Mayo Clinic College of Medicine and Science, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Graduate Medical Education, Mayo Clinic School of Continuous Professional Development, for video What is thyroid cancer? Good news: Serious thyroidectomy complications are relatively rare. at newsletters@mayoclinic.com. A number of reinnervation procedures have been described for addressing the permanently injured RLN. Postoperatorio inmediato en pacientes sometidos a tiroidectoma total en UCI Immediate post-operative period in patients undergoing total thyroidectomy in the ICU. 14th ed. Also the monitoring of the pH changes that can occur with reflux in the esophageal mucosa.12. Complications of Trans-oral Endoscopic Thyroidectomy Vestibular Approach: A Systematic Review. Surgical management of hyperthyroidism. Two percent were in the mediastinal thymus, and another 2% were in other ectopic positions, such as the carotid sheath. which You can email the site owner to let them know you were blocked. International Journal of Molecular Sciences. [7]. The study, which involved data from 14,220 inpatient and 7215 outpatient thyroidectomies, found that persons from highhealth-risk communities undergoing thyroidectomy were more likely to be women and African Americans and that they had a higher likelihood of being operated on by low-volume surgeons. Thick connective tissue called the Berry ligament attaches the thyroid to the trachea at the level of the second or third tracheal ring. I am 8 month Post Thyroidectomy (Large Substernal with deviated Trachea. Numerous descriptions and attempts to quantify the percentages of each relationship of the nerve to the artery have been put forth. If you're experiencing any of these issues and are concerned, make an appointment with your doctor. In the field (title, summary and / or abstract). 2013 Jun. Open Access by MedCrave Group is licensed under a Creative Commons Attribution 4.0 International License. And the Chvostek sign is manifested by the contraction of the facial muscles by striking the jaw above the facial nerve.17 There are studies that also assess parathyroid hormone in addition to calcium levels, since PTH is a reflection of parathyroid function.5,8, Risk of recurrent laryngeal nerve injury (5,11,16). How do the outcomes of inpatient and outpatient thyroid surgery compare? Speech therapy is the only treatment. government site. Definite vocal changes may not manifest for days to weeks. Recurrence is more likely if your cancer is aggressive or if it grows beyond your thyroid. The cohort, 62 patients treated by a single surgeon at an academic, tertiary medical center, included patients who did and those who did not also undergo total thyroidectomy and central compartment dissection. These include thioamides (methimazole, propylthiouracil [PTU]), which affect synthesis. - Of the 1,568 only 140 patients developed some type of complication (1.02% bleeding). Temiz Z, Ozturk D, Ugras GA, et al. If you've been diagnosed with thyroid cancer, you might feel as if you aren't sure what to do next. Epub 2021 Oct 20. How is injury to the superior laryngeal nerve due to thyroid surgery diagnosed and managed? Ligate the vessels as close to the thyroid gland as possible. [QxMD MEDLINE Link]. The .gov means its official. This often increases over the first 1-2 weeksand then begins to resolve over 6-8 weeks. Unauthorized use of these marks is strictly prohibited. How is thyroid surgery infection treated? The nerve is anterior to the artery in 25% and posterior in 25%. Endocrine Practice. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. It can develop preoperatively, intraoperatively, or postoperatively. In addition, a series of recommendations has been made to patients at discharge to empower the patient to be responsible for their health and to recognize early complications, know and take responsibility for medication, know how to heal the wound, etc. Voice Outcomes after Total Thyroidectomy, Partial Thyroidectomy, or Non-Neck Surgery Using a Prospective Multifactorial Assessment. Your incision is swollen, red, or has pus coming from it. Last updated on Jan 5, 2023. A total thyroidectomy is surgery to remove all of your thyroid gland. You may have a sore throat, hoarse voice, or difficulty swallowing after surgery. It is normal to have these problems for up to 6 months after a total thyroidectomy. You have sudden tingling or muscle cramps in your face, arm, or leg. Untreated hypothyroidism causes symptoms such as cold intolerance, fatigue, constipation, muscle cramping, and weight gain. As thyroid hormone levels decrease and as symptoms resolve, medications should be gradually weaned over the weeks after surgery. Most patients who are hypocalcemic after thyroidectomy are initially asymptomatic. Classic long-omicron signs on exam: swollen right small intestine & right upper liver. Abdominal surgical site infections: incidence and risk factors at an Iranian teaching hospital. [4], Nonetheless,a retrospective study by Ayala and Yencha indicated that hospitals with a low surgical volume can safely perform outpatient thyroid surgery. 