scholarly journals Surgery of the Thyroid Gland

1997 ◽  
Vol 40 (3) ◽  
pp. 71-74
Author(s):  
Jan Vokurka ◽  
Stanislava Jakoubková ◽  
Jaroslav Růžička
Keyword(s):  
Thyroid Gland ◽  
Surgical Technique ◽  
Total Thyroidectomy ◽  
Nerve Palsy ◽  
Diagnostic Procedure ◽  
Postoperative Bleeding ◽  
Blood Transfusions ◽  
Recurrent Nerve ◽  
Recurrent Nerve Palsy ◽  
Laryngeal Recurrent Nerve

Since the year 1987 to 1996 all kinds of thyroid surgeries were performed at the ENT Department. Altogether 604 patients underwent 655 surgeries. Total lobectomy or total thyroidectomy represented the most common procedures. Due to a gentle surgical technique, which we call ãpreparationÒ, good results were achieved in the morbidity of laryngeal recurrent nerve (permanent palsy in 0.6%), and in perioperative or postoperative bleeding (0.3% of wound revisions, 0.5% of blood transfusions). Postoperative hypoparythyroidism was found in 4.7% patients. There is no correlation between postoperative hoarseness and laryngeal recurrent nerve palsy. Laryngeal endoscopy immediately after surgery is the most valuable diagnostic procedure.

scholarly journals Evaluation of Total Thyroidectomy for Treatment of Benign Diseases of Thyroid Gland

2020 ◽  
Vol 8 (B) ◽  
pp. 166-170
Author(s):  
Risto Cholancheski ◽  
Natasha Tolevska ◽  
Ardit Qafjani ◽  
Ilir Vela ◽  
Borislav Kondov ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Total Thyroidectomy ◽  
Nerve Palsy ◽  
Laryngeal Nerve ◽  
Thyroid Diseases ◽  
Recurrent Nerve ◽  
Recurrent Nerve Palsy ◽  
Laryngeal Nerve Palsy ◽  
Toxic Goiter ◽  
Benign Thyroid

BACKGROUND: The controversy of using total thyroidectomy (TT) in treatment of benign thyroid diseases still remains controversial over the rates of complication, mostly recurrence nerve palsy and hypocalcemia, compared to non-total thyroidectomies. The latest reports in this field of research showed that that the number of complications of TT is decreasing as the skills of surgeons increase. AIM: In this study, we reviewed 209 cases of total thyroidectomies for benign thyroid diseases where such surgery was indicated. The results were evaluated whether they support the previous reports that TT is save method of treatment of diffuse multinodular goiters, Graves’ disease thyroid adenomas with diffuse goiters and thyroiditis. METHODS: Two hundred and nine patients, 36 males and 173 females, medium age 47 (17–77) operated with TT between 2016 and 2018 were included in the evaluation study. We evaluated the: Diagnosis, indications for operation, pre-operative medication administration, laryngeal recurrent nerve palsy, hypocalcemia, hypoparathyroidism, and patohistology findings. The follow-up for hypocalcemia and laryngeal nerve palsy was performed 1 year postoperatively. RESULTS: The age of the patients was between 17 and 77 years, medium-range 47 years old. Of 209 patients, 173 (83%) were female and 36 (17%) male with a gender ratio of 1:4.8 males to females. Diagnoses before surgery were established as follows: Multinodular euthyroid goiter (MNEG) n = 106 (48.80%), multinodular toxic goiter n = 12 (5.74%), Graves’s disease n = 6 (2.87%), adenoma with multinodular goiter n = 73 (34.92%), and n = 16 (7.65%) patients with thyroiditis. Recurrence laryngeal nerve palsy (RLNP) occurred in 6 patients (2.87%), temporary within 3 months after the operation in 4 patients (1.92%) and permanent palsy within 6 months and more after an operation in 2 patients (0.95%). Voice hoarseness immediately and within 1 month after the operation was registered in 32 patients (15.3%). RLNP and hoarseness were registered mostly in patients with pre-operative problems, mostly with extra big MNEG. One of the permanent injuries of RLN was bilateral and all others were one sided. All patients were operated with normal pre-operative vocal cord movement findings. Post-operative hypocalcemia was registered in 35 patients (16.74%). Temporary nonsignificant hypocalcemia in 10 (4.78%), temporary significant hypocalcemia in 17 (8.13%), temporary severe hypocalcemia in 6 patients (2.87%), and permanent hypocalcemia in 2 patients (0.95%). CONCLUSION: Many studies have shown that the rate of complications is almost even for TT and NTT done for benign and malignant diseases of thyroid gland. Our data have shown that the risk of post-operative complications with TT is proportional to the number of complicated pre-operative findings of benign thyroid glands.

