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Injury of the Thyroid Gland

Neck Injury Thyroid Gland


Presentation

  • Presentation The clinical presentation of a patient with SLN paralysis may be subtle. Most patients do not notice any change. On occasion, a patient presents with mild hoarseness or decreased vocal stamina.[emedicine.medscape.com]
  • Patients with unilateral vocal fold paralysis present with postoperative hoarseness. Presentation is often subacute and voice changes may not present for days or weeks. Unilateral paralysis may resolve spontaneously.[patient.info]
  • Because the thyroid gland is located in the anterior cervix, neck pain without swelling may be the only presenting symptom immediately after neck trauma.[bmcresnotes.biomedcentral.com]
  • Patients with suppurative thyroiditis commonly present with acute unilateral anterior neck pain and erythema of the skin overlying an exquisitely tender thyroid. Fever, dysphagia, and dysphonia also are present.[aafp.org]
  • Presentation Post motor vehicle accident with dysphagia, globus and left neck swelling. Patient Data Age: 55 years Gender: Female Loading images...[radiopaedia.org]
Physician
  • […] with chapters written by the field’s leading authoritative experts, Thyroid Cancer: A Comprehensive Guide to Clinical Management, Third Edition , will be of great interest to not only pathologists, endocrine surgeons, endocrinologists, nuclear medicine physicians[books.google.com]
  • Our physicians and nursing staff are committed to providing safe and compassionate care.[medicine.yale.edu]
  • The dedicated staff includes an osteopathic physician who is board-certified in emergency medicine, and a chiropractor. Both doctors are passionate about relieving patients’ symptoms and providing permanent solutions to their health problems.[thevanguardclinic.com]
  • You will meet with a nurse practitioner or physician’s assistant from the anesthesiology department. The pre-op exam can include laboratory work, chest X-ray, and EKG.[hopkinsmedicine.org]
  • It is important not to move the neck until a physician has cleared the patient. The patient should be taken to the emergency room via paramedics. In the emergency room further workup will be performed to evaluate the extent of the damage.[facialtraumamd.com]
Goiter
  • Multinodular Goiter A multi-nodular goiter is an enlarged thyroid gland with a goiter comprised of multiple thyroid nodules.[surgery.ucsf.edu]
  • A total thyroidectomy may be done for cancer, but also benign thyroid conditions that affect both lobes, such as Graves' disease, multinodular goiter, and substernal goiter, among others.[umm.edu]
  • Acute increase in goiter size during a normal pregnancy: an exceptional case report. Thyroid 2003;13:881–884. CrossRef PubMed Google Scholar 8. Grace RH, Shilling JS.[link.springer.com]
  • Few cases have been published, mostly in patients with pre-existing goiter or thyroid adenoma, and this may explain the isolated thyroid gland hemorrhage.1-4, 7 In our two patients there was no history of goiter, thyroid gland adenoma, or hyperthyroidism[redorbit.com]
  • , secondary toxic goiter, diffuse toxic goiter relapsing after full medical treatment, selected cases of thyroiditis (Hashimoto's thyroiditis) and thyroid cancer.[mmj.eg.net]
Thyroid Nodule
  • Leonard Wartofsky and Douglas Van Nostrand, this gold standard reference is divided into 11 Parts: General Considerations on Thyroid Cancer; General Considerations on Nuclear Medicine; the Thyroid Nodule; Well-Differentiated Thyroid Cancer; Variants of[books.google.com]
