Abstract
Purpose: The aim of this study was to compare the rate of hypocalcaemia after thyroid resection
in patients with versus patients without Graves’ Ophthalmopathy (GO).
Patients and Methods: 153 patients following thyroid surgery for Grave's disease were studied. Patients
were divided into three groups according to the severity of GO at the time of surgery
using the NOSPECS classification. Subgroup I comprised of 70 patients without GO,
subgroup II comprised of 63 patients with moderate GO and 20 patients with severe
GO were assigned to Subgroup III. Association between severe ophthalmopathy and postoperative
hypocalcaemia after thyroidectomy was investigated.
Results: 12/70 patients complained transient and 3/70 permanent hypocalcemia within subgroup
I. 14/63 patients developed transient and 4/63 patients permanent hypocalcaemia within
subgroup II. There were 7/20 patients with transient and 5/20 cases with permanent
hypocalcaemia in the patient group with severe GO (subgroup III). The incidence of
permanent postthyroidectomy hypocalcaemia was significantly higher in the subgroup
III with severe GO when compared to the subgroup I without GO (p=0.004).
Conclusion: Although postthyroidectomy hypocalcemia seems to be a multifactorial phenomenon,
this study implicates unknown role of severe GO at time of surgery in the development
of hypocalcaemia after thyroid surgery for Graves’ disease. Therefore, patients with
GO should be considered for surgery at high volume centres specialised in thyroid
and parathyroid surgery.
Key words
Graves' disease - hypoparathyroidism - endocrine ophthalmopathy - cross sectional
study - NOSPECS
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Correspondence
I. Hassan
Department of Visceral-, Thoracic-, and Vascular Surgery
Philipps University of Marburg
Baldingerstraße
35033 Marburg
Germany
Telefon: +49/6421/286 664 43
Fax: +49/6421/286 89 95
eMail: hassan@med.uni-marburg.de