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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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Synthesis and Regulation of Thyroid Hormones01:20

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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...
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Functions of Thyroid Hormones01:18

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The thyroid hormone (TH) plays a pivotal role in the intricate orchestration of physiological processes, exerting profound effects on development, metabolism, and homeostasis throughout different life stages.
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...
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The Parathyroid Glands00:59

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The two pairs of parathyroid glands embedded within the posterior surface of the thyroid gland are restricted by a dense capsule around them. These glands comprise two distinct cell populations—parathyroid oxyphil and parathyroid principal cells- pivotal in calcium homeostasis.
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Chronic pharyngitis refers to persistent inflammation of the pharyngial mucosa.
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Related Experiment Video

Updated: Feb 28, 2026

Minimal Invasive Resection of Large Retrosternal Thyroid Goiter
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Total Thyroidectomy: the first, the best. The recurrent goiter issue.

A Cappellani1, A Zanghì1, F Cardì1

  • 1Department of Surgery and Medical and Surgical Specialties, General And Breast Surgery Unit, University of Catania.

La Clinica Terapeutica
|June 15, 2017
PubMed
Summary

Redo surgery for recurrent goiter has higher morbidity than primary total thyroidectomy. Preventing recurrence with primary total thyroidectomy is the best management strategy for benign thyroid disease.

Keywords:
ComplicationsRecurrent goiterSurgeryThyroidectomy

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Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Thyroid Surgery

Background:

  • Redo surgery for recurrent goiter is associated with higher morbidity compared to primary total thyroidectomy.
  • Suppressive Levothyroxine therapy has not improved recurrence rates and can induce subclinical hyperthyroidism.
  • Total thyroidectomy is a definitive treatment for benign thyroid diseases, including recurrent goiter.

Purpose of the Study:

  • To compare the morbidity of redo surgery for recurrent goiter with primary total thyroidectomy for benign thyroid diseases.
  • To evaluate the effectiveness of suppressive Levothyroxine therapy in managing recurrent goiter.
  • To determine the optimal surgical approach for benign thyroid diseases to minimize recurrence and complications.

Main Methods:

  • A retrospective study comparing 20 cases of total thyroidectomy for recurrent goiter (RG) with 225 cases of primary total thyroidectomy (PT) between 2001 and 2013.
  • Exclusion of all thyroid cancer cases, including incidentally diagnosed ones.
  • Follow-up of at least 12 months for all patients; statistical analysis using Fisher's exact test due to small sample size for RG.

Main Results:

  • Transient hypocalcemia occurred in 25% of RG cases versus 8% of PT cases.
  • Permanent hypocalcemia was significantly higher in RG (10%) compared to PT (p < 0.05).
  • Transient recurrent laryngeal nerve (RLN) deficit was significantly higher in RG (25%) compared to PT (p < 0.05).

Conclusions:

  • The increased morbidity associated with redo surgery for recurrent goiter necessitates primary total thyroidectomy to prevent recurrence.
  • Conservative surgical approaches for benign thyroid disease are not recommended due to the risk of recurrence and subsequent higher morbidity.
  • Primary total thyroidectomy is the most effective management strategy for benign thyroid diseases, minimizing recurrence and associated complications.