Preservation of parathyroid gland during total thyroidectomy and its outcome

Background: Parathyroid insufficiency is a frequent complication of total thyroidectomy, often leading to hypocalcaemia, which can be transient or permanent. This condition arises from factors like disrupted blood supply, injury or accidental removal of parathyroid glands. Since parathyroid hormone (PTH) is essential for calcium regulation, this study investigated parathyroid preservation, the timing of tetany symptoms post-surgery and the incidence of hypocalcaemia tetany after thyroidectomy. Methods: This cross-sectional observational study, conducted from January to December 2021 at the Department of Otolaryngology-Head & Neck Surgery, Combined Military Hospital, Dhaka, included 42 randomly selected patients who underwent thyroid surgery. Data were collected systematically using structured data sheets. Results: Among the 42 patients, 18 (42.86%) developed hypocalcaemia 16.67% within 24 hours, 61.11% after 48 hours and 16.67% after 72 hours. Of these, 77.78% had asymptomatic hypocalcaemia, while 22.22% showed symptoms. Transient hypocalcaemia occurred in 38.10% and permanent hypocalcaemia in 4.76% of cases. Conclusions: The study revealed a significant postoperative decrease in serum calcium levels, particularly within 48–72 hours, with a 42.86% incidence of hypocalcaemia. These findings align with reported rates in other studies.