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CC BY 4.0 · Int Arch Otorhinolaryngol 2025; 29(02): s00451801852
DOI: 10.1055/s-0045-1801852
Original Research

Role of Preoperative Thyroid-Stimulating Hormone Levels in the Prediction of Thyroid Hormone Replacement after Hemithyroidectomy

Ramona Paula Fernandes Reckziegel
1   Endocrinology Service, Irmandade da Santa Casa de Misericórdia de Porto Alegre, Universidade Federal de Ciências da Saúde de Porto Alegre, RS, Brazil
,
Lenara Golbert
1   Endocrinology Service, Irmandade da Santa Casa de Misericórdia de Porto Alegre, Universidade Federal de Ciências da Saúde de Porto Alegre, RS, Brazil
,
Erika Laurini de Souza Meyer 
1   Endocrinology Service, Irmandade da Santa Casa de Misericórdia de Porto Alegre, Universidade Federal de Ciências da Saúde de Porto Alegre, RS, Brazil
› Author Affiliations
Funding The authors declare that they did not receive funding from agencies in the public, private or non-profit sectors to conduct the present study.
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Abstract

Introduction Hemithyroidectomy is performed for the treatment of symptomatic unilateral benign nodules, cytologically indeterminate nodules, and some cases of well-differentiated thyroid cancer.

Objective To evaluate the frequency of postlobectomy thyroid hormone replacement (THR), and to analyze the clinical-pathological factors predicting L-thyroxine (T4) use in patients undergoing hemithyroidectomy.

Methods We conducted an observational, retrospective study in which clinical, biochemical, and anatomopathological parameters were analyzed and correlated with the need for THR after thyroid lobectomy.

Results The frequency of postoperative THR was 63%. The preoperative thyroid-stimulating hormone (TSH) level was an important predictor of postoperative THR. When stratifying preoperative TSH levels, the frequencies of T4 replacement in each TSH quartile varied, being more frequent with increasing presurgical TSH levels (p = 0.029). The preoperative cutoff that maximized sensitivity and specificity for the development of hypothyroidism was 1.21 μIU/mL.

Conclusion Our results demonstrated a significant frequency of postlobectomy THR. Higher preoperative TSH is a strong risk factor for postsurgical hypothyroidism, and even lower preoperative levels within the normal references do not exclude the risk of thyroid hormone use after thyroid lobectomy.

Keywords

thyroidectomy - hypothyroidism - thyroid hormones


Publication History

Received: 24 September 2022

Accepted: 18 June 2023

Article published online:
15 April 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Ramona Paula Fernandes Reckziegel, Lenara Golbert, Erika Laurini de Souza Meyer. Role of Preoperative Thyroid-Stimulating Hormone Levels in the Prediction of Thyroid Hormone Replacement after Hemithyroidectomy. Int Arch Otorhinolaryngol 2025; 29: s00451801852.
DOI: 10.1055/s-0045-1801852