Delayed-onset vocal cord palsy after thyroidectomy occurring despite normal initial post-operative endoscopy.

Background: Recurrent laryngeal nerve (RLN) injury is a known complication of thyroidectomy. Most cases manifest immediately and are promptly recognized. Rarely, some patients experience delayed-onset vocal cord palsy.

Thyroid cartilage needle vs. endotracheal tube electrodes in EBSLN monitoring during thyroidectomy.

During thyroidectomy, both needle electrodes (NE) and endotracheal tube electrodes (ETE) can be used. Incomplete contact of the endotracheal tube electrode with the vocal cords, endotracheal tube electrode may hinder an optimal outcome and even result in an inability to obtain an electromyography wave while neuromonitoring the external branch of the superior laryngeal nerve (EBSLN). There is no study that compares NE and ETE for EBSLN monitoring.

Anterior Pituitary Dysfunction After Traumatic Brain Injury: A Prospective Study.

Objective: Anterior pituitary dysfunction is one of the major causes of disability and morbidity in patients suffering from traumatic brain injury (TBI). The present study was undertaken to evaluate the incidence of anterior pituitary dysfunction in cases of moderate and severe TBI, its value in long-term prognostication, and the factors that predispose to a higher incidence of anterior pituitary dysfunction in acute and chronic phases.

Methods: This was a prospective cohort study wherein 216 patients with moderate and severe TBI were evaluated within 72 hours of TBI (acute phase) and at 6 months (chronic phase).

Shaping the curve from the microscopic transsphenoidal to the endoscopic endonasal approach for the sellar region.

Objective: This study aimed to investigate the limitations, barriers, and complications in the early transition from the microscopic transsphenoidal approach (MTA) to the endonasal endoscopic approach (EEA) to the skull base in our institution.

Methods: Technical challenges, as well as clinical features and complications, were compared between MTA, EEA, and mixed cases during the early surgical curve.

Results: The period from the early learning curve was 1 year until the EEA protocol was used routinely.

Incidence of Post-Thyroidectomy Hypoparathyroidism and Associated Preoperative and Intraoperative Risk Factors.

Introduction: Thyroidectomy technique and extent are related to parathyroid injury and hypoparathyroidism. Total thyroidectomy is one of the most commonly performed endocrine surgeries, and the majority of patients recover completely without any complications. However, persistent hypoparathyroidism is the most prevalent long-term consequence following total thyroidectomy.

Protocol-Based Standardized Endocrinological Evaluation of Children With Traumatic Brain Injury: A Quality Improvement Initiative.

Introduction: Traumatic brain injury (TBI) can disrupt the hypothalamo-pituitary axis, causing neuroendocrine dysfunction. As a third of children can develop post-traumatic hypothalamo-pituitary axis dysfunction (HPAD), a longitudinal follow-up is required in children with TBI.

Method: The study comprised a pre-quality improvement (QI) phase (baseline phase) and a QI phase (post-intervention phase).

Impact of the severity of brain injury on secondary adrenal insufficiency in traumatic brain injury patients and the influence of HPA axis dysfunction on prognosis.

Objective: To investigate secondary adrenal insufficiency post varying traumatic brain injuries' and its impact on prognosis.

Methods: 120 traumatic brain injury patients were categorized into mild, moderate and severe groups based on Glasgow Coma Scale. Adrenal function was evaluated through testing.

Vocal Cord Monitoring by Flexible Fiberoptic Laryngoscopy During Thyroid Radiofrequency Ablation.

Thermal injury to recurrent laryngeal nerve (RLN) during radiofrequency ablation (RFA) can produce temporary or permanent vocal cord paralysis. Hydrodissection with cold 5% glucose of "danger triangle" protects RLN during RFA. When RFA is performed under local anesthesia, RLN function is monitored by patients producing vocal sounds.

Unusual and lesser-known rare causes of adult growth hormone deficiency.

Growth hormone is among the most common hormones to be deficient in pituitary insult. It can occur either in isolation or combined with other hormone deficiencies. Growth hormone deficiency in adults (AGHD) can be due to causes acquired in adulthood or have a childhood-onset etiology, but the former is about three times more common.

Endocrine Abnormalities in Children With Traumatic Brain Injury at a Tertiary Care Center.

Objective Accidental traumatic brain injury (TBI) can lead to severe complications such as endocrine abnormalities and long-term morbidities and can negatively impact patient lives. These conditions are also associated with a high cost of treatment over a lifetime, a significant concern in low-to-middle-income countries (LMICs). In Pakistan, the prevalence of children with endocrine abnormalities secondary to TBI remains largely unexplored.

Pituitary enlargement in patients with cerebrospinal fluid drainage due to ventricular shunt insertion: know the condition and do not mistake for adenoma.

Objective: Childhood hydrocephalus patients treated by ventriculo-peritoneal (v.-p.) shunting are sometimes referred years after this therapy for evaluation of suspicious pituitary enlargement.

