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BACKGROUND The purpose of this work was to compare methods of detecting nonrecurrent laryngeal nerves (NRLNs). METHODS Specificity and sensitivity were compared in three NRLN detection methods: CT, electromyography (EMG), and A-B point comparison. RESULTS A total of 73 intraoperative pictures and 36 CT details of NRLNs are presented. Incidence of NRLN was 0.39%. Type I NRLN accounted for 50.7%, type IIA 45.2%, type IIB 4.1%. The NRLN median latency was 2.13 ms vs 3.00 ms median in an RLN control group (P

BACKGROUND: Hypocalcemia is the most frequent complication after thyroidectomy and central neck dissection (CND). Early intact parathyroid hormone (iPTH) determination has been proposed as an early predictor parathyroid gland state. We aim to describe iPTH kinetics after central compartment lymph node dissection (CLND). METHODS: A large prospective observational study was conducted among 840 patients who underwent thyroid cancer surgery between July and December 2016 in China-Japan Union Hospital of Jilin University. Data were obtained from the patient’s iPTH evaluation 15 min after CND and serum calcium records during three years of post-operative follow-up. Age, sex, BMI, preoperative PTH, operative and pathologic details were analyzed. Backward stepwise logistic regression analyses were performed to find potential risk factors for predicting iPTH

Background: Hypoparathyroidism is one of the most frequent and serious complications of the thyroid surgery. Preservation of parathyroid glands (PGs) and treatment of postoperative hypocalcemia are key factors. The aim of this review is to evaluate the relevant literature and provide the clinician guidance for preservation of PGs and the formulation of individualized therapeutic strategies for patients with postoperative hypocalcemia. Methods: This was a review of preservation of PGs in thyroidectomy procedures and treatment strategies for postoperative hypocalcemia. Results: In-depth knowledge of the anatomy of PGs along with relations and an adequate preoperative assessment are the cornerstone for surgeons performing safe thyroid parathyroid surgeries. The “capsular dissection” of the thyroid lobe is the key technique to protect PGs and their supply blood vessels; the intraoperative parathyroid autotransplantation if the occasion should arise is an effective method to prevent definitive hypoparathyroidism. The patients after thyroidectomy are given monitoring of the serum calcium and parathyroid hormone (PTH); the early combinational supplement treatment of calcium and calcitriol effectively prevent postoperative hypocalcemia. Conclusion: To master the anatomic regularity of PGs, intraoperative in-situ conservation and autotransplantation of PGs, and postoperative individualized therapeutic strategies of hypoparathyroidism are effective methods to avoid hypocalcemia in thyroid surgery.

Hypoparathyroidism is a frequent and serious complication of thyroid surgery. Identification and preservation of the parathyroid glands are key factors in managing hypoparathyroidism. The aim of the present study was to investigate the efficacy of rapid intraoperative parathyroid hormone (rIO-PTH) assay levels through fine needle aspiration (FNA) in identifying parathyroids as a parameter in thyroid surgery. rIO-PTH assay through FNA and frozen section examination were performed on 194 suspected parathyroids anatomical structures from 50 consecutive patients undergoing thyroidectomy (rIO-PTH group). The association between the rIO-PTH values and histological results were analyzed. Clinical effects were compared between the rIO-PTH and control groups from 50 patients undergoing a similar standard surgery. rIO-PTH levels from 93/194 aspirated anatomical structures certified as parathyroid tissues by histological analysis were demonstrated to have a mean of 3,369 pg/ml (range, 145.2–5,000 pg/ml). These values were significantly increased compared with the mean value of 25.7 pg/ml from non-parathyroids tissues significantly (P0.05). The value of rIO-PTH assay through FNA demonstrated that it is a good parameter for differentiating parathyroids and non-parathyroids tissues. The technique is a highly reliable, quick, simple and non-invasive method with a short learning curve in thyroid surgery, which is particularly valuable for inexperienced surgeons. This method may replace frozen section examination, which relies on a surgeon's personal experience on the basis of topographic or morphologic criteria for recognizing parathyroids.