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Analysis of the incidence and factors predictive of inadvertent parathyroidectomy during thyroid surgery

Published online by Cambridge University Press:  10 June 2016

R W A Hone ,
T Tikka ,
A I Kaleva ,
A Hoey ,
V Alexander ,
A Balfour  and
I J Nixon
R W A Hone*
Affiliation:
Ear, Nose and Throat Department, William Harvey Hospital, Ashford, UK
T Tikka
Affiliation:
Ear, Nose and Throat Department, Heart of England NHS Foundation Trust, Birmingham, UK
A I Kaleva
Affiliation:
Ear, Nose and Throat Department, William Harvey Hospital, Ashford, UK
A Hoey
Affiliation:
Ear, Nose and Throat Department, William Harvey Hospital, Ashford, UK
V Alexander
Affiliation:
Ear, Nose and Throat Department, William Harvey Hospital, Ashford, UK
A Balfour
Affiliation:
Ear, Nose and Throat Department, William Harvey Hospital, Ashford, UK
I J Nixon
Affiliation:
Ear, Nose and Throat Department, William Harvey Hospital, Ashford, UK
*
Address for correspondence: Mr R W A Hone, Ear, Nose and Throat Department, William Harvey Hospital, Head & Neck Directorate, Kennington Road, Willesborough, Ashford, Kent TN24 0LZ, UK E-mail: rwahone@doctors.org.uk
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Abstract

Background:

Inadvertent (or incidental) parathyroidectomy can occur during thyroidectomy. However, the factors associated with inadvertent parathyroidectomy remain unclear. This study aimed to report the rate of inadvertent parathyroidectomy during thyroidectomy and associated risk factors.

Methods:

Variables including fine needle aspiration cytology findings, age, sex, thyroid weight, concurrent neck dissection, extent of thyroidectomy, and the presence of cancer and parathyroid tissue within the specimen were recorded for 266 patients. The incidence of post-operative hypocalcaemia was also recorded. Univariate and multivariate analysis were performed to identify factors associated with inadvertent parathyroidectomy.

Results:

The inadvertent parathyroidectomy rate was 16 per cent. Univariate analysis revealed that cancer and concurrent neck dissection predicted inadvertent parathyroidectomy. On multivariate analysis, only concurrent neck dissection remained an independent predictor of inadvertent parathyroidectomy: it was associated with a fourfold increase in inadvertent parathyroidectomy.

Conclusion:

The inadvertent parathyroidectomy rate was 16 per cent and concurrent neck dissection was identified as an independent predictor of inadvertent parathyroidectomy.

Keywords

Parathyroid GlandsThyroid GlandParathyroidectomyIncidence
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Issue 7 , July 2016 , pp. 669 - 673
Copyright
Copyright © JLO (1984) Limited 2016 

