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Goiter (Endemic Goiter)
Published in Charles Theisler, Adjuvant Medical Care, 2023
A goiter is an abnormal enlargement of the thyroid gland. Endemic goiter is an iodine-deficiency disease (IDD). Endemic goiters occur in those areas where the iodine content of the soil is so low that insufficient iodine is obtained through food and water and when no provision is made for supplying iodized salt. In the U.S., where the use of iodized salt is common, a goiter is most often due to Grave’s disease, Hashimoto’s disease, multinodular goiter, solitary thyroid nodules, or thyroid cancer.1
General Thermography
Published in James Stewart Campbell, M. Nathaniel Mead, Human Medical Thermography, 2023
James Stewart Campbell, M. Nathaniel Mead
Goiter refers to a swelling of the neck caused by enlargement of the thyroid gland. Whether the swelling will appear warm via thermography depends on the underlying etiology.137 Hyperthyroid goiter appears diffusely warm, while hypothyroid goiter often shows a cool gland area. Hashimoto's thyroiditis may have variable thermal findings depending on the state of the disease process – active or quiescent. Graves' disease is characterized by a diffusely hyper-vascularized thyroid, showing high yet variable temperatures over the gland.138 Thermography also offers an assessment tool for patients with active thyroid eye disease (TED), with good accuracy and specificity.139 TED patients with active ophthalmopathy showed orbital temperatures around 3°C (5.4°F) higher than normal, and had eyelid temperatures above 37°C (98.6°F).140 More severe cases of TED may present with systemic fever of unknown origin.141
Acquired hypothyroidism
Published in Pallavi Iyer, Herbert Chen, Thyroid and Parathyroid Disorders in Children, 2020
Once euthyroid, symptoms and sequelae attributed to hypothyroidism should resolve, though goiter may persist even with adequate thyroid hormone replacement (Figure 4.2). Skin and hair findings may take longer to completely resolve owing to the time necessary for renewal of new hair and skin cells, including initial increased loss of hair followed by resumption of the normal hair cycle. Other causes of fatigue, depression, constipation, and accompanying symptoms should be pursued when thyroid function testing is normal or only mildly abnormal.
Anatomy and motor function of extra-laryngeal branching patterns of the recurrent laryngeal nerve; an electrophysiological study of 1001 nerves at risk
Published in Acta Chirurgica Belgica, 2023
This prospective study on the surgical anatomy of the RLN was conducted by consecutively including all patients who underwent primary thyroid surgery between January 2013 and December 2020. The study was approved by the Institutional Review Board, and informed consent was given by patients prior to intervention. We excluded cases of recurrent goiter with secondary thyroid surgery. The primary outcome was the presence and branching location of ETB of the RLN in relation with the ITA, the secondary outcome was the presence motor nerve fibers of all branches, measured by IONM during surgery. The presence of terminal branches of the nerve was macroscopically observed and recorded. The location of division point along the cervical course of the RLN was determined and classified according to the point of intersection between the RLN and the ITA.
Hemodynamic Instability during Thyroidectomy in Graves’ Disease
Published in Journal of Investigative Surgery, 2022
Sami Acar, Candas Ercetin, Nuri Alper Sahbaz, Fırat Tutal, Yunus Yapalak, Fulya Cosan, Yesim Erbil
The patients were analyzed for their demographics, duration of the disease (period of medical treatment), history of smoking, presence of ophthalmopathy, choice of medication, preoperative need for plasmapheresis or use of Lugol’s iodine solution, weight of the resected specimen, TRAb values, type of surgery, and hemodynamic instability patterns. The patients were diagnosed with goiter disease by evaluating palpable diffuse goiter on physical examination, clinical signs of thyrotoxicosis, laboratory results, and results of diffuse radioactive iodine uptake in thyroid tissue on scintigraphy. The included patients also had at least one of the following conditions: ophthalmopathy in a physical examination, antithyroglobulin (antiTg) antibodies, TRAb, and/or positive anti-thyroid peroxidase (antiTPO) in blood tests.
Efficacy and safety of single-session radiofrequency ablation for intrathoracic goiter: preliminary results and short-term evaluation
Published in International Journal of Hyperthermia, 2021
Pi-Ling Chiang, Wei-Che Lin, Hsiu-Ling Chen, Sheng-Dean Luo, Meng-Hsiang Chen, Wei-Chih Chen, Yen-Hsiang Chang, Chen-Kai Chou, Yan-Ye Su, Yu-Cheng Tung, Wen-Chieh Chen, Shun-Yu Chi, Jung Hwan Baek
This retrospective analysis was approved by the institutional review board (201900550B0), and each participants’ private information was protected. A total of 324 patients with benign thyroid nodules underwent thyroid RFA at single medical center in Taiwan during the period of December 2016 to March 2019. In the pre-RFA evaluation, the non-visualized inferior margin of the thyroid nodule by ultrasonography (US) were noted in 71 patients (21.9%). The CT or MRI scan of the neck and upper thorax was performed to evaluate the extension of the thyroid into the thoracic inlet. After the evaluations, fifteen patients confirmed with 16 ITG were included in the study. Of the patients, one presented with a bilateral ITG (Figure 1). At least two US-guided fine-needle aspirations (FNA) or core-needle biopsy (CNB) were performed prior to RFA to confirm the benign nature of the goiter. Benign thyroid nodules were confirmed in all of the 16 ITG patients. The RFA for ITG, as a treatment choice, has been discussed in multidisciplinary team meetings. All patients refused surgical treatment after a visit to the surgery clinic.