2016 May 3. Assess the degree of severity of the hematoma. 6th ed. What are the signs and symptoms of recurrent laryngeal nerve (RLN) injury due to thyroid surgery? 2009 Mar;23(1):53-72. doi: 10.1016/j.idc.2008.10.004. It is still the same today 7 months later. You have chest pain when you take a deep breath or cough, or you cough up blood. The guidelines include a strong recommendation that surgeons performing thyroid surgery identify the recurrent laryngeal nerve or nerves. Cry a little and drop to one knee to pray: 11 y.o. Retraction of the thyroid lobe may result in traction injury and make the nerve susceptible to transection. The gelatin sponge resorbs over time and is, therefore, a temporary treatment. How is postoperative infection diagnosed following thyroid surgery? Accessed Jan. 21, 2022. An endocrinologist should be consulted to assist in this process. What are the benefits of using minimally invasive video-assisted thyroidectomy (MIVAT)? The nonrecurrent laryngeal nerve branches from the vagus at approximately the level of the cricoid cartilage and directly enters the larynx without looping around the subclavian artery. In some cases, genetic testing may be done to help determine any associated hereditary causes. Wound infection is a possible complication after any surgery, but it is unusual after thyroid surgery. To help prevent any infection once you are at home it is important to: If your neck starts to become red, swollen or more painful, or if you have a high temperature (fever), or oozing from the wound, tell your doctor straight away. Levels below 5 pg/ml may be more associated with advanced hypocalcemias with symptomatology and treatment correction. The internal branch provides sensory innervation to the larynx. 5 Treatment Changes to Know About, New Consensus on Thyroid Eye Disease Prompts Some Debate, Mutation Testing in Advanced Thyroid Cancer. Int J Fam Commun Med. A left-sided nonrecurrent laryngeal nerve RLN can occur only when a right-sided aortic arch and ligamentum arteriosum are concurrent with a left retroesophageal subclavian artery. WebSigns that you may have low calcium are numbness and a tingling feeling in your lips, hands, and the bottom of your feet, a crawly feeling in your skin, muscle cramps and These include calcitonin release and hungry-bone syndrome. In the case of a hematoma without impending airway obstruction, transfer the patient to the operating room as soon as is practical. You suddenly feel lightheaded and short of breath. [1], Techniques for assessing vocal fold mobility include indirect and fiberoptic laryngoscopy, Documentation of vocal fold mobility should be a routine part of the preoperative workup, Postoperative visualization should also be performed, as patients may be asymptomatic at first, Laryngeal electromyography (EMG) may be useful to distinguish vocal fold paralysis from injury to the cricoarytenoid joint secondary to intubation, and it may yield prognostic information, In unilateral vocal cord paralysis, hoarseness or breathiness may not manifest for days to weeks; other potential sequelae are dysphagia and aspiration, Bilateral vocal-fold paralysis usually manifests immediately after extubation; patients may present with biphasic stridor, respiratory distress, or both, In unilateral vocal cord paralysis, corrective procedures may be delayed for at least 6 months to allow time for improvement in a reversible injury, unless the nerve was definitely transected during surgery; surgical treatment options are medialization (most common) and reinnervation, In bilateral vocal cord paralysis, emergency tracheotomy may be required, but if possible, first perform endotracheal intubation; cordotomy and arytenoidectomy, the most commonly performed surgical procedures, enlarge the airway and may permit decannulation of a tracheostomy, The patient must be counseled that his or her voice will likely worsen after surgery. In many people, this small cancer - under 1 centimeter - might never grow and may never require surgery. Immediately examine such patients for evidence of hematoma. Assess the presence of tremor in the extremities and numbness of the lips. 1 Thyroid surgery has different complications like hemorrhage, recurrent laryngeal nerve injury resulting in change in The condition may be due to direct trauma to the parathyroid glands, devascularization of the glands, or removal of the glands during surgery. DOI: 10.15406/ijfcm.2019.03.00162. Bookshelf The best way to preserve