Novel Markers of Myocardial Recovery in Patients with Durable Left Ventricular Assist Device (dVAD)

Utilizing Inflow Cannula Angle to Identify Myocardial Recovery in Patients Receiving Left Ventricular Assist Devices

Background and ObjectivesTo investigate the impact of pathogenic bacterial distribution in the nasal cavity on postoperative nasal function recovery in patients with chronic rhinosinusitis with nasal polyps (CRSwNP) after endoscopic sinus surgery (ESS), and to analyze the risk factors for postoperative recurrence.MethodsA total of 178 CRSwNP patients who underwent ESS in our hospital from May 2021 to May 2023 were selected. Based on preoperative nasal secretion pathogen culture results, patients were categorized into the pathogen-negative group (42 cases), bacterial-positive group (90 cases), and fungal-positive group (46 cases). The nasal symptom visual analogue scale (VAS) score, Lund-Kennedy endoscopic score, and Lund-Mackay computed tomography (CT) score were assessed preoperatively and at 12 weeks postoperatively. Patients were followed up for 24 months and categorized into the recurrence group (36 cases) and the recurrence-free group (142 cases) based on postoperative recurrence. Relevant risk factors for recurrence were analyzed.ResultsAmong the 178 patients, the bacterial positivity rate was 50.56% (mainly Corynebacterium, Staphylococcus, and Haemophilus influenzae), while the fungal positivity rate was 25.84% (mainly Candida albicans and Aspergillus). Postoperatively, the nasal symptom VAS scores for individual items, Lund-Kennedy endoscopic scores, and Lund-Mackay CT scores showed significant improvement compared to preoperative values (P < 0.05). Comparisons among the 3 groups revealed a trend of pathogen-negative group < bacterial-positive group < fungal-positive group in nasal symptom VAS scores, Lund-Kennedy endoscopic scores, and Lund-Mackay CT scores, with significant differences observed between each pair of groups (P < 0.05). Univariate analysis showed that the proportions of asthma, history of revision surgery, eosinophilic (EOS)-type nasal polyps, and preoperative Lund-Mackay CT scores were all higher in the recurrence group than in the recurrence-free group (P < 0.05). Multivariate analysis identified history of revision surgery (OR = 6.963, 95% CI: 2.275-21.313), EOS-type nasal polyps (OR = 4.566, 95% CI: 1.449-14.392), and high preoperative Lund-Mackay CT scores (OR = 1.928, 95% CI: 1.475-2.522) as independent risk factors for postoperative recurrence (P < 0.05). Corynebacterium infection might reduce the risk of recurrence (P = 0.065).ConclusionNasal bacterial and fungal colonization in patients with CRSwNP are associated with poor postoperative nasal function recovery, with fungal colonization leading to the worst prognosis. Postoperative recurrence is closely related to EOS-type nasal polyps, a history of previous surgery, and a high preoperative Lund-Mackay CT score. Corynebacterium may serve as a protective microbial population.

Frozen shoulder is a common disorder causing pain, stiffness, disability, and sleep disturbance. While often linked to psychological comorbidities, the impact of preoperative mental health and insomnia on recovery outcomes remains unclear. The purpose of this study was to investigate the effects of preoperative anxiety, depression, and insomnia on postoperative recovery in patients undergoing manipulation under anesthesia (MUA) for frozen shoulder. This study was a secondary analysis of a prospective observational cohort study. A total of 197 patients with primary frozen shoulder were enrolled and treated with MUA. Preoperatively, the Insomnia Severity Index (ISI) and Hospital Anxiety and Depression Scale (HADS) classified patients: 33 with clinical insomnia (ISI≥15) and 45 with psychological distress (PD, including anxiety or depression, HADS anxiety ≥8 and depression ≥8). Shoulder passive range of motion (ROM), pain (visual analog scale, VAS), and functional scores (Constant-Murley Score [CMS], Oxford Shoulder Score [OSS]) were assessed at 3 and 6months postoperatively. Outcomes were compared between patients with/without insomnia or PD. To control for multiple comparisons, all p-values were adjusted using the False Discovery Rate (FDR) method. In the insomnia analysis, the insomnia group had a significantly lower proportion of male patients (12.1% vs. 28.7%, p=0.048) and a lower mean BMI (22.0±2.4 vs. 23.0±2.7, p=0.033) compared to the group without insomnia. Furthermore, baseline abduction was significantly more restricted in the insomnia group (67.2°±21.9 vs. 81.8°±24.8, p=0.001) and OSS was significantly worse (38.5±8.1 vs. 32.6±5.5, p<0.001). Preoperative PD was more common in right-side cases (60.0% vs. 42.8%, p=0.042) and was associated with worse baseline external rotation. Following MUA, all patient groups achieved substantial clinical improvement. At 3 and 6months postoperatively, after FDR adjustment, there were no statistically significant or clinically meaningful differences in ROM, VAS, CMS, or OSS between patients with and without insomnia, nor between patients with and without PD. All observed mean differences between groups were small and fell well below established minimal clinically important difference (MCID) thresholds (e.g.,at 6months, CMS mean difference between PD and no PD was 1.84 [95% CI -0.92 to 4.60]; adjusted p=0.796). Although preoperative clinical insomnia and PD are associated with worse baseline pain and functional presentation, they were not associated with poorer postoperative recovery following MUA in this cohort. At the 3 and 6months postoperative follow-ups, there were no statistical differences in pain or ROM between patients with and without these preoperative conditions.

