Preservation of the recurrent laryngeal nerve (RLN) is a priority for surgeons during thyroidectomy in patients with papillary thyroid cancer (PTC). RLN invasion by PTC in a patient presenting with preoperative vocal fold paralysis may require resection of the nerve with the tumor. However, the decision should be made regarding whether to preserve or sacrifice a functioning RLN invaded by PTC. Under certain conditions, preservation of the nerve with incomplete tumor resection could be considered. An RLN that has been resected due to PTC invasion may be managed by various reinnervation techniques to improve vocal outcomes. This article reviews clinical considerations and rationales for surgical decisions related to patients with PTC invasion of the RLN.
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Options to enhance voice quality during and after thyroidectomy Hyoung Shin Lee Korean Intraoperative Neuromonitoring Society.2024; 4(2): 141. CrossRef
Background Postsurgical hypocalcemia is the most common and troublesome consequence of thyroidectomy. We investigated the potential role of routine calcium or vitamin D supplementation in preventing postsurgical hypocalcemia.
Methods We searched MEDLINE and Embase for English-language publications using the keywords “calcium,” “vitamin D,” and “thyroid cancer.” The primary outcome was any postoperative hypocalcemia, and the secondary outcome was symptomatic hypocalcemia.
Results Four studies that included 381 patients were eligible for this meta-analysis. A random-effects model showed no significant difference in the occurrence of hypocalcemia between calcium/vitamin D treatment and placebo/no treatment. However, the occurrence of symptomatic hypocalcemia was lower in patients with calcium/vitamin D treatment. In the combined results, preoperative calcium and vitamin D supplementation were associated with a reduced incidence of symptomatic hypocalcemia.
Conclusions Our findings support the use of preoperative calcium and vitamin D supplementation in conjunction with routine postsurgical supplementation for patients after total thyroidectomy.
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Preoperative Vitamin D and Calcium Administration in Patients Undergoing Thyroidectomy: A Systematic Review and Meta‐analysis of Randomized Controlled Trials Mohammed Alhakami, Ghassan Bin Lajdam, Abdullah A. Ghaddaf, Sarah Alayoubi, Shaden Alhelali, Mohammad Alshareef, Jabir Alharbi OTO Open.2024;[Epub] CrossRef
Is there enough evidence to recommend preoperative calcium and vitamin D in patients who undergo total thyroidectomy? Hyoung Shin Lee Kosin Medical Journal.2022; 37(3): 173. CrossRef