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Updated: Aug 11, 2026

Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy
Published on: May 12, 2023
Sublingual pyramidal lobe. Complications of subtotal thyroidectomy for Graves' disease
Abstract:
A potential complication of subtotal thyroidectomy where a large pyramidal lobe is present is described. The pyramidal lobe normally is immobilized inferiorly by its attachment to the thyroidal isthmus. When the isthmus is removed and the pyramidal lobe is left in situ during subtotal thyroidectomy its superior attachments will allow the pyramidal lobe to become situated sublingually. This may produce gagging and nausea. To avoid the complication, it is recommended that the pyramidal lobe be removed during subtotal thyroidectomy. If the patient also is thyrotoxic, I-131 can be used to treat this complication successfully.
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