Outcomes and complications of parathyroidectomy in otorhinolaryngology practice: A single-institution, 10-year retrospective observational study

Background Parathyroidectomy is associated with a spectrum of potential complications, including recurrent laryngeal nerve (RLN) injury, permanent hypocalcemia, postoperative hemorrhage, wound infection, and recurrence of hyperparathyroidism (HPT). The objective of this study was to evaluate the outcomes of 223 parathyroid procedures and to determine the incidence of procedure-related complications. Methods This retrospective observational study analyzed parathyroidectomy cases performed between 2013 and 2022. Demographic data and postoperative complications were collected and assessed. The success rates of surgical removal of parathyroid adenomas, hyperplasia, carcinomas, and cysts were evaluated in relation to preoperative and perioperative diagnostic methods. Results A total of 223 parathyroidectomy procedures were performed. Unilateral permanent RLN palsy was observed in 0.91% of cases (95% CI, 0.11–3.21%). Bilateral permanent vocal cord palsy was not observed. A positive response to the parathyroidectomy was observed in 98.43% (95% CI, 96.1–99.72%). Temporary hypercalcemia developed in 13.26% (95% CI, 9.41–18.35%). Revision surgery for persistent HPT or recurrence of HPT was necessary in 16 cases. Conclusion The combination of preoperative multimodal imaging and precise hyperparathyroidism diagnosis is essential for reducing the risk of unsuccessful localization in parathyroid surgery. Ultrasound and scintigraphy offers the most effective diagnostic method. Intraoperative neuromonitoring is recommended for revision surgeries.