Figure 1 Diagram of the literature review process and article selection. Complications of Thyroid Surgery - Medscape Data sources include IBM Watson Micromedex (updated 2 Apr 2023), Cerner Multum (updated 17 Apr 2023), ASHP (updated 10 Apr 2023) and others. Sosa JA, et al. The tumor can grow to invade nearby tissue and can spread (metastasize) to the lymph nodes in the neck. Thyroid cancer rates seem to be increasing. Unauthorized use of these marks is strictly prohibited. AskMayoExpert. They may or may not be accompanied by the presence of goiter and exophthalmos, which is suggestive of this metabolic disorder. The condition may be due to direct trauma to the parathyroid glands, devascularization of the glands, or removal of the glands during surgery. All rights reserved. Factors that may increase the risk of thyroid cancer include: Thyroid cancer can return despite successful treatment, and it can even come back if you've had your thyroid removed. Transaxillary thyroidectomy was initially performed with the assistance of endoscopic technology. The location may be marked with a permanent suture or a metallic hemoclip for easier identification in any future surgeries. Thyroidectomy: What to Expect at Home | Kaiser Permanente Postoperative hypoparathyroidism, and the resulting hypocalcemia, may be permanent or transient. This is an open access article distributed under the terms of the, 2008 Nov;70 Suppl 2:3-10. doi: 10.1016/S0195-6701(08)60017-1. Ask your endocrinologist if you need to take calcium or vitamin D and how much to take. The study involved 278 thyroid surgery patients. The development of complications can lead to poor pain control. The prevention of postoperative bleeding depends on good intraoperative hemostasis. It enters the larynx through the thyrohyoid membrane and, therefore, should not be at risk during thyroidectomy. 2021 Dec 29;55(4):433-437. doi: 10.14744/SEMB.2021.33401. 5 (2):120-3. EMG demonstrates cricothyroid muscle denervation. Thyroid cancer is classified into types based on the kinds of cells found in the tumor. Each incision is Consider exploring the neck to ensure that no reversible causes of nerve injury (eg, misplaced ligature) are present. - After a total thyroidectomy, hypocalcaemia occurred in 9.9% that had to be treated with vitamin D and fell to 4.4% in the 6-month follow-up. Please type the correct Captcha word to see email ID. 2017 Oct. 96 (43):e8245. In addition, the affected vocal fold may be lower than the normal vocal fold. It can be caused by different mechanisms, including the incision, impingement, stretching of the nerve, it can also be secondary to edema or hematoma. - The incidence of permanent bilateral recurrent paralysis of the laryngeal nerve was 0% and the permanent unilateral recurrent laryngeal nerve paralysis was 0.2%, while the incidence of unilateral recurrent paralysis of the laryngeal nerve was 1.3%. After The study, using data from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP), compared safety and outcomes in 8185 patients who underwent outpatient thyroidectomy and an equal number of individuals who underwent the inpatient procedure. Numerous descriptions and attempts to quantify the percentages of each relationship of the nerve to the artery have been put forth. Conclusions: Trauma to the nerve results in an inability to lengthen a vocal fold and, thus, inability to create a high-pitched sound; this may be career-threatening for singers or others who rely on their voice for their profession. These may be followed clinically and allowed to resorb if small and asymptomatic. The updated JBI model for evidence-based healthcare. Hypocalcemia is the most frequent, symptomatic or asymptomatic, rebleeding with hematoma, laryngeal nerve injury, acute pain or infection as the most important. In summary, the nerve is always near the artery, but the exact relationship cannot be determined with certainty. Disclaimer. PMC Total Thyroidectomy The transaxillary robot assisted thyroidectomy approach appears to be replacing endoscopic approaches. You may have a sore throat, hoarse voice, or difficulty swallowing after surgery. Instead, ligate the terminal branches of the superior thyroid artery as close to the thyroid capsule as possible to avoid damaging the nerve. If you're experiencing any of these issues and are concerned, make an appointment with your doctor. Results of several prospective studies have disputed the usefulness of drains. However, again, these reports are limited, and this treatment is not a widely accepted. [5]. } HHS Vulnerability Disclosure, Help The thyroid is a butterfly-shaped gland located at the base of the neck, just below the Adam's apple. General objective: To identify the main care in patients undergoing total or partial thyroidectomy to avoid complications associated with surgery.

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