parathyroid gland function is to identify the glands and to maintain their blood supply. A retrospective study by McMullen et al of bilateral lateral neck dissection for thyroid cancer found the overall risk for permanent hypoparathyroidism to be 37%. The appearance of cervical hematoma does not have to be early can develop within days or hours after surgery and the inaccuracy of identifying patients at high risk generates anxiety for them.5 Bergenfelz et al.6 observed 2.1% of 3,660 patients who had to undergo surgery again due to re-bleeding due to compression hematoma. In order to evaluate the studies and determine the nursing care of patients who underwent a partial or total sea thyroidectomy and reduce the associated complications, a literature review of the literature published from 2008 to the present in English and Spanish was made. This content does not have an Arabic version. Minimally invasive video-assisted thyroidectomy (MIVAT) was described in 1998. All SSIs are characterized by the following symptoms: Redness, swelling, and warmth: Inflammation is the body's natural MeSH This is a butterfly shaped gland that sits at the base of your neck. Or your doctor may remove all of the thyroid. Antibiotics (Basel). In addition, malignant thyroid pathology is associated with increased vascularization, immunosupression and poor wound healing. PTH increases serum calcium levels by causing bone resorption, increasing renal absorption of calcium, and stimulating the synthesis of the biologically active form of vitamin D (1,25-dihydroxy vitamin D). For hypothyroid patients, start levothyroxine (about 1.7 mcg/kg/d). Your in-depth coping with cancer guide will be in your inbox shortly. Most surgeons agree that identifying the SLN, in contrast to the RLN, is unnecessary. The most useful laboratory test for detecting or monitoring of hypothyroidism in the patient who has undergone thyroidectomy is the measurement of thyrotropin (thyroid-stimulating hormone [TSH]) levels. 2021 Dec 29;55(4):433-437. doi: 10.14744/SEMB.2021.33401. I'm frustrated and get depression at times. [QxMD MEDLINE Link]. How is a thyroid surgery infection evaluated? Several studies have demonstrated the efficacy of prophylactic calcium and vitamin D, as well as the assessment of parathyroid hormone.8 Elderly patients presented a similar rate of complications compared to young patients, including transient hypocalcemia and paresis of the vocal cords, but nevertheless presented a higher rate of hospital readmission. Poor scar formation is another frequently preventable complication. WebHypocalcemia: low calcium levels in the blood, a complication from thyroid surgery that is usually shortterm and relatively easily treated with calcium pills. Armed with this information, doctors may decide to do a biopsy to remove a small sample of tissue from your thyroid. There is a problem with How is hematoma treated following thyroid surgery? Three months postoperatively, acoustic voice analysis showed that patients who were treated with conventional thyroidectomy had significantly lower fundamental frequencies, maximum phonation time, and number of semitones. Most thyroid cancers don't cause any signs or symptoms early in the disease. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. The filters were applied to the articles: last 10 years (2008-2018), articles only in Spanish or English, human species, ages over 18 years, as well as being able to access the full texts and not only the Abstract. Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug ReferenceDisclosure: Received salary from Medscape for employment. Of 113 patients who received thyroidectomy, only 12 were given antibiotics perioperatively. The clinical presentation of a patient with SLN paralysis may be subtle. The development of videolaparoscopic surgery in the last decade has allowed several operations to be performed with minimally invasive techniques. Immediately after surgery I began feeling tightness, pressure fullness and a pulling and stretching in the entire neck area. Measurement of TSH levels is the most useful laboratory test for detecting or monitoring of hypothyroidism in these patients. How is hypoparathyroidism managed following thyroid surgery? Do not perform corrective procedures for unilateral vocal-fold paralysis until at least 6 months after thyroidectomy because a reversible injury improves by that time. