Complications of Thyroidectomy*** Vvvv. Important • Hem | Wesalosis " medical "

Complications of Thyroidectomy***
Vvvv. Important
• Hemorrhage
− Due to slipping of ligature on the superior thyroid artery, bleeding from muscular artery
− Hematomas may cause airway compromise and must be evacuated immediately.
− Hematomas may occur immediately or later on.
− An immediate bleed occurs after or shortly before extubation when the patient lightens from anaesthesia and may begin to cough,
causing a vessel to open.
• Respiratory obstruction: Causes include
− Tension hematoma
− Laryngeal edema (by anesthetic intubation): MC cause of respiratory obstruction
− Bilateral recurrent laryngeal nerve paralysis
• Recurrent laryngeal nerve paralysis
− May be unilateral or bilateral, transient or permanent.
− Bilateral paralysis causes respiratory obstruction - Dyspnea, stridor.
• Injury to other nerves
− External branches of superior laryngeal nerve (MC injured nerve during thyroid surgery: External laryngeal nerve)
− Cervical sympathetic trunk - may cause Horner’s syndrome.
• Parathyroid insufficiency
− Due to removal of the parathyroid glands or infarction due to vascular injury.
− Vascular injury is more important.
− Cases usually present 2–5 days after operation with symptoms of hypocalcemia (circumoral and fingertip numbness and tingling
tetany, carpopedal spasm and laryngeal stridor)
− Treatment with oral calcium & vitamin D supplements
− IV calcium gluconate 10% in 10 cc normal saline in 10 minutes may be required in severe cases.
• Thyroid insufficiency
• Thyrotoxic crisis
− Occurs if the thyrotoxic patient has been inadequately prepared for thyroidectomy.