Presentation
CONCLUSIONS: The present study shows that total thyroidectomy can be performed without increasing risk of complication, and it is an acceptable alternative for benign multinodular goiter, especially in endemic regions, where patients present with a huge [ncbi.nlm.nih.gov]
Entire Body System
- Inflammation
One month after operation, the remnant was palpated as a small well-limited mass without signs of inflammation and thyroid function tests were normal. [ncbi.nlm.nih.gov]
Kriss, JP, Pleshakov, V., Rosenblum, AL, Holderness, M., Sharp, G., and Utiger, R., Studies of the pathogenesis of the ophthalmopathy of Graves الصفحة 22 - Platelet-activating factors, in Inflammation, Basic Principles and Clinical Correlates, Gallin [books.google.com]
This surgery is appropriate when nodules, swelling, or inflammation affect the entire thyroid gland, or when cancer is present. Thyroid surgery takes place in a hospital. [healthline.com]
The nodules create an excessive amount of thyroid hormone Heat intolerance Palpitations, fast heart beat etc Causes of subtotal thyroidectomy - Heredity Age Nodules are more likely to form in people who have chronic inflammation of the thyroid gland. [forerunnershealthcare.com]
[…] reoperative or revision surgery is the scarring present from the prior violation of the neck. [34] For patients needing completion thyroidectomy, some surgeons advocate for early intervention within 5-7 days after the first operation, before significant inflammation [emedicine.medscape.com]
- Pathologist
This is a controversial area, and the answer will differ between various surgeons and pathologists. [mythyroid.com]
Pathologists have to look at very thin slices of the tissue to make a diagnosis. [endocrine.surgery.ucsf.edu]
- Myxedema
الصفحة 220 - Isolation and identification of the long acting thyroid stimulator and its relation to hyperthyroidism and circumscribed pretibial myxedema, J. Clin. Endocrinol. Metab., 24. 1005, 1964. 440. [books.google.com]
- Hypothermia
Hypothyroidism presenting as hypothermia following pre-ecampsia at 23 week of gestation. Br J Obstet Gynecol 1991;98:221-224 17. Leung AS., Millar LK, Koonings PP, et al. Perinatal outcome in hypothyroid pregnancies. [tmj.ro]
Respiratoric
- Hoarseness
[…] usually alleviates symptoms. 2) Airway obstruction (compressing hematoma, trachiomalacia) Incidence of hematoma is 1-2%, tracheomalacia incidence is 3) Recurrent laryngeal nerve injury Incidence of injury is 0.77% for unilateral damage resulting in hoarseness [openanesthesia.org]
There is a 1% chance of permanent hoarseness and a 5% chance of temporary hoarseness ( Low blood calcium: There are parathyroid glands that lie behind your thyroid gland that help to control your blood calcium levels. [endocrine.surgery.ucsf.edu]
Indications: Proven neoplasm (FNAC) Suspected neoplasm Age: Extreme Sex: Male Hard, irregular texture and fixity Hoarseness of voice Enlarged cervical nodes Recurrent cysts Pressure symptoms due to goiter Patient’s wish or Cosmesis Types of thyroidectomy [epomedicine.com]
You may also have a hoarse voice or sore throat for a few days. There may be a drain from the site of the incision. It helps with healing and will later be removed. You’ll either stay overnight at the hospital, or go home the day of the surgery. [webmd.com]
Potential complications of thyroid surgery include: Temporary or permanent hoarseness or loss of voice. This can happen if the larynx (voice box) or windpipe is irritated by the breathing tube that was used during surgery. [cancer.org]
- Sore Throat
You may also have a hoarse voice or sore throat for a few days. There may be a drain from the site of the incision. It helps with healing and will later be removed. You’ll either stay overnight at the hospital, or go home the day of the surgery. [webmd.com]
Although both may be soothing to sore throat, soft foods may be tolerated better than liquids if patient experiences difficulty swallowing. Encourage patient to use relaxation techniques: guided imagery, soft music, progressive relaxation. [nurseslabs.com]
Cardiovascular
- Tachycardia
- B blokers to treat the tachycardia patient usually has. - Lugo iodide to decrease the vascularity of the goiter before going for surgery first treat thyrotoxic state with antithyroid medications, propranolol & lugols iodine, otherwise throtoxic storm [bayt.com]
Propranolol decreases very quickly palpitations, tachycardia, nervousness, sweats, tremor, without effects on tiredness and loss of weight of hyperthyroidism. [pharmacorama.com]
[…] high incidence of neonatal goiter and hypothyroidism. 50 Active monitorisation with dosing of TRAB is recommended in selected cases: previous neonatal hyperthyroidism, active disease despite antithyroid medication, thyroidectomy during pregnancy, fetal tachycardia [tmj.ro]