Nursing care in a patient with ischemic stroke undergoing endovascular thrombectomy: A case report

Preoperative rehabilitation is one of the strategies for enhanced recovery after surgery (ERAS) following total knee arthroplasty (TKA), but the optimal duration remains inconclusive. This study aims to evaluate the impact of a 4-week home-based prehabilitation program on accelerating postoperative recovery in patients undergoing TKA. In this retrospective cohort analysis, 176 patients undergoing primary unilateral TKA were categorized into two groups: those who completed a 4-week home-based prehabilitation program (training group, n = 72) and those who did not (control group, n = 104). Baseline demographics, perioperative data, pain scores, and functional outcomes were collected. Patients were followed for over 1year. The primary outcome was the Western Ontario and McMaster Universities Arthritis Index (WOMAC), and secondary outcomes included visual analog scale (VAS), knee range of motion (ROM), Knee Society Score (KSS), timed up-and-go (TUG) test, and stair climbing test. Assessments were performed at baseline, before surgery, and multiple time points after TKA. Baseline characteristics were comparable between groups. The training group demonstrated significantly earlier first postoperative ambulation (median 9 versus 12h, P = 0.003) and shorter hospital stays (median 7 versus 10days, P = 0.002). Pain scores (VAS) were significantly lower in the training group at 1day and 1week postoperatively (P < 0.05). Functional outcomes including ROM, KSS, TUG, and stair test were superior in the training group at 1 and 3months (P < 0.05). WOMAC total scores and its subscales (pain, stiffness, function) also showed significant improvements in the Training group at 1 and 3months (P < 0.05). While advantages in ROM and TUG persisted up to 6months, no significant between-group differences were observed at 12months for any outcome measure. A 4-week home-based prehabilitation program significantly enhances early recovery after TKA, as evidenced by reduced hospital stay, lower early postoperative pain, and improved functional outcomes within the first 3months. Although benefits in certain functional measures persist up to 6months, outcomes converge by 12months. These findings support the integration of structured 4-week home-based prehabilitation program into ERAS pathways.

Children who suffer cardiac arrest are at risk of mortality and morbidity, with survivors often experiencing a severe decline in neurobehavioral function. Despite challenges in neuroprognostication, providers frequently make predictions regarding patient recovery that influence outcomes. We aimed to determine the clinical factors providers report using in real time to predict patient survival and neurologic outcomes at discharge, and how these factors differ by provider and patient characteristics, and time from arrest. Single center prospective observational study. The Children's Hospital of Philadelphia PICU over 12 months, 2023-2024. Children resuscitated from in-hospital cardiac arrest and out-of-hospital cardiac arrest (OHCA) who received post-arrest care in the PICU. Multidisciplinary providers of post-cardiac arrest patients. None. Multidisciplinary team members completed questionnaires on post-arrest days 1, 2, 3, and 7, eliciting demographic data and factors used to form their prediction. Descriptive statistics summarized patient characteristics, provider demographics, and survey data. Mixed-effect models explored changes in factors used for the prediction of patient discharge outcome over survey time points, as well as differences by provider and patient characteristics. Overall, 64 patients (median age, 4.1 yr [interquartile range, 1.2-9.4 yr]; 60% OHCA; and 55% pre-arrest Pediatric Cerebral Performance Category = 1) were analyzed. Five hundred forty-eight questionnaires were completed by 245 unique providers. Across all time points, baseline neurologic function and clinical neurologic examination were the most frequently reported factors used to inform prognosis. Use of intra-arrest factors decreased, while reliance on neuromonitoring and neuroimaging increased over time. Factor use varied by provider discipline and patient and arrest characteristics. Prognostic predictions after pediatric cardiac arrest were dynamic and influenced by both patient characteristics and provider discipline. Future efforts should aim to understand how the integration of patient data impacts prognostic accuracy and clarify how prognostic impressions shape communication and decision-making with caregivers.