Mechanism of The Larynx and Recurrent Nerve Palsy

1956 ◽  
Vol 70 (2) ◽  
pp. 86-96 ◽  
Author(s):  
M. H. Stroud ◽  
E. Zwiefach
Keyword(s):  
Nerve Palsy ◽  
Recurrent Nerve ◽  
Recurrent Nerve Palsy

“Mystic” transient recurrent nerve palsy after thyroid surgery

Head & Neck ◽  
2012 ◽  
Vol 35 (7) ◽  
pp. 934-941 ◽  
Author(s):  
Áron Altorjay ◽  
Miklós Rüll ◽  
Balázs Paál ◽  
Géza Csáti ◽  
Anna Szilágyi
Keyword(s):  
Thyroid Surgery ◽  
Nerve Palsy ◽  
Recurrent Nerve ◽  
Recurrent Nerve Palsy

scholarly journals The relationship between thyroidectomy complications and body mass index

2020 ◽  
Vol 66 (11) ◽  
pp. 1573-1576
Author(s):  
Mehmet Üstün ◽  
Avni Can Karaca ◽  
Ihsan Birol ◽  
Gülberk Uslu ◽  
Semra Demirli Atici ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Nerve Palsy ◽  
Operative Time ◽  
Bleeding Complications ◽  
Recurrent Nerve ◽  
Recurrent Nerve Palsy ◽  
Group A ◽  
Group B ◽  
The Relationship

SUMMARY INTRODUCTION: Obesity is a growing public health problem associated with many comorbid diseases. The aim of this study was to evaluate the relationship between body mass index and complications of thyroidectomy. METHODS: Patients who underwent total thyroidectomy between January 2015 and December 2018 were enrolled. Patients were divided into two groups, i.e., BMI <25 (group A) and BMI≥ 25 (group B). Demographics, operative time, and complications were retrospectively reviewed. RESULTS: The study included 145 patients (66 in Group A and 79 in Group B). There was no significant difference between the two groups in terms of age (p=0.330) and gender (p=0.055). No surgical site infection and bleeding complications were observed in any patients. The mean operative time was 148.4 minutes (90-235) in Group A and 153.4 minutes (85-285) in Group B (p=0.399). Transient hypocalcemia was observed in 25 (37.9%) patients in group A, and 23 (29.1%) patients in Group B (p = 0.291). Permanent hypocalcemia was not observed in any patient in group A, and in 2 patients in Group B (2.5%) (p = 0.501). Transient recurrent nerve palsy was observed in 1 (1.5%) patient in Group A and in 3 (3.8%) patients in Group B (p=0.626). None of the patients had permanent recurrent nerve palsy. Parathyroid autotransplantation was performed on 1 patient (1.5%) in group A and on 7 (8.9%) patients in Group B (p=0.055). CONCLUSION: We think there is no relationship between a high BMI and thyroidectomy complications, and surgery can also be performed safely in this patient group.

scholarly journals Recurrent abducens nerve palsy and hypophosphatasia syndrome

2019 ◽  
Vol 12 (4) ◽  
pp. e226895
Author(s):  
Neha Khade ◽  
Simon Carrivick ◽  
Carolyn Orr ◽  
David Prentice
Keyword(s):  
Nerve Palsy ◽  
Alkaline Phosphatase Level ◽  
Abducens Nerve ◽  
Recurrent Nerve ◽  
Double Vision ◽  
Mechanical Compression ◽  
Sixth Cranial Nerve ◽  
Recurrent Nerve Palsy ◽  
Dorello’S Canal ◽  
Biochemical Testing

A 47-year-old woman presented with six episodes of horizontal binocular double vision over a 2-year period. CT imaging was significant for extensive dural calcification in the spine and calcification of the skull base, likely involving Dorello’s canal. Biochemical testing revealed a persistently low alkaline phosphatase level. Recurrent nerve palsy may possibly be induced by mechanical compression of the sixth cranial nerve in Dorello’s canal from calcification due to hypophosphatasia syndrome.

Surgical treatment of Zenker's diverticulum

1990 ◽  
Vol 104 (4) ◽  
pp. 312-314 ◽  
Author(s):  
K. Aggerholm ◽  
P. Illum
Keyword(s):  
Surgical Treatment ◽  
Nerve Palsy ◽  
Prophylactic Treatment ◽  
Infectious Complications ◽  
Zenker’S Diverticulum ◽  
Recurrent Nerve ◽  
Recurrent Nerve Palsy ◽  
Zenker's Diverticulum ◽  
Local Complications

AbstractOne-hundred-and-fifty patients with Zenker's diverticulum were reviewed; twelve patients received no treatment; 26 patients were treated endoscopically by dilatation, five of these had a diverticulectomy performed at a later stage.One-hundred-and-ten patients had a diverticulectomy performed (a total of 115 primary operations were performed). Eighteen of the patients operated upon had a recurrence and six underwent re-operation.Local complications occurred in 24 patients. Seven patients had a fistula and two had mediastinitis. Ten patients had recurrent nerve palsy, of which five were permanent. Thirteen patients had other complications, usually infection. One death occurred.Post-operative prophylactic treatment with antibiotics was found to significantly reduce the number of local infectious complications and a correlation was found between the occurrence of local, infectious complications and later recurrence of the pouch.

