A case series on the determination of pre-operative risk factors for anticipation of post operative hypocalcaemia in thyroidectomy

During thyroidectomy, careful dissection of the parathyroid and tracing of their blood supply is the dictum. But it may not always be possible. We aim to highlight some of the common situations faced by ENT surgeons during thyroidectomy, where intraoperative identification and preservation of either the parathyroid glands or their blood supply may be difficult or the glands may have to be sacrificed. We wish to highlight 5 cases where hypocalcemic tetany occurred after total thyroidectomy and pre operative anticipation of their risk factors and the reasoning for the same. Extra precaution should be taken to try and identify and preserve at least one parathyroid gland to prevent lifelong morbidity due to hypocalcemia. Additionally, one must be on the lookout for such challenging cases preoperatively and appropriate consent should be taken from the patient.