Pre-operative optimization with super saturated potassium iodide solution (SSKI) in patients with graves’ disease undergoing total thyroidectomy

David Reznick, Eren Berber, Judy Jin, Joyce Shin, Allan Siperstein


Background: Iodine containing solutions have been utilized to help control hyperthyroidism for patients with Graves’ disease. Super saturated potassium iodide solution (SSKI) is traditionally given about 10 days prior to surgery for patients with Graves’ disease with the goal of decreasing thyroid hormone levels and gland vascularity in addition to any other medication they may be taking for symptoms. Despite the routine administrations, few studies have confirmed these findings. The purpose of this study is to look at a single institution retrospective cohort comparing those patients who undergo thyroidectomy for Graves’ disease with the pre-operative administration of SSKI as compared to those who do not.
Methods: Single institution review of all patients at a single hospital system undergoing a total thyroidectomy for Graves’ disease receiving SSKI.
Results: A total of 386 patients had a total thyroidectomy for Graves’ disease between 1999–2016. A total of 308 (79.8%) received SSKI. No statistical differences were noted between the two groups. Of those that received SSKI, there was a significant decreased in both T3 and T4 levels after receiving SSKI (P<0.01) as well as a decrease in flow on 54 of 128 (42.2%) patient’s ultrasound exams (P<0.01).
Conclusions: This study finds that SSKI assists with rendering patients euthyroid prior to total thyroidectomy for Graves’ disease as well as decreases the vascularity of their thyroid glands.