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A Comparison of Completeness and Complication of Total Thyroidectomy with or Without Neuromonitoring

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Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

Objectives

Total Thyroidectomy (TT) in true sense is not total as evidenced by remnant uptake in radio-iodine scans and serum thyroglobulin. The aim of this study is to assess the completeness of TT, operating time and recurrent laryngeal nerve injury with and without neuro-monitoring (IONM).

Methods

Cross sectional analytical study using retrospective data of patients undergoing total thyroidectomy for benign and malignant goiters. Surgeries performed by single surgeon. Patients undergoing TT (2015-22) were grouped into Group A (n = 400) and Group B (n = 400) based on use of IONM. Subgroup of patients (Group A1&B1) who had differentiated thyroid cancer were compared for completeness of thyroidectomy with DxWBS and serum thyroglobulin (TG). Group A and B were compared for operating time and incidence of RLN palsy.

Results

Of the 800 RLN at risk transient RLN palsy was lower with IONM (p = 0.048). Mean operating time was significantly higher in Group-B(p = 0.0038). Subgroup A1 showed lower radio-active iodine uptake percentage, higher number of patients with negative scan, TG of < 1ng/mL indicating better completeness of TT.

Conclusion

Our study shows better completeness of thyroidectomy, lower incidence of transient RLN palsy and shorter operating time with IONM.

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Acknowledgements

Authors wish to acknowledge the contributions of Dr Maharajan MD of Nuclear Medicine Department, Mr Selvaraj from the Dept of Laboratory Medicine.

Funding

No funding was received to assist with the preparation of this manuscript The authors have no relevant financial or non-financial interests to disclose.

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Authors and Affiliations

  1. Endocrine Surgery Department, Baby Memorial Hospital, 673004, Kozhikode, Kerala, India

    Pradeep Puthen Veetil & Shikhil Puzhakkal

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  1. Pradeep Puthen Veetil
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  2. Shikhil Puzhakkal
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Contributions

Author 1 (PPV) designed the model and the computational framework and analyzed the data. Author 2 (SP)carried out the implementation. Author 1 performed the calculations. Author 1 and 2 wrote the manuscript. Author 1 and 2 conceived the study and were in charge of overall direction and planning.

Corresponding author

Correspondence to Pradeep Puthen Veetil.

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Informed Consent was obtained from all individual participants included in the study Patients signed informed consent regarding publishing their data and photographs.

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Ethical committee clearance obtained, Institutional ethical committee (BMH/IEC/33/2022).

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Veetil, P.P., Puzhakkal, S. A Comparison of Completeness and Complication of Total Thyroidectomy with or Without Neuromonitoring. Indian J Otolaryngol Head Neck Surg 75, 1647–1650 (2023). https://doi.org/10.1007/s12070-023-03686-5

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