Evaluation of Postoperative Complications

All patients were clinically evaluated for signs and symptoms of hypocalcemia after surgery. Hypoparathyroidism was classified as either temporary or permanent: temporary hypoparathyroidism was defined as a parathyroid hormone (PTH) level that could not recover above 10 IU/ml until postoperative 1 month or the need for calcium due to persistent hypocalcemia symptoms; permanent hypoparathyroidism was defined as a PTH level that could not reach above 10 IU/ml until postoperative 1 year or persistent hypocalcemia symptoms. Patients who developed hypocalcemia were given oral calcium with active vitamin D replacement. Follow-up data on parathyroid function (serum ionized, total calcium, and intact PTH) were obtained.

The mobility of the vocal fold was examined after surgery at each follow-up using a flexible fiberscope to check for recurrent laryngeal nerve injury.