Am J Otolaryngol Head Neck Surg | Volume 2, Issue 1 | Research Article | Open Access

Surgical and Clinical Risk Factors of Postoperative Hypocalcemia after Total Thyroidectomy

Kamran Khazaeni* and Vahide Mousavi

Department of ENT, Ghaem Hospital, Iran

*Correspondance to: Kamran Khazaeni 

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Introduction: Hypocalcemia is the most common complication of total thyroidectomy. It is important to identify and avoid high-risk surgical techniques to lower the rate of this complication. Additionally, by knowing risk factors of hypocalcemia, lower risk patients can be discharged earlier. In this study we aim to understand the surgical, patient-related, and disease-related and laboratory risk factors of transient hypocalcemia after total thyroidectomy.
Methods: Patients undergoing total thyroidectomy were prospectively recruited. Various variables including status of parathyroid glands and the location of thyroid arteries ligation were recorder during the surgery. Serum PTH levels were measured at the baseline and one hour, 24 hours and one month after the surgery. Statistical analysis was performed to assess the association of study variables with the rate of hypocalcemia.
Results: The rate of hypocalcemia was significantly higher in the more advanced tumors. Number of identified parathyroid glands resulted in lower risk of hypocalcemia. Change in PTH levels from the baseline, both one hour and 24 hours after the surgery, and not the absolute PTH levels was significantly associated with hypocalcemia. Age, sex, tumor size, pathology of the tumor, extent of the surgery, ischemic discoloration or autotransplantation of parathyroid glands and distal location of thyroid arteries ligation was not significantly associated with hypocalcemia.
Conclusion: Proper surgical techniques and identification of the parathyroid glands is important in preventing hypocalcemia after total thyroidectomy. Additionally, for predicting hypocalcemia the relative and not absolute PTH levels should be more emphasized.


Total thyroidectomy; Hypocalcemia; Surgical techniques; Parathyroid hormone


Khazaeni K, Mousavi V. Surgical and Clinical Risk Factors of Postoperative Hypocalcemia after Total Thyroidectomy. Am J Otolaryngol Head Neck Surg. 2019;2(1):1031.

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