Post-thyroidectomy hypocalcemia and related complications

Abstract

The incidence of post-thyroidectomy hypocalcemia is high while the factors involved include age (> 50 years), type of operation, operative time, neck dissection, histology of the surgical specimen and vocal fold paralysis. Low ionic calcium concentrations are indicative of the presence of symptoms of hypocalcemia and the need for oral calcium. Progression to definitive hypoparathyroidism occurs only in patients with clinical manifestations of post-thyroidectomy hypocalcemia. In general, the problem with post-surgical hypoparathyroidism resides in the surgical procedure itself. The most common are related to neuronal hyperexcitability, which explains the paresthesias, cramps and numbness, which usually start in the perioral region and on the fingertips. Muscle spasms and muscle stiffness are also common. When severe, hypocalcemia can lead to life-threatening spastic tetany, laryngospasm, and seizures. The current manuscript aimed to present a review of the bibliography on thyroidectomy and negative impact of its complications on human health, mainly because of a higher risk for developing hypocalcemia. To achieve the study goal, this review covered most recent published articles from 2017 onward.