  • What is a Thyroid Nodule? A thyroid nodule is simply a lump or mass in the thyroid gland. Thyroid nodules are relatively common; 6% of adult women and 2% of adult men in the U.S. have a thyroid nodule that can be felt on examination.[surgery.ucsf.edu]
  • The pathologist will look at one or two sections of the thyroid nodule specimen in question while the patient is still in the operating room to see if is cancer present.[umm.edu]
  • Patient selection: blunt trauma to the thyroid gland and adjacent structures Type of Injury Grade small lacerations to the parenchyma of the thyroid gland I bleeding into thyroid nodules I subcapsular hematoma in the thyroid gland I rupture of the thyroid[meducator3.net]
  • […] is exophthalmos (bulging eyes) Thyroid nodule, if fine needle aspirate (FNA) results are unclear [1] Types [ edit ] A lobectomy of the thyroid gland Hemithyroidectomy—Entire isthmus is removed along with 1 lobe.[en.wikipedia.org]
Thyroid Nodule
  • Leonard Wartofsky and Douglas Van Nostrand, this gold standard reference is divided into 11 Parts: General Considerations on Thyroid Cancer; General Considerations on Nuclear Medicine; the Thyroid Nodule; Well-Differentiated Thyroid Cancer; Variants of[books.google.com]
  • What is a Thyroid Nodule? A thyroid nodule is simply a lump or mass in the thyroid gland. Thyroid nodules are relatively common; 6% of adult women and 2% of adult men in the U.S. have a thyroid nodule that can be felt on examination.[surgery.ucsf.edu]
  • The pathologist will look at one or two sections of the thyroid nodule specimen in question while the patient is still in the operating room to see if is cancer present.[umm.edu]
  • Patient selection: blunt trauma to the thyroid gland and adjacent structures Type of Injury Grade small lacerations to the parenchyma of the thyroid gland I bleeding into thyroid nodules I subcapsular hematoma in the thyroid gland I rupture of the thyroid[meducator3.net]
  • […] is exophthalmos (bulging eyes) Thyroid nodule, if fine needle aspirate (FNA) results are unclear [1] Types [ edit ] A lobectomy of the thyroid gland Hemithyroidectomy—Entire isthmus is removed along with 1 lobe.[en.wikipedia.org]
Surgical Procedure
  • Thyroidectomy is a common surgical procedure that has several potential complications or sequelae including: temporary or permanent change in voice, temporary or permanently low calcium, need for lifelong thyroid hormone replacement, bleeding, infection[en.wikipedia.org]
  • As with any surgical procedure, there are risks involved. There is a risk of bleeding, but this is very low. The average blood loss is less than an ounce. The risk of infection is so low that antibiotics are not routinely used.[hopkinsmedicine.org]
  • This could help the surgical procedures done on the patient and can assess things like the patency of the trachea, the integrity of the esophagus and the structure of the thyroid gland.[autoaccident.com]
  • Minimally Invasive Parathyroid Surgery If the offending parathyroid has been localized with imaging prior to surgery a limited surgical procedure is often appropriate.[kumc.edu]
Neck Mass
  • It often presents as a rapidly expanding neck mass with swallowing and breathing difficulties. Direct invasion of the voice box, trachea and esophagus is common. These cancers are often too large and invasive to be removed surgically.[kumc.edu]