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). They can also appear not only swallowing disorders but also voice. Videostroboscopy demonstrates an asymmetric, mucosal traveling wave. An implant made of silicone or polytetrafluoroethylene (PTFE, Gore-Tex; W. L. Gore & Associates, Inc; Newark, DE) is considered permanent. What is the mortality rate for thyroid surgery infection? Titrate the infusion to the patient's symptoms and calcium levels. All rights reserved. An unrecognized or rapidly expanding hematoma can cause airway compromise and asphyxiation. Please enable it to take advantage of the complete set of features! Sometimes the cancer cells can spread beyond the neck to the lungs, bones and other parts of the body. However, its relationship to the nerve is subject to variation (see the image below). You have sudden swelling in your neck or difficulty swallowing. Most often, diagnosing thyroid cancer starts with the physical exam. And hospital of 3.1 days. Postoperative visualization should also be performed, as these patients may be asymptomatic, especially at first. Am Surg. Control of vital signs looking for the presence of hypotension and tachycardia as these may indicate bleeding. U.S. Nuclear Regulatory Commission. Thyroid carcinoma. What is the thyroid? Talking to people who share your situation can be incredibly helpful. Signs and symptoms of thyrotoxic storm are as follows: Anesthetized patients: Evidence of increased sympathetic output (eg, tachycardia hyperthermia), Awake patients: Nausea, tremor, and altered mental status, Progression to coma in untreated patients, For thyrotoxic crisis during thyroidectomy, stop the procedure, Administer IV beta-blockers, propylthiouracil, sodium iodine, and steroids, Use cooling blankets and cooled IV fluids to reduce the patient's body temperature. [15]. Annals of Surgery. Deliberate intraoperative identification and preservation of the RLN minimizes the risk of injury. Write down your questions so you remember to ask them during your visits. How does hypoparathyroidism, result from thyroid surgery, and how is it evaluated? The right RLN branches from the vagus more superiorly than does the left, at the level of the subclavian artery. Among patients with thyroid cancer, the presence of coronary artery disease and the use of central neck dissection also predict increased risk, according to the model, while in patients without thyroid cancer, complications are predicted by coronary artery disease, dyspnea, complete thyroidectomy, and lobe size. Hi, I had a thyroidectomy 2 1/2 years ago and right after a started getting yeast infections every month. - After the re-intervention there was temporary hypoparathyroidism in 37.7% of the patients, and definitive hypoparathyroidism occurred in 7.2%. Before 1950, the operative mortality rate approached 50%. 2017 Feb. 96 (5):e5752. During your surgery, your surgeon will examine your whole thyroid gland and remove the parts that have cancer. Miccoli P, Berti P, Materazzi G, et al. These dressings obstruct the view of the neck and may delay diagnosis of a hematoma. Typically, thyroid cancer doesn't trigger any signs or symptoms in its early stages. Bethesda, MD 20894, Web Policies Neck stretching exercises in the period of early post thyroidectomy facilitate neck movement and reduce pain and disability, as well as sensitivity. The degree of thyroidectomy can affect the initial results of the voice. It happens when one or more of the parathyroid glands is https://www.snmmi.org/AboutSNMMI/Content.aspx?ItemNumber=10563. 2016 May 3. You may need to return to have your bandage changed, drains removed, or more tests. Electrophysiologic monitoring of the SLN is described, but it is not recommended for routine use. 2004 Feb. 14(1):15-9. Thyroid cancer is a growth of cells that starts in the thyroid. Wang TS, et al. - 24.2% were classified with negative voice results during the early postoperative period. You will also Controversy still surrounds the use of drains after thyroid surgery. Hemorrhage that requires repeated surgery occurred in 0.2% of patients. [QxMD MEDLINE Link]. In addition, they have no direct negative effect on wound healing. By developing a thorough understanding of the anatomy and of the ways to prevent each complication, the surgeon can minimize each patient's risk. The thyroid gland is located at the base of the neck, just below the Adam's apple. The surgical wound and the excised thyroid gland should be carefully examined for parathyroid tissue. [QxMD MEDLINE Link]. M Abraham Kuriakose, MD, DDS, FRCS is a member of the following medical societies: American Association for Cancer Research, American Head and Neck Society, British Association of Oral and Maxillofacial Surgeons, Royal College of Surgeons of EnglandDisclosure: Nothing to disclose. You have a Sosa JA, et al. Methods: However, again, these reports are limited, and this treatment is not a widely accepted. In only 15% is it anterior to the artery. Post Operative Expectations FAQs Mayo Clinic. Hypoparathyroidism, and the resulting hypocalcemia, may be permanent or transient. Patients with postoperative bleeding present with neck swelling, neck pain, and/or signs and symptoms of