The Use of Dexamethasone in Total Thyroidectomy to Improve Voice Outcome and Hypocalcaemia

• Status: Not yet recruiting
• Trial end date: 2025-03-01
• Target enrollment: 0
• Participant gender: All

Summary

Thyroidectomy is a standard procedure for benign and malignant pathologies of the thyroid gland. Each year, some 100 total thyroidectomies are performed in Kowloon East Cluster, Hospital Authority, Hong Kong. Total thyroidectomy is associated with voice dysfunction and temporary hypocalcaemia in up to 80% and 50%, respectively. Previous study from our institute showed a 3% rate of permanent vocal cord palsy and 16% of permanent hypoparathyroidism requiring calcium and/or vitamin D supplements. The use of dexamethasone has been studied in the past in total thyroidectomy patients and has been shown to be safe and effective in improving post-operative nausea and vomiting. No complications or drug related side effects were associated with a single dose of steroid. Recent studies have also shown that Dexamethasone is effective in improving voice outcome and hypocalcaemia in thyroidectomy patients. The investigators aim to study the effect of Dexamethasone in post-operative voice outcome and hypocalcaemia. Objective assessment of the vocal cords during phonation will be performed pre-operative and post-operatively. Serum Calcium level will be monitored.

• Phase: Phase 2
• Accepts Healthy Volunteers?: Accepts Healthy Volunteers

Details

• Lead Sponsor: Tseung Kwan O Hospital, Hong Kong
• Collaborators: CHAN, Shun Yan, Consultant, Department of Surgery, Tseung Kwan O Hospital; CHAN, Ying Kuen Jason, Associate Professor, Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong; CHOW, Tam Lin, Chief of Service, Department of Surgery, United Christian Hospital; Esther POON, Department Manager of Speech Therapy Department, Kowloon East Cluster, Hospital Authority, Hong Kong; LIM, Huey Sing, Chief of Service, Department of Anaesthesiology and Pain Medicine, United Christian Hospital; TSE, Kin Chung, Consultant, Department of Anaesthesia & Operating Theatre Services, Tseung Kwan O Hospital
• Treatments: Dexamethasone

Criteria

Inclusion Criteria:

• Aged 18 or above

• Patients undergoing total thyroidectomy for benign pathologies

• MNG

• Toxic nodular goitre

• Graves' disease

Exclusion Criteria:

• Non-communicable patients

• Patients contraindicated for steroid (DM, Hepatitis carrier, Tuberculosis, peptic ulcer disease)

• Patients contraindicated for analgesics including Panadol, Celebrex, Tramadol or Levobupivacaine

• Malignant thyroid disease

• Patients with previous thyroid surgery, or neck surgery

• Pre-existing hoarseness of voice of any cause or pre-existing vocal cord palsy

• Pregnancy / Lactating female patients

• Pre-existing renal disease / autoimmune disease on steroids

• Patients who require steroid cover during operation e.g. hydrocortisone perioperatively