Conventional open thyroidectomy with direct approach through the neck
12 thyroidectomy
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Transcript of 12 thyroidectomy
THYROIDECTOMY
Mahmoud Sakr, MD, PhD, FACS
PROFESSOR OF SURGERY
CHIEF HEAD & NECK & ENDOCRINE SURGERY UNIT
UNIVERISTY OF ALEXANDRIA
Thyroid Operations
Isthmectomy
Lobectomy
Hemi-thyroidectomy
Subtotal thyroidectomy
Near-Total Thyroidectomy
Total Thyroidectomy
Near-total Thyroidectomy Removal of all grossly visible thyroid tissue,
leaving only a small amount (< 1 g) of tissue
adjacent to the insertion of RLN into the
cricothyroid muscle.
Total Thyroidectomy
Removal of all grossly visible thyroid tissue.
Subtotal Thyroidectomy
Leaving >1 g of tissue with the posterior capsule
on the involved side.
THYROID
Volume 16, Number 2, 2006
© American Thyroid Association
A. Local Complications
1. Hemorrhage (1ry – 2ry – reactionary)
2. Liquifying hematoma
3. Wound infection
4. Unightly scar
5. Respiratory complications (trachiitis)
6. Pneumothorax
7. Mediastinal emphysema
8. Air embolism
B. Specific Complications
1. Respiratory obstruction (stridor)
• Laryngeal edema (glossitis)
• Tracheal collapse (tracheomalacia)
• Hematoma – blood clot
• FB
• RLN affection
2. Nerve Injuries
RLN Injury (unilateral – bilateral)
• Division (partial – complete)
• Stretching
• Ligation
• Compression (edema – hematoma)
• Concussion
• Diathermy
ELN Injury
Cervical sympathetic nerve
3. Endocrinal Abnormalities
• Hypoparathyroidism
• Hypothyroidism
• Recurrent thyrotoxicosis
• Thyrotoxic crisis
• Progressive exophthalmos