Workup

  • […] identification and preservation of the RLN minimizes the risk of injury. [1] Evaluation Techniques for assessing vocal fold mobility include indirect and fiberoptic laryngoscopy Documentation of vocal fold mobility should be a routine part of the preoperative workup[emedicine.medscape.com]
Candida
  • Candida is a common infection, but unfortunately, not many people pay attention to it, nor treat it. Poor levels of healthy gut bacteria create a perfect environment for the yeast.[juicing-for-health.com]
  • Rona: Vitamin D: The Sunshine Vitamin Complete Candida Yeast Guidebook (co-authored with Jeanne Marie Martin). References · Barnes, Broda O. Hypothyroidism, The Unsuspected Illness . Harper and Rowe, 1976. · Stephen Langer, M.D. and James Scheer.[vitalitymagazine.com]
  • It varies: an uncontrolled infection low iodine too much iodine food sensitivities intestinal permeability caused by SIBO (small intestinal bacterial overgrowth) or uncontrolled candida any gut issues even parasites like Blastocystis Hominis and others[stopthethyroidmadness.com]
Streptococcus Pneumoniae
  • pneumoniae ), fungal, mycobacterial, or parasitic infection of the thyroid.[aafp.org]

Treatment

  • A classification and an algorithm for diagnosis and treatment of thyroid gland injuries is proposed. A literature review reveals 16 case reports.[journals.lww.com]
  • There is a valuable reference atlas of scan images and illustrations, and a scholarly summary of the side effects of radioiodine and how to avoid or minimize adverse effects of treatment.[books.google.com]
  • Thyroid Storm Medical Treatment Treatment of thyroid storm consists of life support measures to support vital organ function along with attempts to reduce thyroid hormone release.[emedicinehealth.com]
  • Thyroiditis treatment Treatment for thyroiditis depends on your type and what symptoms you have. If you have symptoms of hyperthyroidism, your doctor may prescribe a medicine called a beta blocker.[familydoctor.org]
  • Conservative treatment may be successful in selected patients with lower grade injuries and without concomitant thyroid disease.[ncbi.nlm.nih.gov]

Prognosis

  • Well-differentiated Thyroid Carcinoma This form of thyroid cancer has an excellent prognosis, especially for people under 45 years of age.[kumc.edu]
  • Furthermore, EMG may yield information concerning the prognosis of the patient with RLN injury.[emedicine.medscape.com]

Etiology

  • Thoroughly revised and extensively expanded, this encyclopedic, highly acclaimed title addresses all aspects of the etiology, pathogenesis, diagnosis, initial treatment and long-term management of all varieties of thyroid cancer.[books.google.com]
  • The presentation of diminished thyroid function during severe or chronic illness of unrelated etiology is often difficult to determine and its treatment is controversial.[hormonesmatter.com]
  • Thyroiditis is an inflammation of the thyroid gland that has several etiologies and can be associated with normal, elevated, or depressed thyroid function, often with evolution from one condition to another.[aafp.org]
  • Regardless of the etiology, the management is unchanged. If uncertainty remains 6 months after surgery, PTH levels may be checked evaluate recovery of parathyroid gland function.[emedicine.medscape.com]
  • The etiology of Anaplastic Carcinoma is unknown and is considered by most to be incurable. It often presents as a rapidly expanding neck mass with swallowing and breathing difficulties.[kumc.edu]

Epidemiology

  • Clinical review 169: interferon-alpha-related thyroid disease: pathophysiological, epidemiological, and clinical aspects. J Clin Endocrinol Metab . 2004;89:3656–61. 23. Schuppert F, Rambusch E, Kirchner H, Atzpodien J, Kohn LD, von zur Muhlen A.[aafp.org]
Sex distribution
Age distribution

Pathophysiology

  • When the thyroid is compromised, a range of other pathophysiological processes emerge, including demyelination.[hormonesmatter.com]
  • Clinical review 169: interferon-alpha-related thyroid disease: pathophysiological, epidemiological, and clinical aspects. J Clin Endocrinol Metab . 2004;89:3656–61. 23. Schuppert F, Rambusch E, Kirchner H, Atzpodien J, Kohn LD, von zur Muhlen A.[aafp.org]

Prevention

  • It is very important that the surgeon preserves the parathyroid glands when removing the thyroid gland to prevent this serious complication.[surgicaloncology.net.au]
  • Prevention Preoperative awareness of the hyperthyroid patient and appropriate medical treatment are the keys preventing thyrotoxic storm.[emedicine.medscape.com]
  • Infection — occurs in about 1/2000 thyroid operations, and the routine use of antibiotics to prevent infection is not necessary. In general, the neck is a clean area that usually does not get infected.[endocrinediseases.org]
  • Thyroid Storm Prevention Thyroid storm can be prevented with early treatment of hyperthyroidism and recognition of the warning symptoms of thyroid storm. Thyroid Storm Prognosis Thyroid storm is a very serious condition that can result in death.[emedicinehealth.com]
  • Louis combine their diverse skills and knowledge to relieve patients of all ages of chronic health conditions, as well as advising them about ways to prevent future illnesses and injuries.[thevanguardclinic.com]

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