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November 1987

Complications of Total Thyroidectomy

Arch Otolaryngol Head Neck Surg. 1987;113(11):1238. doi:10.1001/archotol.1987.01860110104018

To the Editor.—Arguments against total thyroidectomy for well-differentiated carcinoma of the thyroid have usually centered on an unacceptably high risk factor for the operation. Permanent vocal cord paralysis and permanent hypoparathyroidism are always mentioned. Using the senior author's technique for total thyroid lobectomy,1 408 consecutive recurrent laryngeal nerves were placed at risk, with an incidence of less than 0.5% permanent vocal cord paralysis. There were no patients with permanent and complete paralysis of the external branch of the superior laryngeal nerve.

With the same technique for total thyroidectomy, together with search of the surgical specimen,2 liberal autotransplantation of parathyroid glands thought to be at risk, one patient in 66 consecutive total thyroidectomies (1.5%) has documented persistent hypoparathyroidism that has been readily controlled. One other patient has some transient symptoms of hypocalcemia that is responding to treatment with calcium despite documented normal parathormone levels. If both of these

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