Background:
Total thyroidectomy has been accepted as current surgical therapy for benign and malignant thyroidal disorders but extensive resection might increase the risk of postoperative complications.
Intensive effort should be spent to prevent recurrent laryngeal nerve injury and hypoparathyroidism, because they can be avoided with appropriate surgical technique during total thyroidectomy. The authors proposed that the use of a loupe for operative field magnification could improve the outcome of total thyroidectomy as regard to identification of both the recurrent laryngeal nerves and the parathyroids.

Material and Methods:
Patients were subjected to total thyroidectomy with loupe magnification in group A and without loupe in group B. The status of vocal cords of all patients was checked postoperatively by laryngoscope. Serum calcium concentration immediately postoperatively and during follow-up was checked.

Result:
Loupe magnification helps identification of external branch of superior laryngeal nerve and parathyroid
preservation.

Conclusion:
Total thyroidectomy by loupe magnification is feasible, improves the outcome, and should be done by experienced surgeon.