Role of Microscope in Total Thyroidectomy for Multinodular Goiter

Objective: To compare the incidence of post-operative hypocalcemia and RLN injury in patients undergoing thyroidectomy for multinodular goiter with versus without microscope. Material and Methods: The randomized controlled study was conducted in the department of Otorhinolaryngology, HBS Teaching Hospital, Islamabad over 1 year from Jan 2017 to Dec 2017. A total of 92 patients both males and females aged between 18 to 70 years planned for thyroidectomy for nodular thyroid enlargement. These cases were randomly assigned into 2 treatment arms. Patients in one group underwent conventional thyroidectomy while those in the other group underwent microscopic thyroidectomy. The results were analyzed in terms of frequency of post-operative hypocalcemia and RLN injury which were observed and compared between the groups. An informed written consentFto participate infthe study was taken from every patient. Results: Them mean age of the patients was 36.4 +/- 13.4 years. We observed a female predominance among these patients with maleFto female ratio of 1:4.1. Following surgery, the frequency of post-operative hypocalcemia (4.3% vs. 15.2%; p-value=0.079) and RLN injury (2.2% vs. 6.5%; p-value=0.307) was lower in patientsHwho underwent microscopic thyroidectomy as compared to conventional thyroidectomy. Conclusion: Microscopic thyroidectomy was associated with significantly lower frequency of post-operative hypoparathyroidism andFrecurrent laryngealBnerve injury. It is therefore advisable that microscopic thyroidectomy should be preferred in future surgical practice provided the necessary hardware and skills are available.