Intravagal parathyroid adenoma

1989 ◽  
Vol 103 (7) ◽  
pp. 704-706 ◽  
Author(s):  
T. Takimoto ◽  
Y. Okabe ◽  
M. Ito ◽  
R. Umeda
Keyword(s):  
Vagus Nerve ◽  
Parathyroid Adenoma ◽  
Calcium Level ◽  
Serum Calcium Level ◽  
Rare Case ◽  
Nerve Palsy ◽  
Recurrent Nerve ◽  
Surgical Operation ◽  
Recurrent Nerve Palsy ◽  
Left Vagus

AbstractAn extremely rare case of intravagal parathyroid adenoma is presented. The tumour caused fusiform swelling of the left vagus nerve was shelled out. Post-operatively the left recurrent nerve palsy was recovered in the two months. Serum calcium level returned to normal on the tenth day after the surgical operation without symptoms of hypocalcaemia.

scholarly journals Successful treatment with positive airway pressure ventilation for tension pneumopericardium after pericardiocentesis in a neonate: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Makiko Tani ◽  
Tomoyuki Kanazawa ◽  
Naohiro Shioji ◽  
Kazuyoshi Shimizu ◽  
Tatsuo Iwasaki ◽  
...  
Keyword(s):  
Nerve Palsy ◽  
Therapeutic Option ◽  
Insertion Site ◽  
Upper Airway ◽  
Interrupted Aortic Arch ◽  
Drainage Tube ◽  
Positive Pressure ◽  
Recurrent Nerve ◽  
Recurrent Nerve Palsy ◽  
Hemodynamic Deterioration

Abstract Background Pneumopericardium in neonates is often associated with respiratory diseases, of which positive pressure ventilation (PPV) is an exacerbating factor. Here, we present a neonate case of pneumopericardium after cardiac surgery which was resolved after applying PPV. Case presentation A 28-day-old neonate with left recurrent nerve palsy after aortic reconstruction for interrupted aortic arch developed pericardial effusion. Pericardiocentesis was performed under general anesthesia, and a drainage tube was left in the pericardium. After extubation, stridor gradually exacerbated, following hemodynamic deterioration. A chest X-ray demonstrated pneumopericardium. Upper airway stenosis due to recurrent nerve palsy developed excessive negative pleural pressure, and air was drawn into pericardium via the insertion site of the drainage tube. After tracheal intubation and applying PPV, the pneumopericardium improved. Conclusion PPV does not always exacerbate pneumopericardium. In a patient with pericardial-atmosphere communication, increased inspiration effort can cause pneumopericardium, and PPV is a therapeutic option to alleviate the pneumopericardium.

The relationships between surgical histometry, outcome and pre-treatment in Graves' disease

1981 ◽  
Vol 98 (1) ◽  
pp. 43-49 ◽  
Author(s):  
T.J. Wilkin ◽  
A. Gunn ◽  
M. Al Moussa ◽  
T. E. Isles ◽  
J. Crooks ◽  
...  
Keyword(s):  
Thyroid Gland ◽  
Surgical Technique ◽  
Total Thyroidectomy ◽  
Diagnostic Criteria ◽  
Operative Treatment ◽  
Thyroid Tissue ◽  
Lymphocytic Infiltration ◽  
Graves Disease ◽  
Pre Treatment ◽  
The Relationship

Abstract. Quantitative histometric methods were used to established the relationship between the extent of thyroid lymphocytic infiltration at operation, and outcome exactly 18 months later in 50 surgically-treated Graves' disease patients prepared by carbimazole and triiodothyronine. Periods of pre-operative treatment, surgical technique, histometric analysis and diagnostic criteria were all standardised. Controls (107) were obtained from the forensic laboratory. Thirty-seven patients became euthyroid, but there was no relationship between outcome and epithelial or lymphoid content of the thyroid gland. Neither was there any correlation between the size of lymphoid infiltrate and epithelial mass of the resected thyroids, suggesting that simple lymphocyte infiltrations do not replace thyroid tissue as once thought. The variation in thyroid epithelial content was nearly 3-fold, so that a surgeon, even if able accurately to judge the anatomical mass of the remnant, would still have little or no idea of its functional mass. The scatter of epithelial content was even greater in glands from patients prepared for surgery by propranolol alone (38 glands, variation × 5.5) or propranolol and iodide (32 glands, variation × 5.9). Outcome after sub-total thyroidectomy for Graves' disease seems unrelated to the lymphocyte content of the gland and it is questionable to what extent the surgeon can either predict or control the outcome of thyroidectomy in individual Graves' disease patients.

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