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Related Concept Videos

The Thyroid Gland01:23

The Thyroid Gland

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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...
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Hyperthyroidism I: Introduction01:25

Hyperthyroidism I: Introduction

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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...
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Hyperthyroidism II: Pathophysiology01:27

Hyperthyroidism II: Pathophysiology

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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...
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Assessing Body Temperature - Tympanic membrane01:14

Assessing Body Temperature - Tympanic membrane

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Assessing tympanic membrane temperature involves using a tympanic membrane thermometer (TMT). Here is a step-by-step guide:
Step 1: Begin by practicing good hand hygiene to prevent the transmission of microorganisms.
Step 2: Turn on the thermometer and wait until the ready sign appears on the screen to ensure accurate measurement.
Step 3: Slide the probe cover in place to prevent cross-contamination.
Step 4: Instruct the patient to tilt their head to the side for comfort and check for cerumen...
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Goiter01:27

Goiter

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Goiter refers to an abnormal enlargement of the thyroid gland that may appear as a diffuse goiter (uniform enlargement) or nodular (single or multiple nodules). Functionally, it is classified as nontoxic (normal/low hormone levels) or toxic (excess hormone production).PathophysiologyDiffuse thyroid enlargement typically results from prolonged stimulation by thyroid-stimulating hormone (TSH) or TSH-like agents, commonly seen in hypothyroidism or iodine deficiency. In contrast, in hyperthyroid...
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Veins of Head and Neck01:19

Veins of Head and Neck

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The blood drainage from the head and neck is primarily managed by three pairs of veins: the external jugular, internal jugular, and vertebral veins. The external jugular veins drain superficial scalp and face structures, passing over the sternocleidomastoid muscles to empty into the subclavian veins.
On the other hand, the vertebral veins, unlike their arterial counterparts, are not primarily responsible for brain drainage. Instead, they drain the cervical vertebrae, spinal cord, and some small...
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Related Experiment Video

Updated: Apr 26, 2026

Substernal Thyroid Biopsy Using Endobronchial Ultrasound-guided Transbronchial Needle Aspiration
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Substernal Thyroid Biopsy Using Endobronchial Ultrasound-guided Transbronchial Needle Aspiration

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Simple core-needle biopsy for thyroid nodule, complicated tinnitus.

Mathieu Bergeron1, Danielle Beaudoin2

  • 1Department of Otolaryngology - Head and Neck Surgery, Laval University, Quebec, Que., Canada.

European Thyroid Journal
|August 13, 2014
PubMed
Summary

Core-needle biopsy (CNB) can cause rare arteriovenous fistulas (AVFs), leading to tinnitus and complicating pathology readings. Angiography and stenting are recommended for diagnosis and treatment of these CNB-induced vascular issues.

Keywords:
Arteriovenous fistulaCore needle biopsyStentThyroidTinnitus

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Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Endocrinology

Background:

  • Fine-needle aspiration is standard for thyroid nodules, but core-needle biopsy (CNB) is not universally recommended.
  • CNB complications typically include bleeding and hematomas.
  • Arteriovenous fistula (AVF) and associated tinnitus are rare, undocumented complications of CNB.

Purpose of the Study:

  • To alert clinicians to potential vascular complications from CNB.
  • To highlight diagnostic challenges in pathology following CNB.
  • To report a case of AVF and tinnitus secondary to CNB.

Main Methods:

  • A case report of a 44-year-old female presenting with pulsatile tinnitus after CNB.
  • Conventional angiography identified a focal AVF from the left vertebral artery.
  • Endovascular stenting of the AVF was performed.

Main Results:

  • The endovascular stent successfully resolved the AVF and tinnitus.
  • The CNB significantly complicated subsequent pathology interpretation.
  • Biopsy artifacts mimicked tumor invasion.

Conclusions:

  • CNB is not an American Thyroid Association-recommended procedure for thyroid nodules.
  • Angiography is crucial for diagnosing and treating iatrogenic AVFs from CNB.
  • Endovascular stenting offers immediate correction for CNB-induced AVFs.