Abstract
Background.
Endocrine function after surgery for thyrotoxicosis is difficult to predict. The operative morbidity and longβterm thyroid function of patients surgically treated for thyrotoxicosis is presented, and factors postulated to affect longβterm function are correlated with outcome.
Methods.
The clinical records of 289 consecutive patients who underwent surgery for thyrotoxicosis were reviewed. Indications for surgery, intraoperative findings, postoperative complications, and endocrine status 1, 2, and 5 years after surgery were analyzed. Sex, age, duration of medical treatment, weight of thyroid removed and preserved, and antimicrosomal/antithyroglobulin antibody status were correlated with outcome 5 years after surgery.
Results.
The incidence of permanent recurrent laryngeal nerve injury and hypocalcemia were 0.7% and 1.7%. The cumulative hypothyroid and hyperthyroid rates for the first, second, and fifth postoperative years were 13.8% and 3.5%, 14.5% and 4.8%, and 15.6% and 8.0%. All the prognostic variables analyzed did not achieve a significant correlation with outcome at 5 years by univariate and multivariate ageβ and sexβadjusted relative risk.
Conclusions.
Failure from hypothyroidism develops early; recurrent hyperthyroidism increases with the number of years of followβup. Patients undergoing subtotal thyroidectomy warrant longβterm followβup because of the inability to accurately predict postoperative function with consistently reliable prognostic factors. Β© 2004 Wiley Periodicals, Inc. Head Neck 26: 331β337, 2004