Postoperative follow-up is critical in patient recovery, complication detection, and optimizing patient outcomes. Although traditionally, in-office postoperative visits have been the standard of care, remote postoperative follow-up via telehealth has emerged as a comparable alternative. The objective was to systematically review the literature comparing in-office and remote (telehealth visits, phone calls, or apps) postoperative follow-up after urogynecologic surgery to assess the effect on patient satisfaction, health care utilization, and adverse events. MEDLINE, CINAHL, Scopus, and ClinicalTrials.gov were searched through January 14, 2025. The population comprised women undergoing urogynecologic surgery, comparing remote follow-up methods with standard in-office visits. Outcomes assessed were patient satisfaction, health care utilization (unscheduled visits, patient-initiated calls, emergency department visits), and adverse events (eg, mesh complications, urinary retention, urinary tract infections). Abstracts and full-text articles were doubly screened and doubly extracted, with study quality graded using GRADE criteria and Cochrane risk of bias assessments. Meta-analyses were conducted for pooled proportions and mean ratios. Of 1,082 abstracts screened, 9 studies (5 randomized controlled trials, 4 retrospective studies) involving 1,270 patients were included, with 490 patients receiving remote visits and 333 receiving in-office visits. Evidence quality ranged from moderate to high. In the meta-analysis, in-office and remote follow-up had comparable patient satisfaction (89% vs 78%, P =0.30), with no significant mean difference in patient satisfaction scores (mean difference: 0, P =0.70). No difference in health care utilization metrics or adverse events (15% vs 12%, P =0.664) was found. Remote postoperative follow-up after urogynecologic surgery demonstrated no significant differences from in-office visits regarding patient satisfaction, health care utilization, or adverse events, supporting telehealth as an effective alternative to in-office visits.

Dexterous hand motor functions are highly flexible and finely controlled by complex neural commands from the motor cortex. However, in patients with brain injuries such as stroke, restoring fine motor control from the perilesional cortex remains extremely challenging. A major obstacle is the absence of appropriate non-human primate models to elucidate the behavioral and neural signatures of hand motor function during recovery following treatments. Here, we present a new non-human primate model that reflects the motor function recovery processes following lesion-induced hand paralysis after contralateral C7 nerve transfer (CC7) surgery, which establishes a new neural pathway from the ipsilateral cortex to control the paralyzed hand. By developing a hand reach-to-pinch task and quantifying finger kinematics, we established systematic, objective profiles of fine motor recovery in human patients and monkey models following CC7 treatment. Furthermore, when considering behavioral aspects, spontaneous recovery of hand motor skills was notably limited in human patients and monkey models, as indicated by the consistently abnormal "thumb-in-palm" patterns observed in finger kinematic analysis. However, the CC7 surgery gradually restored the finger kinematic patterns during hand-pinch actions to nearly identical patterns to those of the healthy hand. In addition, the human functional MRI and macaque electrophysiology results revealed, on a neural level, the emergence of a new command area and its spiking-based motor-command refinements specifically for the paralyzed hand in the contralesional M1 and premotor cortex (PMC) after CC7 treatment. Thus, our findings strongly support the notion that modifying peripheral nerve pathways greatly promotes the recovery of dexterous motor function in a paralyzed hand by reconstructing new motor-control neural mechanisms within the ipsilateral healthy motor cortex.

Chronic Lower Extremity Wounds: Updates on Lower Extremity Reconstruction in Clinics in Plastic Surgery.

