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Viswanath S, Chisthi MM, Kuttanchettiyar KG. Post-thyroidectomy hypocalcemia: Pathophysiology, prevention, and management strategies for the head and neck surgeon. World J Transl Med 2026; 12(2): 118436 [DOI: 10.5528/wjtm.118436]
World J Transl Med. Jul 28, 2026; 12(2): 118436 Published online Jul 28, 2026. doi: 10.5528/wjtm.118436
Post-thyroidectomy hypocalcemia: Pathophysiology, prevention, and management strategies for the head and neck surgeon
Sindhu Viswanath, Meer M Chisthi, Krishnakumar G Kuttanchettiyar
Sindhu Viswanath, Department of Otorhinolaryngology, Government Medical College Trivandrum, Thiruvananthapuram 695011, Kerala, India
Meer M Chisthi, Krishnakumar G Kuttanchettiyar, Department of General Surgery, Government Medical College Kollam, Parippally 691574, Kerala, India
Author contributions: Viswanath S and Chisthi MM drafted the manuscript; Chisthi MM and Kuttanchettiyar KG acquired and analyzed the data; Viswanath S and Kuttanchettiyar KG vetted the manuscript; all authors approved the final version to be published and agreed to be accountable for all aspects of the work.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Sindhu Viswanath, MS, Professor, Department of Otorhinolaryngology, Government Medical College Trivandrum, Thiruvananthapuram 695011, Kerala, India. sindhuvn@gmail.com
Received: January 4, 2026 Revised: January 30, 2026 Accepted: March 4, 2026 Published online: July 28, 2026 Processing time: 209 Days and 10.4 Hours
Core Tip
Core Tip: Post-thyroidectomy hypocalcemia is common but largely preventable when surgeons deliberately integrate parathyroid preservation, preoperative optimization, and hormone-guided risk stratification into routine thyroid practice. A multimodal strategy that combines vitamin D and calcium supplementation in selected patients, meticulous identification and vascular preservation of all parathyroid glands with selective autotransplantation, and early postoperative parathyroid hormone (PTH) measurement to guide targeted supplementation allows safe early discharge for most patients while minimizing symptomatic hypocalcemia, emergency visits, and readmissions. Emerging optical and digital adjuncts, together with evolving PTH replacement therapies, offer additional opportunities for head and neck surgeons to individualize care and further reduce the burden of post-thyroidectomy hypoparathyroidism.
