Calcium Conundrums (2022 AMW)
2022 AAO-HNSF Annual Meeting & OTO Experience
Hyper- and hypo-calcemia are common problems encountered by otolaryngologists in the academic and private practice setting. Hyperparathyroidism is the most common cause of hypercalcemia in the outpatient setting, but there are other less common causes that should be considered in the differential diagnosis particularly because of the importance in avoiding parathyroid surgery in patients with hypercalcemia due to other causes. Meanwhile, hypocalcemia is the most common complication after total or completion thyroidectomy. Permanent hypocalcemia has been reported to occur in up to 3% and temporary hypocalcemia in up to 50% of patients. Young women are much more likely to undergo thyroid surgery compared to men and hypocalcemia/hypoparathyroidism may have an adverse long term impact on bone health. An understanding of how to prevent and manage this complication is imperative for any surgeon performing thyroid surgery. The purpose of this session is to provide a comprehensive discussion of calcium management. Calcium metabolism will be reviewed and the appropriate evaluation of a patient with hypercalcemia will be discussed. Multiple case presentations (hyperparathyroidism as well as the uncommon causes) will be used to illustrate the pearls and pitfalls of hypercalcemia evaluation and treatment and parathyroid surgery (primary and re-operative). This program was well received at the 2021 meeting. The primary change in the presentation if accepted for 2022 will be to discuss hypocalcemia in greater detail and highlight this via case presentation. Techniques for the identification and intraoperative preservation of parathyroid glands will be discussed and postoperative calcium management options including empiric treatment with calcium regimens versus selective treatment based on parathyroid hormone, vitamin D levels, calcium levels, and other parameters will be reviewed. Guidelines from the American Head and Neck Society on this topic will be presented.
Credits
CME:1.0, MOC:1.0