Posttotal thyroidectomy histopathological evaluation of the parathyroid gland as predictive value for postoperative hypoparathyroidism

Background and aim Hypoparathyroidism after total thyroidectomy is not an uncommon complication; however, not all these complications are due to the removal of the parathyroid gland. It is considered permanent hypoparathyroidism after 6 months. Early diagnosis of permanent hypoparathyroidism by histopathological examination may be beneficial for the outcome and to find the optimum treatment of each type of hypoparathyroidism. This study was done to predict postoperative hypoparathyroidism and clarify the incidence of parathyroidectomy by histopathological examination. Patients and methods A prospective study which included a total of 50 patients undergoing thyroidectomy with benign thyroid disease to determine the incidence of parathyroidectomy by histopathological examination and early diagnosis of hypocalcaemia following thyroid surgery. The study was done in the Surgery Department of Al-Azhar University Hospitals, Assuit. Results Regarding the PTH level, the postoperative level showed a significant postoperative decrease compared to the preoperative level, posttotal thyroidectomy. Histopathological examination of the thyroid gland showed that eight (16%) patients of 50 patients developed hypocalcaemia, and 42 (84%) patients did not develop hypocalcaemia post total thyroidectomy. In our study, five patients were observed with transient hypocalcaemia, and three patients were observed with permanent hypocalcaemia. Permanent hypocalcaemia was observed in the parathyroid gland in 4% and transient hypocalcaemia was observed in the parathyroid gland in 2%in surgical specimens by histopathological examination. Conclusion Histopathological evaluation of the parathyroid gland after total thyroidectomy is important in determining patients suspected of permanent or temporary hypoparathyroidism, changing the management option.