Hypocalcaemia after subtotal thyroidectomy for thyrotoxicosis

✍ Scribed by R. Murley; R. T. J. Holl-Allen

• Publisher: John Wiley and Sons
• Year: 1985
• Tongue: English
• Weight: 145 KB
• Volume: 72
• Category: Article
• ISSN: 0007-1323
• DOI: 10.1002/bjs.1800720143

✦ Synopsis

Sir

I was interested to read the paper on 'Hypocalcaemia after subtotal thyroidectomy for thyrotoxicosis' by N. I. Ramus (Br J Surg 1984; 71: 589-90). In addition to the various causes mentioned, perhaps the removal of intrathyroid parathyroid glands should be added. This anatomical problem is recognized by surgeons undertaking parathyroidectomy, and might explain the hypocalcaemia present despite careful research for the glands, and the lateral ligation of the inferior thyroid artery. The apparent rarity of recurrent nerve palsy, even transient, is commendable, but it appears to have followed laryngeal examination in patients with relevant symptoms only. Without clarification of the relevant symptoms, it is impossible to assess the significance of the finding, as it is well recognized amongst laryngologists, and others' that a normal voice is compatible with recurrent nerve palsy and vice versa. Further, the problem of delayed paralysis should be considered, particularly in relation to a second operation'.