Jaw & Teeth
- Hypersalivation
It can also cause symptoms of iodism such as hypersalivation with metallic taste in the mouth, rhinitis, conjunctival tearing, edema. [pharmacorama.com]
Musculoskeletal
- Neck Pain
For a week patients give accounts of neck pain, difficulty to speak and changed voice, but normally these symptoms go away soon. Patients are usually back to their daily routine within ten days after a thyroid surgery. [hmcisrael.com]
Skin
- Sweating
Propranolol decreases very quickly palpitations, tachycardia, nervousness, sweats, tremor, without effects on tiredness and loss of weight of hyperthyroidism. [pharmacorama.com]
Psychiatrical
- Fear
Furthermore, compared to lifelong replacement therapy, repetitive examination because of the fear of recurrent disease will not only increase the cost but also aggravate the psychological burden. [wjso.biomedcentral.com]
Neurologic
- Tremor
Propranolol decreases very quickly palpitations, tachycardia, nervousness, sweats, tremor, without effects on tiredness and loss of weight of hyperthyroidism. [pharmacorama.com]
Pre-operative heart rate was 80-90 b/m and there were no flapping tremors and patient thyroid profile was within normal range. Indirect laryngoscopy showed bilateral mobile vocal cords. [omicsonline.org]
- Irritability
This can happen if the larynx (voice box) or windpipe is irritated by the breathing tube that was used during surgery. It may also occur if the nerves to the larynx (or vocal cords) are damaged during surgery. [cancer.org]
- Seizure
Additional findings may develop, including carpopedal spasm, tetany, laryngospasm, seizures, QT prolongation and cardiac arrest. Chvostek’s sign is facial contractions elicited by tapping the facial nerve in the per-auricular area. [openanesthesia.org]
Treatment
METHODS: Cost-effectiveness analysis was performed to compare operative strategies to medical treatment strategies for GD. [ncbi.nlm.nih.gov]
Prognosis
To clarify the difference of their prognosis and establish the appropriate thyroid surgery, we studied 105 patients with differentiated thyroid cancer who were treated with total or subtotal thyroidectomy, excluding those with small tumors, under uniform [ncbi.nlm.nih.gov]
Nursing priorities will include managing hyperthyroid state preoperatively, relieving pain, providing information about the surgical procedure, prognosis, and treatment needs, and preventing complications. [nurseslabs.com]
Also, the worsened prognosis observed in patients with locally advanced lesions, positive margins, and high-risk histologic WDTC variants – tall cell, columnar cell, and diffuse sclerosing – are indications for aggressive therapy that includes total thyroidectomy [larianmd.com]
Etiology
Chronic hypocalcemia, irrespectively of its etiology, can lead to severe impairment of the left ventricular (LV) contractility manifesting as dilated cardiomyopathy, usually defined as hypocalcemic cardiomyopathy (hypocaCM). [ncbi.nlm.nih.gov]
The etiology of postoperative hypoparathyroidism has been proven to be multifactorial, with the surgical technique, the devascularization and accidental resection of the parathyroid glands being the most significant factors. 11 It is also related to the [hormones.gr]
[…] thyroid screening INTRODUCTION Over 15% of all pregnancies, if strictly clinically diagnosed abortions are evaluated, excluding those that manifest themselves as polymenorrhea, result in fetal loss, at any time, from the conceiving until week 23. 1 Etiology [tmj.ro]
Epidemiology
Yet, a more recent outcome analysis of the Surveillance, Epidemiology, and End-Results (SEER) database demonstrated that lymph node status did significantly affect the outcome. [larianmd.com]
Malamos B, Koutras DA, Kostamis P, Kralios AC, Rigopoulos G, Zerefos N, 1966 Endemic goiter in Greece: epidemiologic and genetic studies. J Clin Endocrinol Metab 26: 688-695. 16. [hormones.gr]
The epidemiology of thyroid disease and implications for screening. Endocr Metab Clinics N Am 1997;26:189-218. 42. Surks MI, Ortiz E, Daniels GH, et al. Subclinical thyroid disease. JAMA. 2004;291:228-38. 43. Negro R, Formoso G, Mangieri T, et al. [tmj.ro]
The epidemiology of iodine-deficiency diseases in China. Am J Clin Nutr. 1993;57:264S–6S. PubMed Google Scholar Sun X, Shan Z, Teng W. Effects of increased iodine intake on thyroid disorders. Endocrinol Metab (Seoul). 2014;29:240–7. [wjso.biomedcentral.com]
Prevention
CONCLUSION: TT for Graves' disease prevented recurrent hyperthyroidism but did not prevent the progression of ophthalmopathy compared with BST. TRIAL REGISTRATION: ClinicalTrials.gov NCT01408368. [ncbi.nlm.nih.gov]