Grave’s disease/hyperparathyroidism

Thyroid surgery for Grave’s disease is more complicated and must be handled properly for good results.  In Grave’s disease, the gland is typically much more vascular and is frequently partially scarred from chronic inflammation.

Risks of bleeding, metabolic fluctuations and calcium fluctuations are higher with Grave’s disease.  These risks can be dramatically decreased with proper management.

To reduce the vascular and metabolic activity of the gland, patients are treated with a 10-day course of high-dose iodine drops in the days prior to surgery.  During the operation, blood pressure and heart rate are meticulously monitored and controlled with medications. In patients who have significant hyperthyroidism, post-operative monitoring in an ICU setting will be done.

Thyroid Storm—an exuberant post-operative hypermetabolic response—can occur following surgery for hyperthyroidism. However, with modern peri-operative management strategies, this very rarely occurs.