2. Thyroidectomy  Surgical removal of the thyroid gland 2 types:  Subtotal thyroidectomy – removal of about 5/6 th part of the thyroid gland. (Most common)  Total thyroidectomy- removal of the entire thyroid gland.

3. THYROIDECTOMY

4. Preparation before surgery:  Administer PTU until signs of hyperthyroidism have disappeared  Beta adrenergic blocking agents (propanolol) to reduce heart rate  Stop medications that may prolong clotting (aspirin)

5. Postoperative Complications:  Thyroid storm- hyperthermia, sweating, tachycardia, nausea, vomiting, & pain  Wound hemorrhage- may cause respiratory distress  Recurrent laryngeal nerve injury- the voice is husky or hoarse  Hypoparathyroidism- circumoral numbness, tingling of fingertips, anxiety,Chvostek sign, trousseau’s sign, reduced serum calcium, increased phosphorus.

6. Parathyroidectomy  Surgical removal of the abnormal parathyroid tissue.  Aims to restore patient to normocalcemic, euparathyroid state, & to reverse the symptoms of the disease.

7. Criteria for asymptomatic patients:  Younger than 50 years of age  Unlikely to participate in follow up care  Serum calcium level more than 1.0 mg/dL above reference range  Increased urinary calcium level

8. PARATHYROIDECTOMY

9. Postoperative complications:  Hypocalcemia- Draw serum Calcium q12h  Treatment includes calcium gluconate slow IV infusion, oral calcium & vit D.

10. Hypophysectomy 3 Appraches to hypophysectomy  Surgical removal of the pituitary tumor, usually through a transphenoidal approach.  Oronasal transphenoidal approach  Irradiation  Cryosurgery

12. Postoperative complications:  Diabetes Insipidus  CSF leak or fistula  Visual loss  Vascular injury