ABSTRACT
PURPOSE: To find out if the whole parathyroid hormone (wPTH) assay has practical advantages over the intact (iPTH) assay in patients with Graves' disease. METHODS: We measured iPTH and wPTH levels before and after subtotal thyroidectomy in 111 consecutive patients (94 women and 17 men) with Graves' disease. Blood samples for assays were obtained after the induction of anesthesia (basal) and following skin closure (postoperative). RESULTS: There was a significant correlation between wPTH and iPTH in both the basal and postoperative levels. Logistic regression analyses examining the relationship between the reduction in parathyroid hormone (PTH) levels and the incidence of tetany revealed that both the wPTH and iPTH assays were significantly equally predictive of postoperative tetany. CONCLUSION: We found that both the wPTH and iPTH assays were useful for predicting postoperative tetany in patients with Graves' disease, yielding similar results.
Subject(s)
Graves Disease/blood , Graves Disease/surgery , Parathyroid Hormone/blood , Tetany/blood , Thyroidectomy/adverse effects , Adolescent , Adult , Child , Female , Humans , Intraoperative Period , Male , Middle Aged , Postoperative Complications/blood , ROC Curve , Sensitivity and SpecificityABSTRACT
We excised a bronchogenic cyst causing recurrent laryngeal nerve palsy using thoracoscopic surgery. A 28-year-old woman presented after the sudden onset of hoarseness, and laryngoscopic examination showed left vocal cord palsy. Computed tomography and magnetic resonance imaging showed a cystic mass, 4 cm in diameter, in the aortopulmonary window. Thoracoscopic examination revealed that the mass was adhered to the recurrent laryngeal nerve below the aortic arch. We extirpated the cyst via thoracoscopy without any injury to the nerves or major blood vessels. This case illustrates the benefits of thoracoscopic surgery for providing good visualization of the perineural structures and as a safe surgical treatment for a cystic mass in the aortopulmonary window.
