الفهرس 
Anatomical considerationsOnly 14 pages are availabe for public view
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Abstract
45.
ENGLISH SU!.~l!ARY
By far, tl-Jemost common cause of hypoparathyroidism
is the postoperative type. The cause behind the latter
is mainly due to interference with the blood supply of
t”e Idands rather than inadvertent removal of the glands.
This is because parathyroids are vul.ne r-abLe to infarction
as each gland is suP?lied by a single artery which is
not cornmunLcat Lng with vessels outside the capsule of the [;lan:l•
The traumatic hypoparathyroidism is of primary concern
to surgeons who perform total thyroidectomy for cancer
thyroid as such extensive operation imply much dissection
and manipulation not only on the thyroid but also on
cervical lymph nodes especially those lying in tracheooesophageal
groove which is a dangerous site for injury
of parathyroids. The incidence of postoperative hypoparathyroidism
after extensive radical thyroidectomies increased steadily
(up to 40 percent as shown by Beahrs in 1969). However,
more recent studies revealed a revolutionary DROP in the
incidence to 2 percent. (Thompson,197)}. This achievement
is attributed to strict measures adopted iE the identification
and preservation of the glands as well as meticulous operative
techniques to prevent interference with blood supply of the
e;lands.
46.
Diagnosis and early detection of hypoparathyroidi~m
depends mainly on clinical as well as investigatory aids.
It is not justified to diagnose this condition on clinical
grounds only.
THE An~ OF TREATMENT is to keep serum cacium level
at the low side of normal by oral calcium and vitamin
D supplementation as hypocalcemia is the most potent
stimulus for the recovery of parathyroid function.
from time to time it is wise to interrupt the course of
therapy to test for the return back of parathyroid function.
If, for the sake of radicality parathyroid glands,
as recognised during total thyroidectomy for cancer,
have to be remover, auto-transplantation of the removed
glands is the only solution. The glands can be reimplanted
into the sternomastoid muscle as the vascularity of muscular
tissue is usually adeq~te for their survival.