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The Thyroid Gland01:23

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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.
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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.
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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.
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Gene transcription is regulated by the synergistic action of several proteins that form a complex at a gene regulatory site. This is observed in eukaryotes, where the regulation of gene expression is a complex process. Regulatory proteins in eukaryotes can broadly be classified into two types – regulators that bind directly to specific DNA sequences and co-regulators that associate with regulatory proteins but cannot directly bind to the DNA. These co-regulators are further divided into...
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[TOETVA: thyroid surgery without permanent scar].

Menno R Vriens1,2, Inne H M Borel Rinkes1

  • 1UMC Utrecht, afd. Heelkunde.

Nederlands Tijdschrift Voor Geneeskunde
|April 5, 2019
PubMed
Summary
This summary is machine-generated.

Transoral endoscopic thyroidectomy using a vestibular approach (TOETVA) offers scarless thyroid surgery for eligible patients. This innovative technique removes thyroid nodules up to 3 cm through the mouth, avoiding neck disfigurement.

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Area of Science:

  • Endocrinology
  • Surgical Innovation
  • Minimally Invasive Surgery

Background:

  • Conventional thyroid surgery often results in visible neck scarring.
  • Patient demand for cosmetic outcomes in thyroidectomy is increasing.
  • Technological advancements enable novel surgical approaches.

Purpose of the Study:

  • To introduce and describe the transoral endoscopic thyroidectomy using a vestibular approach (TOETVA).
  • To highlight the advantages of TOETVA over conventional thyroidectomy.
  • To outline the eligibility criteria and implementation plan for TOETVA.

Main Methods:

  • TOETVA involves placing endoscopic instruments through the oral vestibule (mouth).
  • Surgical dissection and thyroid removal are performed endoscopically, passing over the chin.
  • Patient selection is limited to thyroid nodules up to 3 cm in diameter.

Main Results:

  • TOETVA achieves thyroid removal without any external cervical scars.
  • The primary benefit is the elimination of potentially disfiguring neck scars.
  • The technique is feasible for selected patients with small thyroid nodules.

Conclusions:

  • TOETVA represents a significant advancement in thyroid surgery, offering a scarless alternative.
  • Widespread adoption is planned through a national proctoring program.
  • This approach addresses cosmetic concerns while providing effective thyroid nodule treatment.