Predictive Factors for Renal Recovery or End-Stage Renal Disease Post-Heart Transplantation for Patients with Chronic Kidney Disease at Transplant

Facelift surgery is a cornerstone of facial rejuvenation, yet the optimal technique remains debated. This prospective cohort study compared outcomes and complication rates between the deep plane and superficial musculoaponeurotic system (SMAS) plication facelift techniques. A total of 166 patients undergoing primary facelift surgery by a single surgeon between January 2019 and December 2024 were prospectively enrolled. Patients were allocated to the deep plane (n = 45, 27.1%) or SMAS plication (n = 121, 72.9%) groups. Data collected included demographics, operative characteristics, aesthetic outcomes, patient satisfaction, recovery duration, and complications. The median patient age was 49years (IQR 42.7-56), with most being female (95.2%) and overweight (46%). Baseline characteristics were comparable between groups. Facial rejuvenation was rated as excellent in 70.5% of SMAS cases versus 29.5% of deep plane cases (p = 0.67). Patient satisfaction was high in both groups (p = 0.09), and recovery duration was similar (median 25.5 vs. 30days, p = 0.65). Overall complication rates did not differ significantly (21.6% vs. 28.7%, p = 0.39), including transient facial nerve weakness (11.1% vs. 12.4%, p = 0.70). Concurrent ancillary procedures were similarly distributed between groups (93.3% vs. 95.9%, p = 0.79). Logistic regression identified no significant predictors of outcome or interaction effects. Deep plane and SMAS plication facelifts demonstrated comparable early postoperative outcomes with no significant differences in patient satisfaction, rejuvenation ratings, recovery, or complication rates within a median follow-up of three months. These findings should be interpreted in the context of short-term follow-up, unequal group sizes, and the absence of validated outcome instruments. Both techniques appear safe and effective in the early postoperative period, with results largely influenced by surgical expertise and patient selection rather than technique alone LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Effective pain management is essential in pediatric orthopaedic procedures to ensure optimal patient outcomes and recovery. Although opioids are an important component of pain control, their misuse remains a notable public health concern. Pediatric patients often encounter opioids for the first time after orthopaedic procedures, underscoring the need for stringent prescribing protocols. The Pediatric Orthopaedic Society of North America guidelines provide a comprehensive framework for tailoring pain management to procedure intensity. Despite their potential, implementation challenges and variability persist. This review examines the Pediatric Orthopaedic Society of North America guidelines, barriers to adoption, and opportunities to optimize postoperative pain management while mitigating risks. Future research and guideline evolution are necessary to uphold patient safety and combat the opioid crisis.

Simultaneous bilateral total knee arthroplasty (BTKA) is avoided due to higher perioperative risk, favoring staged procedures. This study evaluated how the interval between staged TKAs affects patient-reported outcome measures (PROMs) and compared complications between the first and second procedures. We retrospectively reviewed patients undergoing primary, elective, staged, BTKAs at a high-volume academic center between 2011 and 2024. Intra- and perioperative data and complications were compared between the surgeries. Patients were stratified by interval: less than three months ("extremely short waiters"), three to six months, six to nine months, nine to 12 months, one to two years, two to five years, and greater than five years. The PROMs were compared across these groups. A total of 4,210 patients underwent 8,420 staged, BTKAs at a mean 21.4-month interval. The most common intervals were six to nine months (27.4%) and nine to 12 months (21.1%). Patients were more likely to return to the emergency department (22 versus 16, P = 0.030) and be readmitted (48 versus 26, P = 0.113) after the second surgery, primarily due to infection. Revision rates did not differ. "Extremely short waiters" had the greatest improvement in Patient-Reported Outcomes Measurements Information System Pain Intensity and interference scores nine months after the second TKA (change 13.4 and 15.1, P < 0.001). At three months following the second surgery, those who waited three to six months had the largest Knee Injury and Osteoarthritis Outcome Score for Joint Replacement score improvement (change 23.7, P = 0.004). At one year after the second surgery, "extremely short waiters" again showed the greatest reduction in Patient-Reported Outcomes Measurements Information System Pain Intensity (change 10.5, P = 0.007) and Interference (change 11.3, P < 0.001). The interval between surgeries significantly impacted PROMs, with shorter intervals associated with better pain relief and functional recovery. Surgical timing should be tailored to individual patient goals and recovery trajectories.

