Postoperative Hypoparathyroidism

he most common cause of acquired hypoparathyroidism is surgery on the thyroid or parathyroid glands. Symptomatic hypocalcemia after thyroidectomy is most commonly caused by removal of or damage to the parathyroid glands. Total thyroidectomy, surgery for hyperparathyroidism, and lack of identification of parathyroid glands during surgery are the main potential risks for hypoparathyroidism; meanwhile, autografting of parathyroid glands during thyroidectomy can significantly reduce this risk. The main cause of hypoparathyroidism after parathyroidectomy for primary hyperparathyroidism is functional suppression of the normal parathyroid glands by hypercalcemia caused by the pathological excised one. Persistent hypoparathyroidism is rare but possible if bilateral neck exploration, total or subtotal parathyroidectomy for familial hyperparathyroidism, or repetitive surgery is performed.