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T; pl 0. 138 Otolaryngology-Head and Neck Surgery Thyroidectomy Introduction preferableforpatienttobeeuthyroidattimeofsurgerytoavoid thyroid storm (see below) mayconsiderpreoperativepotassiumiodinetoreducevascularityof thyroid gland Indications suspicionofmalignancy compressionsymptoms(airwaycompromise,dysphagia) extensionintomediastinum cosmesis failedmedicalmanagementforGravesdiseaseorhyperthyroidism pregnancyinGravesdiseaseorHashimotosThyroiditis documentedmetastasisfromthyroidcarcinoma Postoperative Complications Hematoma:maypresentasrespiratorycompromisefromcompressive effect; Rx: for respiratory distress immediately remove sutures and open wound, for large hematomas control bleeding in operating room and place suction drains; for smaller hematomas may be observed (place on antibiotics) and aspirate contents after liquification (710 days) VocalFoldParalysis:RLNorSLNinjury(SLNinjurymore common), prevent by identifying nerve and avoiding ligation of inferior thyroid artery; Rx: if discovered interoperatively may consider primary anastomosis (see also pp.
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