Overview
Clinical Frame
Tingling around the mouth or fingertips after thyroid or neck surgery may be the first visible sign of falling calcium, not an incidental postoperative complaint.
Tingling around the mouth or fingertips after thyroid or neck surgery may be the first visible sign of falling calcium, not an incidental postoperative complaint. The immediate question is whether hypocalcemia is producing neuromuscular irritability, airway compromise, seizures, or ECG changes. The diagnostic question is different: does the parathyroid gland show an appropriate PTH response to low calcium? In hypoparathyroidism, PTH is absent or inappropriately low, so calcium falls while phosphate rises. Keep those two decisions linked but separate: stabilize dangerous hypocalcemia first, then establish the cause and whether the postsurgical problem is transient or chronic.