The Utility of Serum PTH Assessment 1 Hour after Total Thyroidectomy / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Hypocalcemia is the most frequent complication following total thyroidectomy. This prospective study examines the predictive value of parathyroid hormone (PTH) levels measured 1 hour after surgery. MATERIALS AND METHOD: Twenty-four patients underwent total or near-total thyroidectomy for benign or malignant thyroid tumor in one year. Serum calcium and PTH levels were measured preoperatively and at 1 hour after surgery. RESULTS: All patients were classified into three groups according to hypocalcemic symptoms and postoperative serum calcium levels. A total of 6 (25%) patients were found with hypocalcemia, as demonstrated by clinical and laboratory findings. PTH levels at 1 hour were below normal level (100%) for 6 of the 6 symptomatic hypocalcemia patients, 5 (45%) of the 11 biochemical hypocalcemia patients, and in 1 (14%) of 7 normocalcemic patients (p=0.002). The sensitivity and specificity of postoperative 1 hour PTH assessment to predict symptomatic hypocalcemia were 100% and 66%. The positive and negative predictive rate of postoperative 1 hour PTH assessment to predict symptomatic hypocalcemia were 50% and 100%. CONCLUSION: Parathyroid gland insufficiency is the main determinant of transient hypocalcemia after bilateral thyroid surgery. Low PTH level at 1 hour after surgery is therefore a feasible predictor of postoperative symptomatic hypocalcemia and permanent hypoparathyroidism.

Prognostic Factors of Acute Acoustic Trauma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The prognosis and prognostic factors for acute acoustic trauma are difficult to predict. The aim of this study was to assess the prognostic factors of acute acoustic trauma. SUBJECTS AND METHOD: The cases selected for this report are 27 patients with acute acoustic trauma and 139 patients with sudden deafness are selected for control group. The following factors were examined for prognostic factors: age, vestibular symptom, degree of initial hearing loss, number of days before the start of treatment. RESULTS: Most strongly related factor for prognosis is number of days before the start of treatment, but other factors are not significant relation for prognosis. The overall hearing recovery rate of acute acoustic trauma was 29.6% and that of sudden deafness is 56.1%. CONCLUSION: Early treatment of acute acoustic trauma increases hearing recovery rate, and acute acoustic trauma has worse prognosis than sudden deafness.