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Hyperthyroidism I: Introduction

Hyperthyroidism I: Introduction

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...

Hyperthyroidism II: Pathophysiology

Hyperthyroidism II: Pathophysiology

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 receptors...

Graves' Disease I: Introduction

Graves' Disease I: Introduction

Graves' disease is an autoimmune disorder that causes hyperthyroidism, or overactivity of the thyroid gland. It results from autoantibodies called thyroid-stimulating immunoglobulins (TSIs), which bind to thyroid-stimulating hormone (TSH) receptors, leading to overstimulation of hormone production and a hypermetabolic state.EtiologyAlthough considered idiopathic, Graves’ disease has well-established contributing factors. There is a strong genetic component, with increased prevalence in...

Graves Disease II: Pathophysiology

Graves Disease II: Pathophysiology

Graves’ disease is an autoimmune disorder characterized by the production of thyroid-stimulating immunoglobulins (TSI) that activate TSH receptors, leading to excessive synthesis and release of thyroid hormones (T3 and T4) and resulting in hyperthyroidism.Among all causes of hyperthyroidism, Graves’ disease is the most common and can happen at any age, though it is more frequent in women. It produces a hypermetabolic state with features such as weight loss, tachycardia, tremor, and heat...

Goiter

Goiter

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...

Hypothyroidism II: Pathophysiology

Hypothyroidism II: Pathophysiology

Hypothyroidism is a disorder characterized by insufficient production of thyroid hormones, which regulate metabolism, energy balance, and multiple organ systems.TypesHypothyroidism is classified based on the level of dysfunction. Primary hypothyroidism results from intrinsic thyroid gland dysfunction, causing reduced hormone production despite normal or increased stimulation. Secondary hypothyroidism arises from inadequate thyroid-stimulating hormone (TSH) secretion by the pituitary. Tertiary...

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Updated: Jul 24, 2026

Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy

Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy

Published on: May 12, 2023

The morbidity of total thyroidectomy

E F Scanlon, J E Kellogg, D P Winchester

Archives of Surgery (Chicago, Ill. : 1960)

|May 1, 1981

Summary

Total thyroidectomy in patients with prior head and neck irradiation shows low operative mortality. Long-term morbidity, particularly hypocalcemia, is minimal after total thyroidectomy for benign conditions.

Area of Science:

Endocrinology
Surgical Oncology
Head and Neck Surgery

Background:

Thyroidectomy is a common surgical procedure.
Previous irradiation of the head and neck is a known risk factor for thyroid pathology.
The long-term outcomes of total thyroidectomy in patients with prior irradiation require evaluation.

Purpose of the Study:

To assess the outcomes of total thyroidectomy in patients with a history of head and neck irradiation.
To evaluate the short-term and long-term morbidity associated with this procedure.

Main Methods:

Retrospective review of 245 total thyroidectomies performed over a ten-year period.
Analysis of patient history, focusing on prior head and neck irradiation for benign conditions.
Assessment of operative mortality, postoperative bleeding, recurrent laryngeal nerve function, and calcium requirements.

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Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach

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Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma

Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma

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Last Updated: Jul 24, 2026

Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy

Transoral Endoscopic Thyroidectomy Vestibular Approach for Thyroid Lobectomy

Published on: May 12, 2023

Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach

Gasless Endoscopic Thyroidectomy via the Trans-Axillary Approach

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Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma

Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma

Published on: September 15, 2023

Main Results:

No operative mortality was observed.
One patient (0.4%) required reoperation for postoperative bleeding.
Recurrent laryngeal nerve function recovered in 5 out of 6 patients within one year.
Postoperative hypocalcemia requiring calcium supplementation decreased significantly from hospital discharge to one year post-surgery.

Conclusions:

Total thyroidectomy can be performed with low morbidity and mortality in patients with prior head and neck irradiation.
Long-term complications, such as hypocalcemia, are infrequent.
The benefits of total thyroidectomy should be weighed against potential long-term morbidity, not just immediate postoperative risks.