الفهرس 
Thyroid physiology and calcium metabolismOnly 14 pages are availabe for public view
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Abstract
Hypocalcemia is a common complication following Thyroidectomy, although hypocalcemia is rare. It pose significant problem.
The incidence of hypocalcemia is relatively much common after Total thyroidectomy than after subtotal thyroidectomy .permanent hypocalcemia which could be defined as hypocalcemia lasting six monthes or more after thyroid surgery is due to vascular necrosis and / or accidental removal of the parathyroid glands.
The main risk factors of post thyroidectomy hypocalcemia are reoperative thyroid surgery and total thyroidectomy with neck dissection.
The most early manifestations of hypocalcemia is tetany. Latent tetany may be indicated by mild or moderate paresthesia with a positive chvostek or trousseau sign.
Parathyroid preservation during thyroid surgery is crucial in the overall management of thyroid diseases.
The application of parathyroid auto-transplantation may preserve parathyroid function for inadvertently removed or de-vascularized glands during thyroid surgery.
The quick PTH assay can monitor parathyroid function during thyroidectomy and identify patients at risk of clinically significant hypocalcemia much earlier than serum calcium monitoring.
Patients who are markedly symptomatic or who have serum calcium level below 7 mg/dl are given prescriptions for oral calcium and calcitriol to minimize hypocalcemia. This treatment has resulted in shorter hospitalization and fewer symptoms of tetany, but it has also resulted in imprecise assessment of outcome and over prescriptions of these medications.
If the symptoms of hypocalcemia are severe and the patient appears to be on the verge of tetany the clinician may need to treat with i.v. calcium. These symptoms can usually be rapidly corrected by the infusion of 2 mg/kg of elemental calcium over 15 min, while monitoring ECG and respiration, symptoms return unless a longer infusion is used.