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Related Concept Videos

The Thyroid Gland01:23

The Thyroid Gland

The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...
Synthesis and Regulation of Thyroid Hormones01:20

Synthesis and Regulation of Thyroid Hormones

Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The iodine is then...
Hyperthyroidism II: Pathophysiology01:27

Hyperthyroidism II: Pathophysiology

Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH receptors...
Graves Disease II: Pathophysiology01:24

Graves Disease II: Pathophysiology

Graves’ disease is an autoimmune disorder characterized by the production of thyroid-stimulating immunoglobulins (TSI) that activate TSH receptors, leading to excessive synthesis and release of thyroid hormones (T3 and T4) and resulting in hyperthyroidism.Among all causes of hyperthyroidism, Graves’ disease is the most common and can happen at any age, though it is more frequent in women. It produces a hypermetabolic state with features such as weight loss, tachycardia, tremor, and heat...
Hyperthyroidism I: Introduction01:25

Hyperthyroidism I: Introduction

Hyperthyroidism is a type of thyrotoxicosis characterized by the thyroid gland's overproduction of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). This hormone excess increases the basal metabolic rate and enhances sensitivity to catecholamines.DiagnosisDiagnosis is based on clinical features and biochemical testing. It typically shows suppressed thyroid-stimulating hormone (TSH) levels below 0.4 mIU/L, with elevated free T3 and/or T4. Additional tests, including thyroid...
Hypothyroidism II: Pathophysiology01:23

Hypothyroidism II: Pathophysiology

Hypothyroidism is a disorder characterized by insufficient production of thyroid hormones, which regulate metabolism, energy balance, and multiple organ systems.TypesHypothyroidism is classified based on the level of dysfunction. Primary hypothyroidism results from intrinsic thyroid gland dysfunction, causing reduced hormone production despite normal or increased stimulation. Secondary hypothyroidism arises from inadequate thyroid-stimulating hormone (TSH) secretion by the pituitary. Tertiary...

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Related Experiment Video

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Minimal Invasive Resection of Large Retrosternal Thyroid Goiter
04:09

Minimal Invasive Resection of Large Retrosternal Thyroid Goiter

Published on: September 20, 2024

Reoperative surgery for thyroid disease.

Jérémie H Lefevre1, Christophe Tresallet, Laurence Leenhardt

  • 1Service de Chirurgie Générale, Hôpital de la Pitié, 47-83 Boulevard de l'hôpital, 75651, Paris Cedex 13, France. fabrice.menegaux@psl.aphp.fr

Langenbeck'S Archives of Surgery
|June 27, 2007
PubMed
Summary

Reoperative thyroid surgery carries higher risks of complications like recurrent laryngeal nerve (RLN) palsy and hypoparathyroidism compared to primary surgery. Careful patient selection and adherence to surgical techniques are crucial for minimizing these risks.

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Mixed Reality Assisted Radical Endoscopic Thyroidectomy
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Minimal Invasive Resection of Large Retrosternal Thyroid Goiter
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Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Thyroid Surgery

Background:

  • Reoperative thyroid surgery is uncommon but necessary for conditions like recurrent nodules or completion thyroidectomy for well-differentiated thyroid cancer (WDTC).
  • This procedure carries risks of postoperative complications, including recurrent laryngeal nerve (RLN) palsy and hypoparathyroidism.

Purpose of the Study:

  • To describe the patient population undergoing reoperative thyroid surgery.
  • To evaluate postoperative morbidity and identify risk factors associated with reoperative thyroid surgery.

Main Methods:

  • Retrospective analysis of 685 patients undergoing completion thyroidectomy over 14 years.
  • Standardized surgical technique included identification of RLN and parathyroid glands.
  • Postoperative complication rates were compared to primary bilateral thyroid resection.

Main Results:

  • Transient morbidity was 8% (5% hypoparathyroidism, 1.2% RLN palsy).
  • Permanent morbidity was 3.8% (1.5% RLN palsy, 2.5% hypoparathyroidism), higher than primary surgery.
  • Incidental carcinoma found in 13% of cases, highest in completion thyroidectomy for cancer (21%).

Conclusions:

  • Reoperative thyroid surgery has significant potential for complications, particularly permanent RLN palsy and hypoparathyroidism.
  • This surgery should be reserved for carefully selected patients.
  • Strict adherence to specific surgical techniques is essential to minimize complications.