DOI: http://dx.doi.org/10.18203/2349-2902.isj20173868

The number of parathyroid glands preserved during thyroidectomy and relationship between hypoparathyroidism

Kummankandath Abbas Sidhic, Yousef Hisham, Thommil Padinjarenalakath Nabeel, Karat Prambil Ali Abid

Abstract


Background: The aim of the study was to determine the number of parathyroid glands that need to be preserved to prevent hypoparathyroidism and to understand the relation between the number of parathyroid glands preserved and hypoparathyroidism.

Methods: A retrospective study was performed on 350 patients who had undergone trans cervical total thyroidectomy with or without neck dissection for papillary thyroid carcinoma between July 2010 to August 2015.

Results: Incidental parathyroidectomy occurred in 19.1% of patients, one parathyroid gland in 17.8%, two in 2% and 3 in 0.5%. Transient hypoparathyroidism increased when incidental parathyroidectomy occurred on multivariate regression analysis, but it was not influenced by the actual number of parathyroid glands removed. There was no relationship between the number of parathyroid glands preserved and hypoparathyroidism.

Conclusions: It is not compulsorily required to prevent permanent hypoparathyroidism, but the preservation of all the four parathyroid glands during thyroidectomy decreases the incidence of transient hypoparathyroidism. When auto transplantation is not performed, to prevent permanent hypoparathyroidism, preserving at least one parathyroid gland with an intact blood supply is sufficient.


Keywords


Hypoparathyroidism, Parathyroid, Thyroidectomy

Full Text:

PDF

References


Pattou F, Combemale F, Fabre S, Carnaille B, Decoulx M, Wemeau JL, et al. Hypocalcemia following thyroid surgery: incidence and prediction of outcome. World J Surg. 1998;22:718-24.

Shaha AR, Jaffe BM. Parathyroid preservation during thyroid surgery. Am J Otolaryngol. 1998;19:113-7.

McHenry CR, Speroff T, Wentworth D, Murphy T. Risk factors for postthyroidectomy hypocalcemia. Surg. 1994;116:641-7.

Lappas D, Noussios G, Anagnostis P, Adamidou F, Chatzigeorgiou A, Skandalakis P. Location, number and morphology of parathyroid glands: results from a large anatomical series. Anat Sci Int. 2012;87:160-4.

Song CM, Jung JH, Ji YB, Min HJ, Ahn YH, Tae K. Relationship between hypoparathyroidism and the number of parathyroid glands preserved during thyroidectomy. World J Surg Oncol. 2014;12:200.

Palazzo FF, Sywak MS, Sidhu SB, Barraclough BH, Delbridge LW. Parathyroid autotransplantation during total thyroidectomy: does the number of glands transplanted affect outcome? World J Surg. 2005;29:629-31.

Cavicchi O, Piccin O, Caliceti U, Decataldis A, Pasquali R, Ceroni A. Transient hypoparathyroidism following thyroidectomy: a prospective study and multivariate analysis of 604 consecutive patients. Otolaryngol Head Neck Surg. 2007;137:654-8.

Sasson AR, Pingpank JF Jr, Wetherington RW, Hanlon AL, Ridge JA. Incidental parathyroidectomy during thyroid surgery does not cause transient symptomatic hypocalcemia. Arch Otolaryngol Head Neck Surg. 2001;127:304-8.

Thomusch O, Machens A, Sekulla C, Ukkat J, Brauckhoff M, Dralle H. The impact of surgical technique on postoperative hypoparathyroidism in bilateral thyroid surgery: a multivariate analysis of 5846 consecutive patients. Surg. 2003;133:180-5.

Almquist M, Hallgrimsson P, Nordenström E, Bergenfelz A. Prediction of permanent hypoparathyroidism after total thyroidectomy. World J Surg. 2014;38(10):2613-20.