• Marco Bononi, Stefano Amore Bonapasta, Alessandra Vari, Massimo Scarpini, Alessandro De Cesare, Michelangelo Miccini, Massimo Meucci, and Adriano Tocchi.
• Department of Surgery Pietro Valdoni, University of Rome Sapienza, Rome, Italy.
• Head Neck. 2010 Sep 1;32(9):1173-7.

BackgroundCervical hematoma is hardly a predictable complication of thyroid surgery. Postoperative vomiting has been reported as a likely risk factor.MethodsFive hundred sixty-two patients undergoing thyroidectomy were prospectively enrolled in the study and divided into 2 groups. Patients in group A received ondansetron to prevent postoperative vomiting. In group B, patients with low vomiting risk received ondansetron whereas patients at high risk received ondansetron plus dexamethasone. Postoperative outcomes of the groups were analyzed and compared.ResultsCervical hematomas developed in 3 patients (0.53%): 2 in group A and 1 in group B. All hematomas occurred after 6 hours. The incidence of postoperative vomiting was 11.4% in group A and 6.4% in group B (p = .04).ConclusionCareful hemostasis remains of prime importance in preventing cervical hematoma. Postoperative vomiting has not been confirmed by this study as a risk factor for the development of hematoma. Ambulatory thyroid surgery is not advisable.

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