AHI in the surgically treated group significantly improved. The complication rate for a tertiary pediatric hospital population that included patients with multiple comorbidities was acceptable.
We introduce an inexpensive tool for measuring initial tracheal anastomosis stability with human cadavers, which demonstrated no difference in the tracheal pull-through strength of Vicryl and PDS.
Cartilaginous reinforcing sutures were found to provide a higher force requirement for tracheal anastomotic rupture when compared with anastomoses without these sutures. This improved stability in tracheal anastomosis may result in a decreased risk of early tracheal rupture after anastomosis.
Objective: Hypocalcemia is one of the principal complications of total or completion thyroidectomy. A number of different protocols for managing this potential complication have been published. Our simple postoperative regimen is described and the safety and cost-effectiveness assessed.Method: Prospective analysis of a consecutive series of patients undergoing thyroid surgery from January 2008 through June 2010 was performed. Data collected included age, gender, procedure performed, levels of ionized calcium, parathyroid hormone, vitamin D, complications, and need for readmission. Standard descriptive statistics were used to summarize this data.Results: A total of 526 patients had thyroid surgery during the 30-month study period. Of these, 307 patients underwent completion or total thyroidectomy and were prescribed a 3-week, tapering course of calcium carbonate postoperatively. Twenty-four patients (7.8%) experienced symptoms of hypocalcemia which were managed easily with additional doses of oral calcium. A single patient (0.3%) required readmission. The cost of a 3-week regimen of calcium carbonate is approximately $15. This is considerably less expensive than the cost of overnight admission or published laboratory protocols that are designed to predict the risk of hypocalcemia.
Conclusion:Prophylactic calcium supplementation without routine laboratory assessment proved to be a safe and costeffective method of preventing and managing postoperative hypocalcemia following total or completion thyroidectomy.
Head and Neck SurgeryCan Pathology of a Thyroid Nodule Be Determined by Positron Emission Tomography? Brendan C. Stack Jr, MD (presenter); Jacob O. Boeckmann, MD; Donald Bodenner, MD, PhD; Eric R. Siegel, MS Objective: Positron emission tomography (PET) uptake in the thyroid gland is common. It occurs incidentally in diagnosis or surveillance of many cancers. Focal uptake indicates thyroid mass lesions. The goal was to determine if standardized uptake values (SUV) on PET can predict pathology in masses of the thyroid gland.Method: A total of 23,982 PET scans were retrospectively reviewed from the University of Arkansas for Medical Sciences in Little Rock, AR. These scans were performed from 2002 to 2010. 1,290 (5.4%) of scans had uptake in the thyroid gland, 614 were considered to be diffuse and 676 were considered focal.Results: A total of 112 patients had PET scan with accompanying thyroid cytology or pathology. The mean SUV for benign (N = 78) was 3.75 ± 2.99 and for malignant (N = 35) was 8.22 ± 7.91, × 2 0.0011. Age, lesion size, and gender were not significant. Receiver operating curves (ROC) were constructed with empirical or binormal distribution assumptions. The area under the curve (AUC) was 0.693 and 0.702 respectively. A SUV of 3.6 maximized empirical sensitivity and sensitivity while minimizing (FP) and negatives (FN). A SUV threshold of 3.6 minimized binormal FP and FN whereas a SUV of 7.9 maximized sensitivity and specificity.Conclusion: Uptake on the thyroid on PET scan is a common incidental fi...
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