Effectiveness of an i-PTH Measurement in Predicting Post Thyroidectomy Hypocalcemia: Prospective Controlled Study

PURPOSE: Hypocalcemia is the most common complication after total thyroidectomy. The purpose of this study was to determine whether measurement of intact parathyroid hormone (i-PTH) level in thyroidectomy patients could predict hypocalcemia. MATERIALS AND METHODS: We performed a prospective study of patients undergoing total thyroidectomy. Serum concentration of i-PTH, total calcium (Ca), ionized calcium (Ca2+), phosphate (P), magnesium (Mg), and albumin were measured preoperatively and at 0 hour, 6 hours, 12 hours, 24 hours, 48 hours, and 72 hours postoperatively. RESULTS: 108 patients were recruited to the study. A total of 50 patients (46%) experienced hypocalcemia. The serum i-PTH concentration was linearly related to the time of measurement, while concentrations of P, Mg, albumin, Ca, and Ca2+ were not. We compared odds ratios, and found that the concentration of i-PTH at 6 hours post operation was the most closely related to the occurrence of hypocalcemic symptom. On ROC analysis using i-PTH level at 6 hours, an i-PTH level of 10.6 mg/dL was found to maximize both sensitivity and specificity at the same time point. CONCLUSION: We found that i-PTH was a predictor of hypocalcemia, and that the earliest predictor of hypocalcemic symptoms was an i-PTH concentration lower than 10.6 mg/dL obtained 6 hours after total thyroidectomy.

Lower Lip Reconstruction Using a Submental Island Flap / 대한이비인후과학회지

Squamous cell carcinoma (SCC) of the lower lip is the most common malignant tumor, comprising 90% of all lip SCC. The typical picture of SCC of the lower lip is an ulcerated lesion with raised margins. Surgery is the treatment of choice for SCC of lower lip. After resection, reconstruction is important both aesthetically and functionally, because the lower lip is a prominent location in the face and it is where essential functions of the sphincter are carried out as in assisting mastication, swallowing, phonation, and expressing emotion. Depending on the location and size of the tumor, different types of flaps are used. We describe here a successful technique to reconstruct a large lower lip defect using a submental island flap and a mucosal flap for patients.

Cutaneous Angiosarcoma in Face / 대한이비인후과학회지

A cutaneous angiosarcoma is a rare, aggressive malignancy with a poor prognosis, with only a few cases of it in head and neck have been reported. In the present case, we reported a primary angiosarcoma of the nasal dorsum in a 70-year-old man without prior irradiation of head and neck region. The authors reviewed the literature and discussed treatment and prognosis of cutaneous angiosarcoma in nasal dorsum.