Guideline From the Brazilian Society of Surgical Oncology and Brazilian College of Surgeons in Preventing and Managing Acute Hypoparathyroidism After Thyroid Surgery.

The risk of hypoparathyroidism and hypocalcemia is a critical concern in thyroid surgery. Preserving parathyroid gland vascularization during surgery is essential for effective prevention. Preoperative and postoperative management, including calcium and Vitamin D supplementation, is paramount. Measurement of parathyroid hormone levels after surgery is the best predictor of hypoparathyroidism. This guideline offers recommendations for the prevention, diagnosis, and treatment of acute hypoparathyroidism and hypocalcemia after thyroid surgery.

Retalho Supraclavicular: Versatilidade em cirurgias reconstrutivas em cabeça e pescoço / The Supraclavicular flap: Versatility in reconstructive surgery in head and neck

Introdução: Os grandes defeitos estéticos e disfuncionalidade orgânica são os grandes problemas nas reconstruções em cabeça e pescoço. Estudos recentes mostram o surgimento de novas técnicas reparadoras. Objetivos: Demonstrar a versatilidade morfo-funcional do retalho Supraclavicular em Cabeça e Pescoço. Método: Estudo realizado no Hospital Araújo Jorge, de março de 2011 a Agosto de 2012, com 33 pacientes submetidos à reconstrução com o retalho Supraclavicular em diversos tipos de defeitos, de pele e mucosa, na cabeça e pescoço. Avaliadas variáveis como: Cirurgia proposta, esvaziamento cervical, defeito primário e secundário, complicações, irradiação prévia e etc. Resultados: Os defeitos mucosos foram os mais abordados com essa técnica cirúrgica; pós pelveglossomandibulectomia. Complicação mais frequente foi a deiscência com fístula de resolução espontânea e tratamento clínico. Conclusões: O retalho Supraclavicular mostrou-se morfo-funcionalmente versátil e esteticamente aceitável, para as grandes reconstruções de pele e mucosa, da Cabeça e Pescoço.

Introduction: Dysfunctional and cosmetic defects are one of the great obstacles in the reconstructive field of the Head and Neck Surgery. Recent studies have revealed new technics of reconstructive surgery. Objective: To demonstrate the morphofunctional usefulness of the supraclavicular flap in head and neck surgery. Methods: A study realized at the Araújo Jorge Hospital, dated from March 2011 to august 2012 that included 33 patients that were submitted to the supraclavicular flap reconstruction technique to cover a number of skin or mucosal defects on the head and neck region. The variables evaluated were: type of surgery, neck dissection associated primary and secondary defect, previous irradiation and complications associated to the reconstructive technique. Results: The mucosal defects were the main type of indication for the reconstruction using the flap, being the pelvisglossomandibulectomy the main indication. The most frequent complication was dehiscence with fistula which was resolved spontaneously with clinical treatment. Conclusions: The supraclavicular flap revealed to be aesthetically acceptable for large reconstructions of the skin and mucosa of the head and neck surgery besides of being a morpho-functionally versatile flap.