Risk Factors and Prevention Strategies for Permanent Hypoparathyroidism after Total Thyroidectomy

Corresponding author: Guo Dan, 300356@hospital.cqmu.edu.cn

DOI: 10.12201/bmr.202605.00073

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  Abstract: Total thyroidectomy is an important treatment for differentiated thyroid carcinoma, multifocal thyroid diseases, Graves’ disease, and selected cases of large benign goiter. However, postoperative hypoparathyroidism remains one of the major complications affecting patients’ long-term quality of life. Compared with transient hypoparathyroidism, permanent postoperative hypoparathyroidism often requires long-term supplementation with calcium and active vitamin D, thereby imposing a sustained impact on patients’ quality of life. This review summarizes the evolution of the definition of permanent hypoparathyroidism from 6 months to 12 months after surgery, analyzes the risk factors for permanent hypoparathyroidism following total thyroidectomy, and discusses preventive and management strategies, including preoperative risk stratification, intraoperative in situ preservation of the parathyroid glands, auxiliary identification techniques, selective parathyroid autotransplantation, and early postoperative prediction and follow-up monitoring. This review aims to provide a reference for clinical risk assessment and targeted intervention.

  Key words: Total thyroidectomy; permanent hypoparathyroidism; risk factors; parathyroid preservation; prevention strategy

  Submit time: 21 May 2026

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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  1	2026-04-28	10.12201/bmr.202605.00073V1	Download

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