Approach to the Patient: A Case With an Unusual Cause of Hypopituitarism.

Hypopituitarism, which refers to insufficiency of one or more hormones of the pituitary, can be due to myriad causes. The clinical and radiological spectrum of the condition is heterogeneous, based on the patient's age, gender, clinical setting, and/or other past medical history. Hypopituitarism includes central hypocortisolism, hypothyroidism, hypogonadism, and growth hormone deficiency.

Alcohol consumption affects the late endocrine consequences of mild traumatic brain injury.

Background: Currently there are no widely applied methods which could identify, at the time of head trauma, those mild traumatic brain injury (mTBI) patients who later develop pituitary dysfunction. The effect of alcohol consumption on post-TBI endocrine dysfunction is unclear.

Methods: Five hundred and eight TBI patients, 406 of them with mTBI, were studied.

Clinical application of endoscopic surgery using a gasless unilateral transaxillary approach in the treatment of primary hyperparathyroidism.

Objectives: To investigate the safety and feasibility of gasless axillary parathyroid surgery in the treatment of primary hyperparathyroidism.

Methods: A total of 12 patients who received gasless axillary parathyroidectomy (endoscope group) and 14 patients who received traditional open parathyroidectomy (open group) from January 2019 to April 2022 were screened and included. The differences in baseline characteristics, surgical efficiency, incidence rate of complications, changes in biochemical indicators, and incision satisfaction between the two groups were analyzed and compared.

Saliva Cortisol as a Biomarker of Injury in Youth Sport-Related Concussion.

Increasing rates of sport-related concussion (SRC) in youth impose a significant burden on public health systems and the lives of young athletes. Accurate prediction for those likely to develop persistent post-concussion symptomology (PPCS) using a fluid biomarker, reflecting both acute injury and recovery processes, would provide the opportunity for early intervention. Cortisol, a stress hormone released through the hypothalamic-pituitary-adrenal (HPA) axis following injury, may provide a missing physiological link to clinical recovery.

Improving Voice Outcomes after Thyroid Surgery and Ultrasound-Guided Ablation Procedures.

The field of endocrine surgery has expanded from the traditional open neck approach to include remote access techniques as well as minimally invasive approaches for benign and malignant thyroid nodules. In experienced hands and with careful patient selection, each approach is considered safe, however complications can and do exist. Post-operative dysphonia can have serious consequences to the patient by affecting quality of life and ability to function at work and in daily life.

Association of Traumatic Brain Injury With the Risk of Developing Chronic Cardiovascular, Endocrine, Neurological, and Psychiatric Disorders.

Importance: Increased risk of neurological and psychiatric conditions after traumatic brain injury (TBI) is well-defined. However, cardiovascular and endocrine comorbidity risk after TBI in individuals without these comorbidities and associations with post-TBI mortality have received little attention.

Objective: To assess the incidence of cardiovascular, endocrine, neurological, and psychiatric comorbidities in patients with mild TBI (mTBI) or moderate to severe TBI (msTBI) and analyze associations between post-TBI comorbidities and mortality.

Diagnosis and surgical repair of delayed tracheal perforation post thyroidectomy in context of previous cranio-spinal radiotherapy - A case report.

Introduction And Importance: This is the first case of delayed tracheal perforation post total thyroidectomy in the context of previous radiotherapy to the neck. Such a presentation can be easily misdiagnosed and managed as a seroma at significant risk to the patient, as the latter had no precipitating factors and cardiorespiratory compromise. There are nineteen previously described cases of delayed tracheal injury post thyroidectomy of variable severity and variable intervention.

Routine Exposure Versus Non-Exposure of Recurrent Laryngeal Nerve during Thyroid Surgery: Our Experience of 300 Cases.

The technique of thyroidectomy has been in evolution for many years. It is a basic rule of surgery that an important structure of a human body must be recognized certainly during the surgical procedure in order to prevent its damage. The purpose of this study was to evaluate our routine identification and without identification of recurrent laryngeal nerve during thyroidectomy aiming to lessen the inadvertent injury of the recurrent laryngeal nerve.

Effect of surgeon volume on pediatric thyroid surgery outcomes: A systematic review.

Background: Pediatric thyroidectomy has been identified as a surgical procedure that may benefit from concentrating cases to high-volume surgeons. This systematic review aimed to address the definition of "high-volume surgeon" for pediatric thyroidectomy and to examine the relationship between surgeon volume and outcomes.

Methods: PubMed, Embase, Cochrane Library, Scopus, Web of Science, ClinicalTrials.

Improving Voice Outcomes After Thyroid Surgery - Review of Safety Parameters for Using Energy-Based Devices Near the Recurrent Laryngeal Nerve.

Technological advances in thyroid surgery have rapidly increased in recent decades. Specifically, recently developed energy-based devices (EBDs) enable simultaneous dissection and sealing tissue. EBDs have many advantages in thyroid surgery, such as reduced blood loss, lower rate of post-operative hypocalcemia, and shorter operation time.