[The surgical therapy of normally functioning multinodular goiter: our experience]

Surgical treatment of multinodular goiter is still now discussed: total versus subtotal thyroidectomy. Advantages of partial thyroidectomy are the low incidence of laryngeal nerve injury and the low risk of hypoparathyroidism. Disadvantages are the increased recurrent disease, the risk of carcinoma, the elevated possibility of laryngeal nerve lesions and permanent hypoparathyroidism after reoperations. Own experience regarding 401 thyroid operations is reported; 60 patients were operated for multinodular goiter; 48 subtotal and 12 total thyroidectomy were performed. Among those 1 (1.65%) inferior laryngeal lesion and 1 (1.65%) permanent hypoparathyroidism occurred. Anatomic knowledge and correct surgical procedure give a reduction in the mobility of total thyroidectomy which in selective case can be considered the treatment of choice.