Prof. Dralle of the University of Halle explored the theme of permanent hy-
poparathyroidism pursuant to thyroidectomy. This adverse effect of this surgical
procedures is linked to the anatomy of the parathyroid glands. They are small
glands embedded within or behind the thyroid; hence, the operating space be-
tween the thyroid tissue and the
parathyroid glands is very limited.
Another problem, typical of surgery
on very young patients, is the diffi-
culty of identifying the parathyroid
glands amidst the thyroid gland tissue. Nor should we for-
get that at least 20% of the parathyroid gland tissue is lo-
cated ectopically; for example, in the thymus or behind
the esophagus; this factor certainly does not aid surgeons
to preserve parathyroid tissue while operating. It is very
important to check calcium and PTH levels on the first
post-operative day; below-normal values for either parameter constitute a significant risk factor for
hypoparathyroidism, independently of the absence/presence of symptoms. The surgeon’s experience,
the type of operation, and the method used during the operation to safeguard the parathyroid glands
are all factors which can significantly influence the risk of permanent postoperative hypoparathyroid-
ism.
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Henning Dralle
Halle/Saale, D
Permanent postoperative hypoparathyroidism
What solutions to these problems does Prof. Dralle propose?
What are the most efficacious surgical aids?