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References

1Modarai, B, Sawyer, A, Ellis, H.The glands of Owen. J R Soc Med 2004;97:494–5Google Scholar
2Udelsman, R, Donovan, PI.Open minimally invasive parathyroid surgery. World J Surg 2004;28:1224–6CrossRefGoogle ScholarPubMed
3Mohebati, A, Shaha, AR.Anatomy of thyroid and parathyroid glands and neurovascular relations. Clin Anat 2012;25:19–31CrossRefGoogle ScholarPubMed
4Akerstrom, G, Malmaeus, J, Bergstrom, R.Surgical anatomy of human parathyroid glands. Surgery 1984;95:14–21Google ScholarPubMed
5Wang, C.The anatomic basis of parathyroid surgery. Ann Surg 1976;183:271–5Google Scholar
6Fancy, T, Gallagher, D 3rd, Hornig, JD.Surgical anatomy of the thyroid and parathyroid glands. Otolaryngol Clin North Am 2010;43:221–7Google Scholar
7Alveryd, A.Parathyroid glands in thyroid surgery. I. Anatomy of parathyroid glands. II. Postoperative hypoparathyroidism – identification and autotransplantation of parathyroid glands. Acta Chir Scand 1968;389:1–120Google Scholar
8Abboud, B, Sleilaty, G, Braidy, C, Zeineddine, S, Ghorra, C, Abadjian, G et al. Careful examination of thyroid specimen intraoperatively to reduce incidence of inadvertent parathyroidectomy during thyroid surgery. Arch Otolaryngol Head Neck Surg 2007;133:1105–10Google Scholar
9Perros, P, Boelaert, K, Colley, S, Evans, C, Evans, RM, Gerrard Ba, G et al. Guidelines for the management of thyroid cancer. Clin Endocrinol (Oxf) 2014;81(suppl 1):1–122Google Scholar
10Yazici, P, Bozkurt, E, Citgez, B, Kaya, C, Mihmanli, M, Uludag, M.Incidental parathyroidectomy as a cause of postoperative hypocalcemia after thyroid surgery: Reality or illusion? Minerva Chir 2014;69:315–20Google Scholar
11Lin, DT, Patel, SG, Shaha, AR, Singh, B, Shah, JP.Incidence of inadvertent parathyroid removal during thyroidectomy. Laryngoscope 2002;112:608–11Google Scholar
12Sasson, A, Pingpank, JJ, Wetherington, R, Hanlon, A, Ridge, J.Incidental parathyroidectomy during thyroid surgery does not cause transient symptomatic hypocalcemia. Arch Otolaryngol Head Neck Surg 2001;127:304–8CrossRefGoogle Scholar
13Gourgiotis, S, Moustafellos, P, Dimopoulos, N, Papaxoinis, G, Baratsis, S, Hadjiyannakis, E.Inadvertent parathyroidectomy during thyroid surgery: the incidence of a complication of thyroidectomy. Langenbecks Arch Surg 2006;391:557–60Google Scholar
14Khairy, GA, Al-Saif, A.Incidental parathyroidectomy during thyroid resection: incidence, risk factors, and outcome. Ann Saudi Med 2011;31:274–8Google Scholar
15Sippel, RS, Ozgul, O, Hartig, GK, Mack, EA, Chen, H.Risks and consequences of incidental parathyroidectomy during thyroid resection. ANZ J Surg 2007;77:33–6Google Scholar
16Wingert, DJ, Friesen, SR, Iliopoulos, JI, Pierce, GE, Thomas, JH, Hermreck, AS.Post-thyroidectomy hypocalcemia. Incidence and risk factors. Am J Surg 1986;152:606–10Google Scholar
17Asari, R, Passler, C, Kaczirek, K, Scheuba, C, Niederle, B.Hypoparathyroidism after total thyroidectomy: a prospective study. Arch Surg 2008;143:132–7Google Scholar
18Demeester-Mirkine, N, Hooghe, L, Van Geertruyden, J, De Maertelaer, V.Hypocalcemia after thyroidectomy. Arch Surg 1992;127:854–8Google Scholar
19Falk, SA, Birken, EA, Baran, DT.Temporary postthyroidectomy hypocalcemia. Arch Otolaryngol Head Neck Surg 1988;114:168–74Google Scholar
20Edafe, O, Prasad, P, Harrison, BJ, Balasubramanian, SP.Incidence and predictors of post-thyroidectomy hypocalcaemia in a tertiary endocrine surgical unit. Ann R Coll Surg Engl 2014;96:219–23Google Scholar
21Edafe, O, Antakia, R, Laskar, N, Uttley, L, Balasubramanian, SP.Systematic review and meta-analysis of predictors of post-thyroidectomy hypocalcaemia. Br J Surg 2014;101:307–20Google Scholar
22Rajinikanth, J, Paul, MJ, Abraham, DT, Ben Selvan, CK, Nair, A.Surgical audit of inadvertent parathyroidectomy during total thyroidectomy: incidence, risk factors, and outcome. Medscape J Med 2009;11:29Google Scholar
23Manouras, A, Markogiannakis, H, Lagoudianakis, E, Antonakis, P, Genetzakis, M, Papadima, A et al. Unintentional parathyroidectomy during total thyroidectomy. Head Neck. 2008;30:497–502Google Scholar
24Lee, NJ, Blakey, JD, Bhuta, S, Calcaterra, TC.Unintentional parathyroidectomy during thyroidectomy. Laryngoscope 1999;109:1238–40Google Scholar
25Sakorafas, GH, Stafyla, V, Bramis, C, Kotsifopoulos, N, Kolettis, T, Kassaras, G.Incidental parathyroidectomy during thyroid surgery: an underappreciated complication of thyroidectomy. World J Surg 2005;29:1539–43CrossRefGoogle ScholarPubMed
26Rix, TE, Sinha, P.Inadvertent parathyroid excision during thyroid surgery. Surgeon 2006;4:339–42Google Scholar
27Bourrel, C, Uzzan, B, Tison, P, Despreaux, G, Frachet, B, Modigliani, E et al. Transient hypocalcemia after thyroidectomy. Ann Otol Rhinol Laryngol 1993;102:496–501Google Scholar
28Altman, DG, Machin, D, Bryant, TN, Gardner, MJ.Statistics with Confidence. Bristol: BMJ Books, 2000.Google Scholar
29Gagner, M, Inabnet, WB 3rd.Endoscopic thyroidectomy for solitary thyroid nodules. Thyroid 2001;11:161–3Google Scholar