Complications after Thyroid Surgery

Thyroid surgery rates have tripled in the last three decades. In most thyroid pathology, surgical treatment is the definitive treatment. The three most frequent complications after thyroid surgery are: neck hematoma, recurrent laryngeal nerve paralysis and hypocalcemia due to hypoparathyroidism.

Neck hematoma:
– Low incidence, but it is the most severe complication.
– Most cases occur within the first 24 hours after surgery.
– Prevention: use of energy devices and Valsalva maneuver 🡪 help making correct hemostasis.
– Leaving a drain has not been shown to prevent neck hematomas.

Hypoparathyroidism:
– The most frequent complication.
– It can be transitory (in most cases) or permanent.
– The identification of a minimum of two parathyroid glands during surgery is recommended.

Recurrent laryngeal nerve paralysis:
– Less frequent.
– Risk factors: bilateral thyroidectomy, reintervention and malignant pathology.
– Unilateral paralysis: dysphonia, dysphagia and breathing difficulty.
– Bilateral lesions can cause an acute airway obstruction medical emergency!
– Nerve function can be recovered (especially in unilateral lesions).