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Thyroid surgery in children and adolescents
Jaromír Astl1, Marcela Dvoráková, Petr Vlcek
1Department of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, Charles University, Prague CZ-15800, Czech Republic. jaromir.astl@seznam.cz
International Journal of Pediatric Otorhinolaryngology
|September 15, 2004
Summary
Thyroid surgery in children and adolescents is often indicated for non-malignant conditions like Graves-Basedow disease and toxic adenoma. Malignant tumors, primarily papillary cancer, also necessitate surgical intervention in this age group.
Area of Science:
- Pediatric Surgery
- Endocrinology
- Otorhinolaryngology
Background:
- Thyroid diseases in children and adolescents represent a significant portion of surgical cases.
- Understanding the specific indications and outcomes for pediatric thyroid surgery is crucial for effective management.
Purpose of the Study:
- To analyze the indications, surgical procedures, and outcomes for thyroid diseases in children and adolescents.
- To highlight the multidisciplinary approach required for optimal thyroid disease management in pediatric patients.
Main Methods:
- Retrospective analysis of 114 pediatric patients (ages 0-18) who underwent thyroid surgery between 1991 and 2000.
- Review of patient demographics, disease types (malignant vs. non-malignant), histological findings, and surgical interventions.
Main Results:
- Non-malignant conditions accounted for 71.9% of surgeries, with Graves-Basedow and Hashimoto toxicosis being most common. Malignant tumors were found in 28.1% of cases, predominantly papillary cancer.
- The male to female ratio was 1:6.5 for non-malignant and 1:5.4 for malignant thyroid diseases.
- Two cases of distant metastases (lung) were reported, with pre-disease stages exceeding 12 months.
Conclusions:
- Thyroid surgery in pediatric patients requires a collaborative effort between pediatric endocrinologists and specialized surgeons.
- Centralization of care in specialized centers and integration with pediatric oncology and nuclear medicine are vital for managing malignant thyroid conditions.
- Technological advancements, such as surgical microscopes for recurrent laryngeal nerve identification, improve surgical safety and outcomes.