Toxic multinodular goiter surgery
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Furqan M M. M.B.B.S[2],Sunny Kumar MD [3]
Overview
Surgery is the mainstay of treatment for Toxic multinodular goiter. Almost all multinodular goiters can be surgically removed through a collar incision. Usually, subtotal thyroidectomy is performed but unilateral thyroid lobectomy can also be performed in selected cases.
Surgery
Surgery is the mainstay of treatment for Toxic multinodular goiter.
Indications
Indications of surgery for multinodular goiter (MNG) includes:
- Rapid enlargement of goiter
- Rapidly enlarging thyroid nodules
- FNAC is positive or suspicious of malignancy
- Compression of trachea, esophagus, and other neck structures
- Substernal thyroid extension
- Co-existence of hyperparathyroidism
- Risk of malignancy
- Suspicious cervical lymphadenopathy
- Radiation exposure
Surgical procedures
Almost all multinodular goiters can be surgically removed through a collar incision. An additional thoracotomy is very rarely necessary.
Subtotal thyroidectomy
Bilateral subtotal thyroidectomy is effective in the treatment of multinodular goiter (with hot or cold nodules).
Unilateral Lobectomy
A unilateral thyroid lobectomy may be performed if only one thyroid lobe is enlarged.
Side effects of surgery
The side effects associated with thyroidectomy include:[1][2][3]
- Post-operative hypothyroidism
- Recurrent laryngeal palsy
- Hypocalcaemia
References
- ↑ Pelizzo MR, Bernante P, Toniato A, Fassina A (1997). "Frequency of thyroid carcinoma in a recent series of 539 consecutive thyroidectomies for multinodular goiter". Tumori. 83 (3): 653–5. PMID 9267482.
- ↑ "Complications after Total ThyroidectomyOtolaryngology-Head and Neck Surgery - Larry J. Shemen, Elliot W. Strong, 1989".
- ↑ "Morphological and functional polymorphism within clonal thyroid nodules | The Journal of Clinical Endocrinology & Metabolism | Oxford Academic".