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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...

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Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy
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Paediatric thyroidectomy: When and why? A 25-year institutional experience.

Fanny Yeung1, K P Wong2, Brian Hh Lang2

  • 1Division of Paediatric Surgery, Department of Surgery, The University of Hong Kong, Hong Kong.

Journal of Pediatric Surgery
|April 5, 2022
PubMed
Summary

Pediatric thyroidectomy for conditions like Graves' disease and thyroid cancer is complex. Postoperative hypocalcemia and vocal cord palsy are typically transient, with nerve monitoring reducing vocal cord issues.

Keywords:
HypoparathyroidismPaediatricsPostoperative complicationsThyroidectomyVocal cord palsy

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Area of Science:

  • Pediatric Surgery
  • Endocrinology
  • Oncology

Background:

  • Thyroidectomy in children is infrequent but can present unique challenges.
  • Understanding risk factors for complications is crucial for optimizing patient outcomes.

Purpose of the Study:

  • To review the institutional experience with pediatric thyroidectomy.
  • To identify risk factors associated with postoperative complications in children undergoing thyroidectomy.

Main Methods:

  • Retrospective analysis of 87 pediatric patients (92 thyroidectomies) from April 1995 to January 2021.
  • Data collected included demographics, preoperative cytology, surgical indications, complications, and histology.
  • Surgical outcomes and long-term follow-up were analyzed.

Main Results:

  • Common indications included Graves' disease (40.2%), benign nodules (26.4%), thyroid carcinoma (23.0%), and MEN2A (10.3%).
  • Malignancy risk was 43.9% in patients with nodules/lymph nodes. Postoperative hypocalcemia occurred in 32%, with 8% permanent hypoparathyroidism. Transient vocal cord palsy was 3%.
  • Intraoperative neck dissection, drain use, and hypocalcemia treatment correlated with longer hospital stays. Recurrent laryngeal nerve monitoring reduced vocal cord palsy (p=0.022).

Conclusions:

  • Pediatric thyroid disease management requires careful surgical planning.
  • While hypocalcemia and vocal cord palsy are common, they are usually transient after total thyroidectomy.
  • Recurrent laryngeal nerve monitoring improves safety, and multidisciplinary care achieves good outcomes for thyroid cancer.