Complications of thyroidectomy

Thyroidectomy is a very important neck surgery which could present with some life threatening complications if proper care is not taken.

1. COMPLICATIONS OF THYROIDECTOMY Dr Afuye Olubunmi MB;BS (Ilorin) 1 st February, 2016

2. DEFINITION Thyroidectomy is the surgical removal of all or part of the thyroid gland.

3. INDICATIONS Toxic multinodular goiter; does not respond well to antithyroid drugs or radio-iodine Toxic solitary nodule; it may be neoplastic Malignant goiter Presence of pressure symptoms Large goiter; does not respond to drugs and relapse is likely

4. Male patient; likely have relapse after prolong therapy Failure of patient to take drugs regularly or follow-up Complications during drug therapy Relapse after previous drug therapy Exophthalmus Cosmesis

5. CONTRAINDICATIONS Recurrent thyrotoxicosis after subtotal thyroidectomy Thyrotoxicosis without a palpable thyroid Drug goiter Thyrocardia Children

6. TYPES OF THYROIDECTOMY Isthmusectomy Hemi-thyroidectomy Subtotal thyroidectomy Near-Total Thyroidectomy Total Thyroidectomy

7. COMPLICATIONS OF THYROIDECTOMY

8. EARLY 1. Respiratory Obstruction: Haemorrhage Haematoma Tracheal collapse Oedema of the larynx from trauma to the endotracheal tube 2. Tetany In first 3 days from corrected thyrotoxicosis After 1 week with hypoparathyroidism

9. 3. Recurrent laryngeal nerve palsy [ division,stretching,ligation,compression,concussion,diathermy ] 95% neurapraxia and resolves If bilateral, cord adduct to midline so needs immediate reintubation Thyroid crisis, if throtoxic patient is inadequately prepared rare with modern technique 4 . Wound infection 5. Hypoparathyroidism 6. Thyrotoxic crisis

10. LATE Keloid Hypothroidism - 20% Recurrent thyrotoxicosis- <5% of patients undergoing thyroidectomy for grave disease

11. THANK YOU