How to minimize complications in thyroid surgery?

Background: in ancient times, operations on the thyroid gland caused unacceptable morbidity and mortality. Only after the landmark work of Kocher, the technical principles of thyroidectomy were solidly established, and are still valid nowadays.Methods: Revision article on practical suggestions to decrease morbidity associated with thyroidectomy, as well as warning against common pitfalls that the surgeon may encounter.Results: the following subjects are objectively addressed: how to manage upper airway obstruction, how to avoid non-esthetic scars and how to recognize the most prevalent anatomic variations concerning the recurrent nerve, the external branch of the superior laryngeal nerve and the parathyroid glands, in order to decrease operative morbidity.Conclusion: the Head and Neck Surgeon must be fully aware of the complex anatomy of the central visceral compartment of the neck, as well as must be prepared to handle some complications of thyroidectomy that can be life-threatening. (C) 2009 Elsevier Ireland Ltd. All rights reserved.Univ São Paulo, Dept Head & Neck Surg, Sch Med, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Head & Neck Surg, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Head & Neck Surg, São Paulo, BrazilWeb of Scienc