General Risks

General risks are the risks related to the patient's heart, lung diseases and systemic disorders.  These risks are assessed during pre-anaesthesia consultation and for some patients, it may be required to perform the surgery under intensive care conditions.  This intensive care condition is necessary for close monitoring of the patient's post-operative cardiac and respiratory parameters.  Patient is usually hospitalized in Intensive Care on the day of surgery, on the next day transferred the normal room.


Risks of Thyroid Surgeries

Hoarseness: The nerve that moves the vocal cords is very close to the thyroid gland.   This nerve is explored during thyroid surgeries and after exposed, it is protected and the thyroid gland is removed.  In patients without specific risk, the rate of hoarseness is below 1%.  Often this kind of hoarseness develops as a result of oedema (swelling developed in the tissues during surgery), and 95% of them heals when edema is regressed.

Since oedema around the nerve causes a temporary paralysis in the nerve, the movement ability of the vocal cords is reduced, hoarseness arises due to that.  This temporary hoarseness usually heals within 1 week to 1 month. The risk rate is higher in patients with thyroid cancers, secondary operations, internal goiter, hyperthyroidism (toxic goiter), giant goitre.  Permanent hoarseness is very rare. 


Low Calcium: The parathyroid glands, which regulate the calcium balance of the body, are located next to the thyroid gland. In some patients, the blood supply of the parathyroid glands may be reduced temporarily due to clamping the vessels during thyroid surgeries. In such case, the synthesis of "parathormone" secreted from the parathyroid glands is reduced thus, blood calcium level is reduced.

Due to low level of blood calcium, the patient may have numbness, tingling and sometimes spasms around the lips and at the fingertips and tiptoes.  Patients are warned about that after surgery and are asked to report if they have such complaints.  Low level of calcium is replaced with serum or by oral administration. Patients with vitamin D deficiency are at higher risk of hypoglycaemia (low level of calcium in the blood).  In patients with no risk factor, the incidence of hypocalcemia is 5-10%, and this condition is temporary for almost all patients and heals within 1-2 weeks.


Bleeding: It is a very rare complication that may occur in all surgeries. The thyroid gland has a rich blood supply.  All vessels are clamped during surgery or sealed with new technologic devices.  Although not very common, bleeding may occur as a result of special conditions such as breakage of sealed vessel, postoperative hypertension.  This rate is a 1/1000 chance, which we can consider as very low.


Wound Infection: Since the neck are has a rich blood supply, it is very rare.


Fluid Collection in the Wound Area (Seroma): Although very rare, patients with excess fat tissue may have fluid collection in the wound area.  It usually disappears spontaneously within 1-2 weeks. 

   

Protected nerves during surgery (for hoarseness)

 

Guarded parathyroid glands to avoid calcium hypogonadism