The impact of near-infrared autofluorescence on postoperative hypoparathyroidism during total thyroidectomy: a case-control study.

PURPOSE: Near-infrared autofluorescence is a new technology in thyroid surgery to better localize and preserve parathyroid glands. The purpose of this study is to assess if the adoption of NIR-AF can improve in short-, medium-, and long-term post-operative calcium and PTH levels compared to conventional "naked eye" surgery in patients undergoing TT for benign or malignant conditions. METHODS: 134 patients undergone total thyroidectomy between January 2020 and June 2022; 67 were treated with conventional thyroidectomy, the other 67 underwent surgery adopting an autofluorescence detecting device. RESULTS: Significant differences were found between the two groups in percentage of patients with short-term hypocalcemia (p = 0.04) and short-term hypoparathyroidism (p = 0.011). Median short-term (p = 0.01) and medium-term (p = 0.03) PTH levels were significantly higher in autofluorescence group, while, short- (p = 0.001), medium- (p < 0.001) and long-term (p = 0.019) percentage variation of PTH levels from baseline were significantly higher in the standard-care group. Finally, the prescription of oral calcium (p < 0.01) after surgery were significantly lower in the autofluorescence group. CONCLUSION: The adoption of near-infrared autofluorescence during total thyroidectomy is related to lower short-term hypocalcemia and hypoparathyroidism rates, decreased variation of post-operative PTH levels in short- and medium- and long-term, reducing the necessity of supplementation therapy with oral calcium compared to conventional surgery.

Pediatric otorhinolaryngologic manifestations of endocrinological pathologies.

OBJECTIVE: Aim of the present review is to offer a concise but complete discussion about pathologies with pediatric otorhinolaryngological interest recognizing: (i) growth disorders, (ii) chromosomal disorders, and (iii) tumors. METHODS: Pathologies characterized by a growth anomaly have been grouped, underlining the characteristics of otorhinolaryngological interest. Numerous syndromes typical of the pediatric age have been reported and classified according to the ailments of the orofacial district. Tumoral pathologies, for which the otorhinolaryngological operation is fundamental, have been descripted. We reviewed recent literature and older papers. We did not find recent literature regarding otorhinolaryngological features related to some of the pathologies described. RESULTS/CONCLUSIONS: Otorhinolaryngologists should be familiar with pediatric disorders, since many of them have head and neck manifestations. This knowledge allows to treat them with a correct surgical approach, in order to implore children's quality of life.