The Incidence of Transient and Permanent Hypocalcaemia After Total Thyroidectomy for Thyroid Cancer

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 hypocalcae¬mia in patients who had undergone total thyroi¬dectomy, due to malignant thyroid diseases and to determine the value of parathyroid gland au¬totranplantation in thyroid cancer surgeries. Materials and Methods: Sixty-five patients, di¬agnosed 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 39.59?10.24 years) and 40% were male (mean age 42.11? 11.93 years). Complications of total thyroidectomy, perma¬nent and transient hypocalcaemia in particular, were studied. In eleven patients, parathyroids were transplanted within fibers of sternoclei¬domastoid and deltoid muscles. Results: Tran¬sient 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 pa¬tients 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 thy¬roidectomyt with neck dissection (p=0.01).Conclusion: Hypocalcaemia after total thyroi¬dectomy is a serious and dangerous complica-tion, 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 perma¬nent hypocalcaemia.