Blood Flow Restriction Therapy for the Upper Extremity: An Emerging Adjunct for Patient Recovery and Rehabilitation.

From the first aortic valve replacement (AVR) in 1960, surgical approaches evolved toward reduction of surgical invasiveness and enhanced recovery. Conventional minimally invasive approaches still require postoperative opioid use and chest restrictions. To further minimize aortic valve surgery, a robotic technique for transcervical AVR (TC-AVR) was developed to avoid major chest wall incisions and to facilitate expedited recovery. Following extensive cadaver simulations, the TC-AVR was performed in 7 patients between March and July 2025. The procedure includes cervical incision, similar to a thyroidectomy approach, representing a working port for robotic AVR. Cardiopulmonary bypass is established with femoral cannulation. After native valve excision, a conventional prosthetic valve is implanted with a running suture technique. Patients (mean age, 66 ± 8 years; 71% male) presented mostly with severe aortic stenosis, whereas a bicuspid aortic valve was present in 57%. Mean aortic cross-clamp and cardiopulmonary bypass times were 118 and 218 minutes, respectively, with reductions observed in later cases. There was no postimplantation aortic regurgitation, and intraoperative peak and mean gradients were 10 ± 5 mm Hg and 5 ± 2 mm Hg, respectively. There were no deaths. Postoperatively, no opioids were required for patients not needing reoperation (uncomplicated cases; n = 5), with mean in-hospital stay of 3.2 days (2-4 days). Patients resumed daily activities soon after discharge, unrestricted by chest precautions. Robotic TC-AVR is feasible, with the potential to offer superior patient recovery compared with traditional approaches. Accordingly, continued development of this technique and specialized instrumentation along with further safety evaluation are warranted and should be actively pursued.

Millions of individuals sustain traumatic injuries each year, yet the emotional impact of hospitalization and acute medical care remains understudied. Trauma-informed care (TIC) offers a framework for reducing retraumatization and supporting both patients and providers, but little is known about how TIC is understood or applied in trauma centers. This qualitative study used a human-centered design approach to examine healthcare workers' experiences, perceptions, and training needs related to TIC within a Level 1 trauma center to inform development of a training on TIC. This study employed a qualitative approach guided by principles of Human-Centered Design (HCD) to explore healthcare workers' perceptions, experiences, and training needs related to trauma-informed care (TIC) within a high-acuity trauma setting. Healthcare workers, including nursing assistants, registered nurses, physical therapists, advanced practice providers, and physicians were included as key informants in defining the relevance, challenges, and applicability of trauma-informed practice at the trauma center. Participants were recruited from the Trauma and Acute Care Division and hospital unit serving predominantly traumatically injured patients. Using thematic reflexive analysis, semi-structured interviews (range: 10-25min) with 20 multidisciplinary staff revealed three overarching themes: the emotional toll and burnout associated with trauma work; TIC-aligned practices (including empathetic communication and perspective taking); and training needs including format and content and skills needed to deliver TIC effectively. Participants emphasized the need for practical, hands-on training tailored to the realities of trauma care. Trauma-informed approaches have the potential to improve patient recovery, reduce psychological distress, and lessen strain on healthcare systems. Study findings can inform broader behavioral medicine practices by guiding the development of scalable TIC interventions that meet providers' identified needs which are adaptable to trauma centers, emergency care, and other high-acuity medical settings to enhance patient-centered care.

When discharging patients, identifying those with a high risk of short-term readmission is crucial, as these readmissions may disrupt patient recovery and increase healthcare costs. The READMIT risk index has been developed to address this need across all psychiatric diagnoses. However, a broad model might not be applicable to specific diagnoses, e.g., major depressive disorder. We aimed to investigate the predictive validity of the READMIT risk index in a cohort of Danish patients suffering from major depression, and to develop an alternative prediction model for the risk of readmission within 30 days. Based on national register data, we included 24,984 patients discharged from a Danish psychiatric hospital after treatment for major depression. The proportions of patients who experienced readmission within 30 days were 8% (n=1969) with major depression, 13% (n=3343) with any psychiatric diagnosis, and 19% (n=4718) with all-cause readmission. For readmission related to major depression, the predictive performance of the READMIT index, defined as area under the receiver operating characteristic curve (AUC), was 0.48 (95% CI:0.47; 0.49), whereas the prediction model developed in this study showed an AUC of 0.58 (95% CI:0.57; 0.59). Neither the READMIT risk index nor a newly developed alternative prediction model based on individual-level variables, achieved an acceptable AUC, i.e., 0.70 or above, and were therefore not able to appropriately predict the risk of readmission within 30 days for patients with major depressive disorder. However, organizational factors and factors related to capacity in the Danish psychiatric system could potentially improve the results.

