Neck pain after thyroid surgery, beware of three complications

Clinically, thyroid cancer is extremely harmful to the human body, and surgery is often used to treat it. Some patients will experience neck pain after the operation. In fact, improper operation may also cause the following complications.

1. Bleeding from wound

If there is swelling in the wound or excessive bleeding, surgery should be performed again to stop the bleeding.

2. Nerve damage:

Including recurrent laryngeal nerve and superior laryngeal nerve damage. (1) Recurrent laryngeal nerve damage: Recurrent laryngeal nerve damage is mainly caused by direct damage during surgery, such as cutting, suturing, contusion or excessive pulling. A small number of cases are caused by compression of hematoma or pulling of scar tissue. The former will show symptoms immediately during the operation, while the latter will show symptoms a few days after the operation. Cutting and suturing cause permanent damage; contusion, pulling or compression of hematoma are mostly temporary injuries, which can generally recover gradually within 3 to 6 months after treatment. Hoarseness caused by unilateral recurrent laryngeal nerve injury can be improved by excessively adducting the healthy vocal cord toward the affected side; bilateral recurrent laryngeal nerve injury will lead to bilateral vocal cord paralysis, causing aphonia or severe dyspnea, requiring tracheotomy. (2) Superior laryngeal nerve injury: This is usually caused by ligating and cutting the superior thyroid artery and vein, which is far from the upper pole of the thyroid gland and is not carefully separated, and a large bundle of surrounding tissue is ligated. External branch injury will paralyze the cricothyroid muscle, causing vocal cord relaxation and a lower pitch. Damage to the internal branches can cause loss of sensation in the laryngeal mucosa, making it easy to swallow incorrectly and cough when drinking water. Generally, the condition can be cured on its own after treatment.

3. Hand and foot convulsions

It is caused by the parathyroid gland being missected or insufficient blood supply. The blood calcium level drops below 2.0mmol/L. In mild cases, the face, lips, hands and feet become numb, and in severe cases, the limbs become convulsed. Prevention should emphasize the protection of the parathyroid gland safety area during surgery to avoid missected parathyroid gland or loss of blood supply. Treatment: Oral calcium can be taken for mild symptoms. In severe cases, 10% calcium gluconate 10-20ml is injected intravenously during attacks; oral dihydrotachysterol has a better long-term effect. When permanent parathyroid damage cannot be improved by calcium supplementation and limb convulsions, fetal vascularized thyroid-parathyroid transplantation to the inguinal area can be considered, which can have a good effect.