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Thyroidectomy for selected patients with thyrotoxicosis.

E A Mittendorf1, C R McHenry

  • 1Department of Surgery, MetroHealth Medical Center, Case Western Reserve University School of Medicine, 2500 MetroHealth Dr, Cleveland, OH 44109-1998, USA.

Archives of Otolaryngology--Head & Neck Surgery
|February 15, 2001
PubMed
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Surgical treatment for thyrotoxicosis is indicated for compressive symptoms, dominant nodules, or patient preference. Near-total or total thyroidectomy offers better outcomes than subtotal procedures, with transient hypocalcemia being common.

Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Thyroid Surgery

Background:

  • Thyrotoxicosis, a condition of excess thyroid hormones, can necessitate surgical intervention.
  • Indications for surgery and outcomes of thyroidectomy for thyrotoxicosis require detailed examination.

Purpose of the Study:

  • To investigate the primary reasons for surgical intervention in thyrotoxicosis cases.
  • To determine the frequency, effectiveness, and overall outcomes of surgical treatment for thyrotoxicosis.

Main Methods:

  • Retrospective review of medical records for patients undergoing thyroidectomy between 1990 and 1998.
  • Analysis of operative indications, laboratory results, extent of thyroidectomy, pathology, and patient outcomes.

Main Results:

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  • Out of 347 thyroidectomies, 54 patients (16%) had thyrotoxicosis, primarily due to Graves' disease or toxic multinodular goiter.
  • Indications included compressive symptoms (35 patients), patient preference (12), and dominant nodules (3).
  • Near-total or total thyroidectomy was performed in 45 patients, with 7% incidental carcinoma found. Symptomatic hypocalcemia occurred in 19% of patients.

Conclusions:

  • Surgical treatment for thyrotoxicosis is recommended for compressive symptoms, dominant nodules, and patient preference.
  • Near-total or total thyroidectomy is superior to subtotal thyroidectomy for preventing recurrence and should be considered standard practice.
  • Transient postoperative hypocalcemia is a frequent complication, correlating with the severity of thyrotoxicosis.