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Thyroidectomy
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Risks of bleeding, infection, vocal cord palsy, parathyroid dysfunction, inpatient stay, and time off work are equal to those for conventional thyroidectomy. However, RAT can potentially cause brachial plexus dysfunction. Airway obstruction does not occur following RAT because blood can disseminate in a larger space than is available after conventional thyroidectomy.
Endocrinology and metabolism
Published in Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan, Essential Notes for Medical and Surgical Finals, 2021
Kaji Sritharan, Jonathan Rohrer, Alexandra C Rankin, Sachi Sivananthan
Surgery Thyroidectomy – useful in large goitres, if relapse after initial drug treatment, or in patients with contraindications to the above treatments.
The Endocrine System and Its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Hypothyroidism is treated with natural (e.g., desiccated thyroid, thyroglobulin) or synthetic (e.g., L-thyroxine, L-triiodothyronine, thiotrix) thyroid hormones in an effort to attain and maintain a euthyroid (normal) state. The three major approaches to treatment of hyperthyroidism are use of thioamides to block conversion of T4 to T3, radioactive iodine (RAI) to destroy the gland, and surgery to remove the gland. Removal of the thyroid gland is known as thyroidectomy(-ectomy - excision). Adjunctive agents include iodinated contrast dye, iodides, adrenergic antagonists, prednisone, and lithium to block conversion or release the thyroid hormone.
Vocal tract discomfort and voice handicap index in patients undergoing thyroidectomy
Published in Logopedics Phoniatrics Vocology, 2022
Masoumeh Saeedi, Meysam Yadegari, Samira Aghadoost, Maryam Naderi
Twenty-one individuals were included in the study. The sample composed of two men (mean age: 51.0 years old) and 19 women (mean age: 41.3 years old) with the mean age was 42.2 years old (SD = 9.99; min = 23 and max = 60). An equal number of total thyroidectomy (n = 10) and partial thyroidectomy (n = 11) was included. The inclusion criteria for enrolment were: (1) absence of gastroesophageal reflux, (2) no evidence of preoperative immobility of the vocal fold, (3) perceptual assessment of voice, and (4) being >20 years of age. The participants were evaluated before thyroidectomy and three months afterwards. According to previous studies, most of the vocal symptoms are reduced by three months following the surgery [32–35]. The enrolment exclusion criteria were: (1) immobility of the vocal fold confirmed by videolaryngoscopy and (2) rejecting the post-operative normality of voice. The auditory-perceptual evaluation (grade (GRBAS) scale) was used to assess normality of voice before and after the surgery. An experienced speech and language pathologist (SLP), who had no knowledge of the purpose of the study, rated each patient on running speech before and after thyroidectomy. The perceptual judgments scale (GRBAS) rates were graded on the scale of 0–3 (0, normal; 1, slight deviance; 2, moderate deviance; 3, severe deviance) [36].
A cohort study of microwave ablation and surgery for low-risk papillary thyroid microcarcinoma
Published in International Journal of Hyperthermia, 2021
Yuan Zu, Yujiang Liu, Junfeng Zhao, Peipei Yang, Jianming Li, Linxue Qian
With the continuous improvement of thyroidectomy, bleeding, sepsis, and other complications have significantly improved [58]. The main complications of thyroidectomy are currently hypoparathyroidism and vocal cord paralysis. The reported rates of hypocalcemia and vocal cord paralysis are 3.0–7.2% [58,59] and 0.2–5.0% [60,61], respectively, which were similar to those of the surgery group in our study (3.7% and 3.7%, respectively). Temporary hoarseness caused by MWA, the most common complication (3.8%), may be caused by heat injury, bleeding, or other factors. Indeed, the injection of a liquid isolation band and infiltration of a small amount of lidocaine into the recurrent laryngeal nerve can result in temporary recurrent laryngeal nerve paralysis, inflammation, and peripheral nerve fibrosis [62,63]. In our study, there were various degrees of complications in both groups, and the incidence of major complications in the MWA group was significantly lower than that in the surgery group (p < 0.001). Therefore, MWA is a safe alternative for patients with PTMC.
Efficacy and safety of radiofrequency, microwave and laser ablation for treating papillary thyroid microcarcinoma: a systematic review and meta-analysis
Published in International Journal of Hyperthermia, 2019
Mengying Tong, Shuang Li, Yulong Li, Ying Li, Yue Feng, Ying Che
Although surgery is recommended for PTMC by current guidelines [7–9], there are some circumstances when the patients are ineligible for surgery due to systemic disease. Moreover, thyroidectomy may have complications such as laryngeal nerve paralysis, hypothyroidism, hypoparathyroidism, lifelong medication and scarring [10–13]. Thus, surgery may lead overtreatment for PTMC, which is generally considered a harmless disease. The 2015 American Thyroid Association (ATA) guideline recommended that patients with low-risk PTMCs can take an active surveillance management approach [8]. However, active surveillance management is not acceptable for many anxious patients with PTMC. Therefore, thermal ablation, which considered a moderate approach between surgery and surveillance, may be attempted for patients with PTMCs. According to the 2017 Korean Society of Thyroid Radiology guideline, patients with PTC who refuse or cannot undergo surgery can be treated by thermal ablations [14]. Although indications of thermal ablations for PTMCs have not been clearly established, radiofrequency ablation (RFA) [15–23], microwave ablation (MWA), [24–28] and laser ablation (LA) [29–32] have recently been applied to non-surgical candidates with PTMCs. Accumulating evidence indicates that these alternative approaches can effectively eliminate PTMCs with a low complication rate over a certain follow-up period [33].