RESUMO
BACKGROUND AND OBJECTIVE: Hypoparathyroidism is the most common complication of total thyroidectomy and usually requires monitoring of calcaemia, whereby it is one of the factors that most contributes to hospital stay. The objective of the study is to evaluate the clinical usefulness of the application of our protocol for early detection, intensive treatment and control of hypoparathyroidism in the first month after thyroidectomy. PATIENTS AND METHOD: Retrospective observational cross-sectional study of 79 patients who underwent total thyroidectomy in whom parathormone (PTH) and calcemia determinations were performed at 6-8â¯h and 18-24â¯h post-surgery. When the PTH value was lower than inferior limit of the reference (15â¯pg/ml), oral treatment was started with 1000â¯mg of calcium and 0.25⯵g of calcitriol every 8â¯h followed by calcemia controls. RESULTS: Twenty-six cases (32.9%) of normocalcemic hypoparathyroidism were detected in whom treatment prevented their progression to hypocalcaemia, except for 3 cases that had an episode of mild asymptomatic hypocalcaemia. There were no cases of moderate/severe hypocalcaemia and only one case of asymptomatic mild hypercalcaemia. There were no readmissions due to calcium abnormalities. No case with PTHâ¯>â¯15â¯pg/ml had hypocalcaemia. The protocol allowed a hospital stay of 24â¯h. The prevalence of permanent hypoparathyroidism was 5.1%. CONCLUSIONS: The application of our protocol during the first month after thyroidectomy is very useful because it avoids the appearance of moderate/severe hypocalcaemia and hypercalcaemia, allows a short hospital stay and is associated with a low prevalence of permanent hypoparathyroidism.
Assuntos
Hipercalcemia , Hipocalcemia , Hipoparatireoidismo , Humanos , Hipocalcemia/diagnóstico , Hipocalcemia/tratamento farmacológico , Hipocalcemia/epidemiologia , Cálcio/uso terapêutico , Hipercalcemia/complicações , Tireoidectomia/efeitos adversos , Estudos Retrospectivos , Estudos Transversais , Complicações Pós-Operatórias/etiologia , Hipoparatireoidismo/diagnóstico , Hipoparatireoidismo/tratamento farmacológico , Hipoparatireoidismo/epidemiologia , Hormônio ParatireóideoRESUMO
We report a case of a young man with transient syncopes as a first clinical manifestation. Neck radiographic examination showed a bilateral calcification of the stylohyoid ligament, doubly articulated in its extension and compressing the internal carotid artery.