POST-THYROIDECTOMY
LARYNGOSPASM MAY BE DUE TO CLINICAL POSTOPERATIVE HYPOCALCEMIA
Hypocalcemia
is the most common complication following thyroidectomy and is commonly due to parathyroid
injury / ischemia or inadvertent (incidental) parathyroidectomy. Hypocalcemia
is most often asymptomatic (‘biochemical’) and transient, occurring in up to 80
% of cases, while clinical hypocalcemia is less frequently observed. Less
severe clinical hypocalcemia is associated with circumoral numbness, paresthesias
of the hands and feet, while in more severe hypocalcemia increased
neuromuscular irritability (clinical signs of Chvostek and Trousseau), muscular
cramps and laryngospasm may be observed. Hypocalcemia-induced laryngospasm may
aggravate the clinical consequences of post-thyroidectomy recurrent laryngeal
nerve paresis (which is typically transient and caused by surgical
manipulations next to the nerve [traction, use of diathermy etc]). Appropriate management
of coexistent hypocalcemia (and potentially hypomagnesemia) may ameliorate the
clinical manifestations of post-thyroidectomy recurrent laryngeal nerve paresis.
Σχόλια
Δημοσίευση σχολίου