The Endocrine System and Its Disorders
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss in Understanding Medical Terms, 2020
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.
Differentiated thyroid carcinoma
David S. Cooper, Jennifer A. Sipos in Medical Management of Thyroid Disease, 2018
The main complications of thyroidectomy are hypoparathyroidism and recurrent laryngeal nerve damage, which are most common after total thyroidectomy rather than lobectomy. The rates of hypoparathyroidism immediately after surgery are reported to range between 5–52%, depending on the extent of surgery and the experience of the surgeon. However, the rates of persistent hypocalcemia, lasting beyond 6 months, are lower, ranging from 1–16% (165, 166). A retrospective study of 1087 patients who had undergone total thyroidectomy +/− central compartment dissection found significantly higher rates of transient hypoparathyroidism in the patients for whom central compartment dissection was performed (27.7% total thyroidectomy only, 36.1% thyroidectomy plus ipsilateral central compartment dissection, 51.9% thyroidectomy plus bilateral central compartment dissection). When rates of permanent hypoparathyroidism were compared, only the bilateral central compartment group had significantly higher rates (6.3, 7, 16.2%, respectively) (165).
Endocrinology
Fazal-I-Akbar Danish in Essential Lists of Differential Diagnoses for MRCP with diagnostic hints, 2017
Thyroidectomy – complications:1 Immediate: a Recurrent laryngeal nerve palsy.b Thyroid crisis.c Hypoparathyroidism.d Local haemorrhage (→ laryngeal compression).e Wound infection.1 Late: a Hypothyroidism.b Keloid formation.
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.
Correlations of neck ultrasound and pathology in cervical lymph node of papillary thyroid carcinoma
Published in Acta Chirurgica Belgica, 2020
Bassam Abboud, Tarek Smayra, Hicham Jabbour, Claude GHORRA, Gerard Abadjian
All the operations were performed by a single surgeon (BA). Chlorehexidine (iodine-free solutions) were used to swab the operative field. Thyroidectomy was performed under general anesthesia via a transverse cervicotomy. During dissection, the parathyroid glands with their vascular supply, and the recurrent laryngeal nerves were identified and preserved. Lymph node exploration was systematically performed centrally and bilaterally in all cases. Macroscopically enlarged lymph nodes and adenopathies detected on preoperative imaging studies were all removed for pathologic study. Our institutional policy is to perform central neck dissection in cases of papillary thyroid cancer if the primary tumor size is larger than 1cm, and when there are preoperative or intra-operative evidence of enlarged lymph nodes. The central and lateral compartment lymph nodes group consists of level VI-VII, and Level II, III, IV, V, respectively. Surgery was macroscopically complete in all cases. Valsalva maneuver was performed at the end of operation in all patients to detect hemorrhage. Cervical wound was closed without drain tubes in all cases.
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].
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