Postoperative pain management is crucial for optimising recovery after total knee arthroplasty. Adequate pain control facilitates early rehabilitation, enhances quadriceps muscle recovery, improves knee function and improves patient satisfaction. Corticosteroids are widely used for postoperative pain management. However, studies comparing the efficacy of periarticular (PA) and intravenous (IV) corticosteroid injection are limited. Therefore, this study aimed to evaluate the effect of PA and IV corticosteroid injections on quadriceps strength (QS) recovery in patients undergoing total knee arthroplasty. A total of 59 patients were included in this study. Patients were randomly assigned to two groups: the PA triamcinolone group (n = 29) and the IV hydrocortisone group (n = 30). Patients were followed up for 6months and their QS, Visual Analogue Scale score, Modified Timed Up and Go (MTUGT) score, Western Ontario and McMaster Universities Osteoarthritis Index score, Knee Society Score and inflammatory marker levels were assessed. On postoperative day 3, the PA group exhibited a significantly lower reduction in QS (-43.11% ± 23.36% versus -63.7% ± 17.67%, p = 0.02) and significantly lower changes in MTUGT scores than the IV group (153.3% versus 301.3%, p < 0.01). Additionally, the knee flexion angle was significantly greater in the PA group than in the IV group on postoperative day 3 (91° ± 11° versus 82.6° ± 10.9°, p < 0.01) and at week 2 (103.2° ± 12.2° versus 97.4° ± 8.7°, p = 0.04). C-reactive protein levels were significantly lower in the PA group than in the IV group on postoperative day 1 (10.4; IQR: 5.3-17.2 versus 15.4; IQR: 9.4-28.6, p = 0.01), on day 3 (65.5; IQR: 38.3-96 versus 119.1; IQR: 69.6-146.1, p < 0.01) and at week 2 (3.9 versus 8.9, p = 0.01). On postoperative day 3, the PA group had significantly higher glucose levels than the IV group (115; IQR: 106-127 versus 106; IQR: 93-122, p = 0.02). No wound complications were observed in both groups. PA corticosteroid injection improves knee function in terms of muscle recovery, faster ambulation, increased knee flexion and reduced inflammation for up to 2weeks after surgery compared with IV corticosteroid injection. A transient increase in serum glucose was observed but is unlikely to be clinically significant.

Hypocalcemia (HC) is a common complication after thyroid surgery. This retrospective case-control study aimed to evaluate the efficacy of postoperative betamethasone infusion in reducing the incidence of HC following thyroid surgery, with recurrent laryngeal nerve palsy and other complications as secondary outcomes. A total of 196 patients who underwent total or completion thyroidectomy were retrospectively analyzed. Patients were divided into groups receiving postoperative betamethasone infusion or no glucocorticoid treatment. Postoperative data on HC incidence (at least one serum calcium measurement below 8.0 mg/dL), symptomatic HC (HC associate with numbness of the extremities, facial paresthesia, muscular spasms, and Chvostek's or Trousseau's signs), pain, recurrent laryngeal nerve palsy, voice dysfunction, sore-throat and dysphagia were collected and analyzed. Additionally, demographic and clinical characteristics were assessed, including preoperative assessments, intraoperative techniques, and postoperative recovery parameters. The study found a significantly lower incidence of HC and symptomatic HC in the betamethasone group compared to the control (32.0% vs. 49.5%, p=0.013; 11.3% vs. 25.3%, p=0.012, respectively). Betamethasone-treated patients also reported lower postoperative pain scores (p=0.002). Betamethasone infusion post-thyroidectomy demonstrated efficacy in reducing HC and symptomatic hypoparathyroidism, with minimal impact on other complications. The findings suggest the potential of glucocorticoids as a therapeutic option in thyroid surgery to enhance postoperative outcomes and patient recovery.