title: Postoperative Hypoparathyroidism and the Viability of the Parathyroid Glands During Thyroidectomy.
abstract: OBJECTIVE
  To prevent hypoparathyroidism after thyroidectomy, preservation of the parathyroid glands and their vascularity are essential. The aim of this study was to determine the association between postoperative parathyroid function and the viability of the parathyroid glands during thyroidectomy.
  
  
  METHODS
  We prospectively analyzed 111 patients who underwent total thyroidectomy and in whom all 4 parathyroid glands were preserved in situ during the operation. The surgeons scored the viability of each parathyroid gland from 0 (normal) to 3 (severely compromised viability) based on its gross appearance and vascularity intraoperatively. The index of parathyroid viability score (IPVS) was defined as the sum of the viability scores of the 4 parathyroid glands. We evaluated the relationship between postoperative parathyroid function and IPVS.
  
  
  RESULTS
  Transient hypoparathyroidism occurred in 25 patients (22.5%), and permanent hypoparathyroidism in 4 patients (3.6%). The IPVS were significantly different in the three groups: 2.87±1.46 in the normal group, 3.68±1.41 in the transient hypoparathyroidism group and 7.50±1.00 in the permanent hypoparathyroidism group. The rates of transient hypoparathyroidism were 13.6% in patients with IPVS 0-2, 23.8% in patients with IPVS 3-4, and 42.9% in patients with IPVS 5-6. All the patients with IPVS of 7 or more had permanent hypoparathyroidism.
  
  
  CONCLUSIONS
  IPVS is correlated with the incidence of hypoparathyroidism. It could be a good quantitative indicator of the probability of hypoparathyroidism after thyroidectomy.
authors: Department of Otolaryngology-Head and Neck Surgery, Hanyang University College of Medicine, Seoul, Korea.
authors: Yong Bae
authors: YB
authors: Ji
authors: Department of Otolaryngology-Head and Neck Surgery, Hanyang University College of Medicine, Seoul, Korea.
authors: Chang Myeon
authors: CM
authors: Song
authors: Department of Otolaryngology-Head and Neck Surgery, Hanyang University College of Medicine, Seoul, Korea.
authors: Eui Suk
authors: ES
authors: Sung
authors: Department of Otolaryngology-Head and Neck Surgery, Hanyang University College of Medicine, Seoul, Korea.
authors: Jin Hyeok
authors: JH
authors: Jeong
authors: Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
authors: Chang Beom
authors: CB
authors: Lee
authors: Department of Otolaryngology-Head and Neck Surgery, Hanyang University College of Medicine, Seoul, Korea.
authors: Kyung
authors: K
authors: Tae
keywords: Hypocalcemia; Hypoparathyroidism; Parathyroid Glands; Thyroidectomy