airway obstruction (eg, dyspnea, stridor, hypoxia). What are the signs and symptoms of thyroid surgery infection? This approach has introduced new complications not associated with thyroidectomy in the past. An intact parathyroid hormone-based protocol for the prevention and treatment of symptomatic hypocalcemia after thyroidectomy. In this way the patient will gain security and Independence in their care.19. Thyrotoxic storm is potentially lethal and must be dealt with astutely. Cellulitis typically presents as erythema, warmth, and tenderness of neck skin around the incision, A superficial abscess produces fluctuance and tenderness, A deep neck abscess may manifest subtly but can produce fever, pain, leukocytosis, and tachycardia, Send purulence expressed from the wound or drained from an abscess for Gram stain and culture, CT imaging is useful when a deep neck abscess is thought to be possible, To exclude esophageal perforation in patients with a deep neck abscess, an esophageal swallow study performed with sodium amidotrizoate and meglumine amidotrizoate solution (Gastrografin) may be useful, Treat cellulitis with antibiotics that provide good coverage against gram-positive organisms (eg, staphylococci and streptococci), Drain abscesses, and direct antibiotic coverage according to culture findings, For deep neck abscesses, begin with broad-spectrum antibiotics (eg, cefuroxime, clindamycin, ampicillin-sulbactam) until definitive culture results are available. Use cooling blankets and cooled intravenous fluids to reduce the patient's body temperature. A 13-Year-Old Girl With Fever After Travel, Type II Polyglandular Autoimmune Syndrome, Psychiatric Comorbidity in Schizophrenia: Assessing Patients and the Impact on Treatment Decisions and Outcomes, Genetic Analysis Shows Causal Link of GERD, Other Comorbidities to IPF, Proposal to Limit 'Forever' Chemicals in US Drinking Water, Shrinking Thyroid Nodules with Radiofrequency Ablation, Pregnant With Thyroid Disease? Frequently asked questions about potassium iodide. Dry the area and put on new, clean bandages as directed. Therefore, dissect carefully near this muscle and avoid electrocautery damage when possible. published on the subject, backed by different health institutions or scientific societies and this may be a limitation of the evidence in this study. } Transfer of neuromuscular pedicles have been described and reportedly restore movement of the vocal fold. [17] No deaths, hematomas, wound infections, cases of hypothyroidism, or RLN palsies were reported. While some minimal swelling, puffiness, or bruising at the incision is normal, rapid, sudden swelling of the Vaccarella S, et al. Neither of these differences was statistically significant. [Full Text]. Remove the tube over a Cook catheter and in a controlled setting in case reintubation is necessary. - Complications: 2.5% Hypocalcaemia, 0.4% Hematoma, 0.4% vocal cord injury, 0.9% wound infection and 0.4% acute pain. [QxMD MEDLINE Link]. National Comprehensive Cancer Network. Improvement in phonation quality has been documented in humans after reinnervation with the ansa cervicalis, but no movement is observed. The rate of injury to the external branch of the SLN is estimated at 0-25%. Among the surgical complications encountered were temporary recurrent laryngeal nerve (RLN) injury (four patients), permanent RLN injury (one patient), temporary bilateral RLN injury (one patient), delayed hematoma (two patients), and transient hypocalcemia (eight patients). Trauma to the nerve results in an inability to lengthen a vocal fold and, thus, an inability to create a high-pitched sound. Swallowing disorders after thyroidectomy: What we know and where we are: a systematic review. Mayo Clinic; 2021. Finally, avoid the use of neck dressings. [QxMD MEDLINE Link]. You feel very tired and cold, gain weight for no reason, and your skin is very dry. Complications included postoperative bleeding (0.1%), recurrent nerve palsy (1.3%), and definitive hypoparathyroidism (0.2%). Your type is determined when a sample of tissue from your cancer is examined under a microscope. A deep neck abscess may manifest subtly, but signs such as fever, pain, leukocytosis, and tachycardia should raise clinical suspicion. Accessed Jan. 21, 2022. What is the prevalence of complications of thyroid surgery? Alonso-Garca M, Toledano-Muoz A, Aparicio-Fernndez JM, De-la-Rosa-Astacio FM, Rodrguez-Villar D, Gil-de-Miguel A, Durn-Poveda M, Rodrguez-Caravaca G. Sci Rep. 2021 Aug 12;11(1):16413. doi: 10.1038/s41598-021-95831-9. Del Rio P, Rossini M, Montana CM, et al. 