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Abstract 45. ENGLISH SU!.~l!ARY By far, tl-Jemost common cause of hypoparathyroidism is the postoperative type. The cause behind the latter is mainly due to interference with the blood supply of t”e Idands rather than inadvertent removal of the glands. This is because parathyroids are vul.ne r-abLe to infarction as each gland is suP?lied by a single artery which is not cornmunLcat Lng with vessels outside the capsule of the [;lan:l• The traumatic hypoparathyroidism is of primary concern to surgeons who perform total thyroidectomy for cancer thyroid as such extensive operation imply much dissection and manipulation not only on the thyroid but also on cervical lymph nodes especially those lying in tracheooesophageal groove which is a dangerous site for injury of parathyroids. The incidence of postoperative hypoparathyroidism after extensive radical thyroidectomies increased steadily (up to 40 percent as shown by Beahrs in 1969). However, more recent studies revealed a revolutionary DROP in the incidence to 2 percent. (Thompson,197)}. This achievement is attributed to strict measures adopted iE the identification and preservation of the glands as well as meticulous operative techniques to prevent interference with blood supply of the e;lands. 46. Diagnosis and early detection of hypoparathyroidi~m depends mainly on clinical as well as investigatory aids. It is not justified to diagnose this condition on clinical grounds only. THE An~ OF TREATMENT is to keep serum cacium level at the low side of normal by oral calcium and vitamin D supplementation as hypocalcemia is the most potent stimulus for the recovery of parathyroid function. from time to time it is wise to interrupt the course of therapy to test for the return back of parathyroid function. If, for the sake of radicality parathyroid glands, as recognised during total thyroidectomy for cancer, have to be remover, auto-transplantation of the removed glands is the only solution. The glands can be reimplanted into the sternomastoid muscle as the vascularity of muscular tissue is usually adeq~te for their survival. |