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Thyroid surgery rates have tripled in the last three decades. In most thyroid pathology, surgical treatment is the definitive treatment. The three most frequent complications after thyroid surgery are: neck hematoma, recurrent laryngeal nerve paralysis and hypocalcemia due to hypoparathyroidism. Neck hematoma: – Low incidence, but it is the most severe complication. – Most cases occur within the first 24 hours after surgery. – Prevention: use of energy devices and Valsalva maneuver 🡪 help making correct hemostasis. – Leaving a drain has not been shown to prevent neck hematomas. Hypoparathyroidism: – The most frequent complication. – It can be transitory (in most cases) or permanent. – The identification of a minimum of two parathyroid glands during surgery is recommended. Recurrent laryngeal nerve paralysis: – Less frequent. – Risk factors: bilateral thyroidectomy, reintervention and malignant pathology. – Unilateral paralysis: dysphonia, dysphagia and breathing difficulty. – Bilateral lesions can cause an acute airway obstruction medical emergency! – Nerve function can be recovered (especially in unilateral lesions).