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. It then continues superiorly until entering the larynx behind the cricothyroid articulation. Send purulence expressed from the wound or drained from an abscess for Gram staining and culturing to direct the choice of antibiotics. https://www.nccn.org/guidelines/guidelines-detail?category=3&id=1454. In summary, the nerve is always near the artery, but the exact relationship cannot be determined with certainty. Nov. 11, 2021. According to the Ministry of Health and Consumption and Social Welfare, the procedures on thyroid, parathyroid and thyroglossal tract have a low percentage of mortality of 0.03% compared to other surgical procedures.2 Surgery offers an early remission of endocrine disorder and more stable than more conservative strategies and also an earlier detection of thyroid cancer.1 Goiter recurrence remains a problem that sometimes cannot be resolved with thyroxine suppressive therapy and primary surgery is a more aggressive but more effective way to prevent relapse. The consequence of an RLN injury is true vocal-fold paresis or paralysis. A cell's DNA contains the instructions that tell the cell what to do. Transoral Thyroidectomy: Initial Results of the European TOETVA Study Group. Caulley L, Johnson-Obaseki S, Luo L, Javidnia H. Risk factors for postoperative complications in total thyroidectomy: a retrospective, risk-adjusted analysis from the National Surgical Quality Improvement Program. Karakas E, Klein G, Michlmayr L, Schardey M, Schopf S; Endoscopic Thyroid and Parathyroid Surgery Study Group. [QxMD MEDLINE Link]. clip-path: url(#SVGID_4_); In general, complications of thyroid surgery can be divided into minor, rare, or major. In a 5-year study, Miccoli et al (2004) selected 579 patients to undergo MIVAT. sharing sensitive information, make sure youre on a federal These are normal sensations. From a total of 140 documents found in the search (10 Pubmed, 70 CINAHL, 60 Cochrane), 60 were excluded because they did not meet the inclusion criteria listed above (Table 2) and 50 were eliminated because they were duplicated in the different bases of data. The most obvious sign of infection is oozing of cloudy fluid or pus from the incision itself. 5 There are several risk factors associated with the development of hypocalcemia after thyroid cancer surgery. [18] The operation consisted of total thyroidectomy in 312 patients and lobectomy in 267. Feb. 26, 2022. [1] Intraoperative hemostasis and a thorough understanding of the anatomy are essential for identifying and preserving the nerve. Immediately after the operation, you will be carefully monitored for signs and symptoms of excess bleeding and infection. Twenty-nine patients underwent VAT and 24 underwent conventional thyroidectomy. What are the signs and symptoms of postoperative bleeding, following thyroid surgery? There are different ways to diagnose this complication, by laryngoscope or endoscopy, directly observing the mobility of the vocal cords or the associated alteration of the mucosa such as Barret's esophagitis by endoscope. -Preoperative factors that affected complication rates for thyroidectomies in hospitalized patients included: age 70 years, non-Caucasian, functional dependent status, history of congestive heart failure, history of smoking, bleeding disorder, wound infection and preoperative sepsis. Another frequent complication may be the appearance of hypoparathyroidism that involves hypocalcaemia.5 Generally the management of hypocalcemia is successful with calcium supplements although some may be readmitted for starting intravenous calcium treatment in refractory cases. [19]. Results: Out of a total of 140 articles found, 30 met the inclusion criteria of the finally selected topics. WebYou will see swelling or bruising develop in the area around the incision 1-3days after surgery. A total thyroidectomy is surgery to remove all of your thyroid gland. You lose weight, feel very nervous and hungry, and sweat for no reason. Phone: +36 180 38 002, Email: support@medcrave.com More Locations One to two grams of elemental oral calcium should be supplied each day. Otolaryngol Head Neck Surg. What are the physical signs of recurrent laryngeal nerve (RLN) injury due to thyroid surgery? Thyroidectomy. Furthermore, EMG may yield information concerning the prognosis of the patient with RLN injury. What are the signs and symptoms of thyrotoxic storm due to thyroid surgery? Whether you're looking for answers for yourself or someone you love, we're here to give you the best information available. In some patients, intravenous administration of 10% calcium gluconate may be necessary if the blood calcium concentration is very low. You suddenly feel lightheaded and short of breath. And although it can occur at any age, it generally affects people ages 30 to 50. The thyroid is a highly vascular organ and bleeds copiously. Minimally invasive video-assisted thyroidectomy: five years of experience.

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