally for indications other than
cancer until the last quarter of the twentieth
Name & Address of Corresponding Author
Dr. Akshay Jain
Assistant Professor,
Department of ENT &HNS,
TMMC&RC, Moradabad.
century.
[2]
The use of total thyroidectomy remains
controversial for small differentiated thyroid
carcinomas, but even more controversial is its use to
treat benign diseases.
[7]
Most surgeons avoid the
procedure owing to the possible complications such
as permanent recurrent laryngeal nerve palsy and
permanent hypoparathyroidism; subtotal
thyroidectomy has been the preferred operation for
benign thyroid diseases.
[7]
However, the indication of total thyroidectomy (TT)
for certain benign diseases is a trend that is gaining
acceptance in the last two decades. Although the
extent of resection for benign diseases remains
controversial, an increasing number of total
thyroidectomies are currently being performed in
specialist endocrine surgery units and the indications
for this procedure include Graves disease and
multinodular goitre.
[7]
The disadvantages of subtotal thyroidectomy to treat
multinodular goitre are that the procedure does not
reduce the risk of persisting symptoms and has a
high recurrence rate (30%–50%) owing to the gland
remnants, even under hormonal suppression
treatment with L-thyroxine.
[7]
Disease recurrence
usually requires a repeat surgery which greatly
increases the risk (up to 20 times) of damage to the
parathyroid glands and laryngeal nerves.
TT should be considered in cases of suspected
malignant nodules, multinodular nontoxic goiter