Hypothyroidism – An Underestimated Complication After Hemithyroidectomy: A Preliminary Study Report
Article Sidebar
Main Article Content
Abstract
Introduction
Hypothyroidism is a significant but an under-appreciated complication of hemithyroidectomy. The focus of this study was to assess the incidence of hypothyroidism occurring after hemithyroidectomy, identify the risk factors and to suggest a possible follow-up guideline for diagnosis.
Materials and Methods
An institution based preliminary study was conducted in the Department of Otorhinolaryngology, in a tertiary care hospital, from August 2014 to December 2015 on 25 patients. The patients were regularly followed up in 1st month, 3rd month, 6thmonth, 9th month and 1 year period with the thyroid function test.
Results
Incidence of hypothyroidism occurring after hemithyroidectomy including transient and permanent cases is 32%. Increased age of presentation, longer duration of thyroid swelling, pre-operative serum TSH level >2.5 mIU/ml, lymphocytic infiltration in histopathology and right sided hemithyroidectomy were found to be the possible risk factors.
Conclusion
It is indicated from this preliminary report that there should be a serial thyroid function monitoring in every post-operative hemithyroidectomy patient, and special attention should be given to the risk group
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
References
Verloop H, Louwerens M, Schoones JW, Kievit J, Smit JWA, Dekkers OM. Risk of hypothyroidism following hemithyroidectomy: Systematic review and meta-analysis of prognostic studies. Journal of Clinical Endocrinology and Metabolism. 2012; 97(2):2243-55
Jameson JL, Weetman AP. Disorders of the thyroid gland (Chapter 341) in; Harrison’s Principles of Internal Medicine 18th ed. Longo DL et al (Eds.). McGraw-Hill Companies. United state of America.2012; pp 2912-27
Ross DS. Serum thyroid-stimulating hormone measurement for assessment of thyroid function and disease. Endocrinol Metab Clin North Am. 2001; 30(2):245-64
Seiberling KA, Dutra JC, Bajarmovic S. Hypothyroidism following hemithyroidectomy for benign nontoxic thyroid disease. ENT- Ear, Nose and Throat Journal 2007; 86(5):295-9
Parle JV, Franlyn JA, Cross KW, Jones SC, Sheppard MC. Prevalence and follow-up of abnormal thyrotrophin (TSH) concentrations in the elderly in the United Kingdom. Clin Endocrinol (Oxf). 1991; 34(1):77-83
Buchanan MA and Lee D. Thyroid auto-antibodies, lymphocytic infiltration and the development of post-operative hypothyroidism following hemithyroidectomy for non-toxic nodular goitre. Journal of the Royal College of Surgeons of Edinburgh 2001; 46(2): 86-90
Elsherbiny TM. Review: Post-thyroidectomy hypothyroidism. Egyptian Journal of Obesity, Diabetes and Endocrinology 2012; (2): 114-20
Lee J, Chung WY. Hypothyroidism After Hemithyroidectomy: Incidence, Risk Factors, Natural History and Management in, Hypothyroidism - Influences and Treatments, Springer D(Ed.), InTech, 2012;35-50. DOI: 10.5772/32153 http://cdn.intechopen.com/pdfs-wm/27823.pdf. accessed on 20/04/2016
Said M, Chiu V, Haigh PI. Hypothyroidism After Hemithyroidectomy. World Journal of Surgery 2013; 37: 2839-44
Klein I, Ojamaa K. Thyroid hormone and the cardiovascular system. N Eng J Med. 2001; 344(7): 501-9
Miller FR, Paulson D, Prihoda TJ, Otto RA. Risk Factors for the Development of Hypothyroidism after Hemithyroidectomy. Arch Otolaryngol Head Neck Surg. 2006; 132: 36-8
Lankarani M, Mahmoodzadeh H, Poorpezeshk N, Soleimanpour B, Haghpanah V, Heshmat R. Hypothyroidism following thyroid surgery. Acta Medica Iranica 2008; 46(3): 225-32
Ying M, Yung DMC. Asymmetry of Thyroid Lobe Volume in Normal Chinese Subjects: Association with Handedness and Position of Esophagus. Anat Rec. 2009; 292 (2):169-74
De Carlucci Jr D, Tavares MR, Obara MT. Thyroid Function after Unilateral Total Lobectomy Risk Factors for Postoperative Hypothyroidism. Arch Otolaryngol Head Neck Surg. 2008; 134(10):1076-9
Wormald R, Sheahan P, Rowley S, Rizkalla H, Toner M, Timon C. Hemithyroidectomy for benign thyroid disease: who needs follow-up for hypothyroidism? Clin. Otolaryngol. 2008; 33:587-91
Koh YW , Lee SW , Choi EC , Lee JD , Mok JO , Kim HK, et al. Prediction of hypothyroidism after hemithyroidectomy: a biochemical and pathological analysis. Eur Arch Otorhinolaryngol. 2008; 265:453-7
Moon H, Jung E, Park S, Jung TS, Jeong C, Ju Y. Thyrotropin Level and Thyroid Volume for Prediction of Hypothyroidism Following Hemithyroidectomy in an Asian Patient Cohort. World Journal of Surgery 2008; 32:2503-8
Wartofsky L, van Nostrand, D. Overt and subclinical hypothyroidism in women Obstet Gynecol Surv. 2006; 61(8):535-42
Col NF, Surks MI, Daniels GH. Subclinical thyroid disease: clinical applications. JAMA 2004; 291(2):239-243
Surks MI, Oritz E, Daniels GH, Sawin CT, Col NF, Cobin RH,Franklin JA, Hershman JM, Burman KD, Denke MA, Gorman C, Cooper RS, Weissman NJ. Subclinical thyroid disease: scientific review and guidelines for diagnosis and management. JAMA 2004; 291(2):228-38
Cooper DS, Biondi B. Subclinical thyroid disease. Lancet 2012; 379(9821):1142-56
Benediktsson R, Toft AD. Management of the unexpected results: Compensated hypothyroidism. Postgrad Med J. 1998; 74:729-32