VOLUME 37 - NUMBER 3 - 2016

Use of loupes magnification and microsurgical technique in thyroid surgery: ten years experience in a single center

  • D'Orazi V., Panunzi A., Di Lorenzo E., Ortensi Al., Cialini M., Anichini S., Ortensi A.
  • Original Article, 101-107
  • Full text PDF

  • Aim. The use of microsurgical technique and loupes magnification as a support to traditional surgery can help surgical performance and prevent complications in thyroid surgery.

    Patients and methods. Between January 2004 and December 2014, 782 patients with thyroid diseases were operated by our team with microsurgical technique and loupes magnification 4.5x. All patients had pre and postoperative vocal cords assessment and calcemia and the collected data were analysed.

    Results. Among the 782 patients, only six patients (0.77%) had unilateral vocal fold immobility treated with medical therapy, phoniatric and neck physiotherapy. All six patients showed complete laryngeal recovery of motility 6/8 weeks after treatment. There were not cases of permanent monolateral or bilateral vocal cord palsy. In 84 patients there were signs and symptoms of hypocalcemia. In 81 patients (10.36%) the restoring of biochemical parameters and the resolution of symptoms occurred between 2 and 6 weeks and in 3 cases (0.38%) there was permanent hypocalcemia more than six months.

    Conclusion. The use of microsurgical technique and loupes magnification in thyroid surgery are safety and effective procedures, that require an appropriate training in reconstructive microsurgery, but may significantly reduce post-operative complications. Here, we report for the first time the largest series of thyroid surgery performed with the use of microsurgical technique and loupes magnification, analysing the postoperative morbidity. In view of our results, we suggest the routine use of 4.5X loupes and microsurgical technique in thyroid surgery.

  • KEY WORDS: Microsurgery - Loupes magnification - Thyroid - Hypocalcemia - Recurrent laryngeal nerve injury - Vocal cord palsy - Hypoparathyroidism.