Partial Thyroidectomy

No Video Available
Procedures Consult Mobile
Quick ReviewFull DetailsChecklist
Pre-ProcedureProcedurePost-Procedure
Help  |  Print
SAMPLE EXCERPT
- Full procedure text, video and illustrations available with the full product
PRE-PROCEDURE
INDICATIONS
  • Extensive multinodular disease
  • Hyperthyroidism
  • Thyroid cancer larger than 2 cm in size without palpable lymph nodes
  • Palpable adenopathy an indication for a neck dissection in conjunction with a total thyroidectomy
CONTRAINDICATIONS
  • Poor candidate for surgery
  • Anaplastic thyroid cancer in selected patients
EQUIPMENT
  • Standard thyroidectomy set
  • Mahorner retractor
ANATOMY
  • The two lateral lobes are joined at the midline by an isthmus, the superior edge of which is situated at or just below the cricoid cartilage.
  • The pyramidal lobe may be a prominent structure that can extend from the midline of the isthmus to as far cephalad as the hyoid bone.
  • The recurrent laryngeal nerves ascend on either side of the trachea.
    • Each lies just lateral to the ligament of Berry.
  • The superior laryngeal nerve separates from the vagus nerve at the base of the skull and descends toward the superior pole of the thyroid along the internal carotid artery.
  • The superior thyroid artery courses medially onto the surface of the inferior pharyngeal constrictor muscle and enters the apex of the superior pole.
  • The inferior thyroid artery ascends into the neck on either side behind the carotid sheath and then arches medially and enters the thyroid gland posteriorly, usually near the ligament of Berry.

PROCEDURE
Sample excerpt does not include step-by-step text instructions for performing this procedure
The full content of this section includes:
  • Step-by-step text instructions for performing the procedure
  • Clinical pearls providing practical clinical tips from medical experts
  • Patient safety guidelines consistent with Joint Commission and OHSA standards
  • Links to medical evidence and related procedures

POST-PROCEDURE
CARE
  • Calcium assay performed within 24 hours of surgery
    • If no signs of hypocalcemia are present, no calcium supplementation may be necessary.
    • If symptoms occur or if the surgeon is concerned about the patient's parathyroid status, daily supplements of 1500 to 3000 mg of elemental calcium may be started.
COMPLICATIONS
  • Postprocedure hypocalcemia secondary to devascularization of the parathyroid
  • Hoarseness caused by recurrent laryngeal nerve injury induced by either traction or division
  • Unilateral injury to recurrent laryngeal nerve with a paralyzed vocal cord with loss of movement from the midline
RESULT ANALYSIS

Most patients with papillary carcinoma can expect an excellent prognosis, with the 10-year survival rate approaching 95% for the most favorable stages.

About Procedures Consult | Help | Contact Us | Terms and Conditions | Privacy Policy
Copyright © 2017 Elsevier Inc. All rights reserved.