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2.1
Injury of the Thyroid Gland
Neck Injury Thyroid Gland

Presentation

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]

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 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]

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]

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]

Entire Body System

  • 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]

    secondary toxic goiter, diffuse toxic goiter relapsing after full medical treatment, selected cases of thyroiditis (Hashimoto's thyroiditis) and thyroid cancer. [mmj.eg.net]

    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]

  • Thyroid Nodule

    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]

    an enlarging thyroid nodule, or a benign nodule that is large enough to cause symptoms, such as difficulty swallowing, shortness of breath, or hoarseness. [umm.edu]

    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]

    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]

    Indications [ edit ] Thyroid cancer Toxic thyroid nodule (produces too much thyroid hormone) Multinodular goiter (enlarged thyroid gland with many nodules), especially if there is compression of nearby structures Graves' disease, especially if there is [en.wikipedia.org]

  • Cold Intolerance

    Problems that may occur later and their symptoms include Hypothyroidism (not enough thyroid hormone): fatigue, constipation, weight gain, irregular menstrual periods, cold intolerance Hypogonadism (not enough sex hormones): in women, a stop in menstruation [thyroidnation.com]

    Chronic fatigue Weight gain and swelling in the eyes, face and limbs Low body temperature and cold intolerance Feeling depressed, anxious and irritable Having short-term memory loss and difficulty concentrating High blood cholesterol level that does not [juicing-for-health.com]

    intolerance, and dry skin. 10 The overlap in presentation likely contributes to the tendency to overlook endocrine dysfunction and focus solely on TBI. [rainbowrehab.com]

    They also do not tolerate cold temperatures (cold intolerance) as well as their friends with normally functioning thyroids. 4) Depression and Anxiety – When depression, anxiety, irritability, short-term memory loss, panic attacks and insomnia are present [vitalitymagazine.com]

    trembling hands, palpitations, insomnia, anxiety, increased bowel movement frequency - especially if the symptoms are new or persistent Hypothyroid Symptoms Weight gain, cold intolerance, constipation, very dry skin, slowed thinking, depressed mood, [surgery.ucsf.edu]

  • Malingering

    Many individuals who suffered from whiplash injuries were thought to be malingering or seeking insurance or disability benefits without cause from minor motor vehicle accidents. [wellnessresources.com]

Respiratoric

  • Hoarseness

    Throat injury can damage the trachea and can cause difficulty breathing, swallowing, or hoarseness of the throat. [autoaccident.com]

    Injury to this nerve during surgery can result in a permanent change to the voice, making it sound hoarse (rough) and soft. Thyroid surgery involves identifying these nerves and protecting them from injury. [surgicaloncology.net.au]

    The patient may have no symptom, be slightly hoarse, or have difficulty breathing. This cannot wait and the patient will need to go to the emergency room right away. [facialtraumamd.com]

    […] thyroid A thyroid lobectomy may be recommended for a variety of conditions, such as a toxic nodule, goiter, an enlarging thyroid nodule, or a benign nodule that is large enough to cause symptoms, such as difficulty swallowing, shortness of breath, or hoarseness [umm.edu]

    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]

  • Aspiration

    Página 83 - Mooney EE, Glasgow B, et al: What constitutes an adequate smear in fine needle aspiration cytology of the breast? ‎ [books.google.es]

    A thyroid lobectomy may also be done because the pre-operative fine needle aspiration biopsy may be suspicious for cancer or non-diagnostic. [umm.edu]

    […] operations on large thyroid glands. [ 5 ] Complications Possible complications following thyroid surgery include: Minor complications such as collections of serous fluid (they resolve spontaneously if small and asymptomatic but may require single or repeated aspiration [patient.info]

    […] produces too much thyroid hormone) Multinodular goiter (enlarged thyroid gland with many nodules), especially if there is compression of nearby structures Graves' disease, especially if there is exophthalmos (bulging eyes) Thyroid nodule, if fine needle aspirate [en.wikipedia.org]

  • Dyspnea

    We report a 75-year-old woman who was brought to our emergency room (ER) with dyspnea and cervical swelling after a fall. Fiberscopic examination identified partial occlusion of the trachea. [jstage.jst.go.jp]

    Patients with dyspnea and respiratory distress should be referred immediately for direct laryngoscopy. [clinicaladvisor.com]

    Although our patient did not complain of dyspnea on admission, laryngeal fibroscopy revealed arytenoid edema. According to the literature, the management of this type of injury varies. [bmcresnotes.biomedcentral.com]

    Patients present with neck swelling, neck pain, and/or signs and symptoms of airway obstruction (eg, dyspnea, stridor, hypoxia). [emedicine.medscape.com]

Gastrointestinal

  • Dysphagia

    Presentation Post motor vehicle accident with dysphagia, globus and left neck swelling. Patient Data Age: 55 years Gender: Female Loading images... [radiopaedia.org]

    Fever, dysphagia, and dysphonia also are present. In the absence of preexisting thyroid disease, thyroid function most often is normal, but hyperthyroidism and hypothyroidism may be present. [aafp.org]

    Other potential sequelae of unilateral vocal-fold paralysis are dysphagia and aspiration. Bilateral vocal-fold paralysis may occur after total thyroidectomy, and it usually manifests immediately after extubation. [emedicine.medscape.com]

Cardiovascular

  • Palpitations

    Decreased body temperature Difficulty losing weight despite dieting Fatigue Low energy Decreased appetite Depression or anxiety Increased need for sleep Return to top Weight loss Difficulty maintaining a normal weight Increased energy or hyperactivity Palpitations [ebtherapy.com]

    When this happens, the following symptoms may occur: increased heart rate abnormal heartbeat rhythm (palpitations or "pounding") increased body heat, causing one to feel warm even in a cool room moist skin because of perspiration increased activity of [medbroadcast.com]

    […] loss of interest in sex itchy skin with raised itchy swellings (urticaria) nails become loose menstrual problems in women, especially lighter periods or absence of periods alopecia where hair is lost in patches accelerated heartbeat, sometimes with palpitations [medicalnewstoday.com]

    Hyperthyroidism Overproduction of thyroid hormone (hyperthyroidism) also occurs in several forms and may cause insomnia, weight loss, heart palpitations, high blood pressure, temperature intolerance, osteoporosis, and eye disorders among other problems [kumc.edu]

    […] new and persistent Coughing up blood Shortness of breath Symptoms of Possible Cancer Spread Bone pain in one spot without relief Weakness or numbness of an arm or leg that persists Hyperthyroid Symptoms Weight loss, heat intolerance, trembling hands, palpitations [surgery.ucsf.edu]

  • Hypertension

    Also of the patients 25.8% had diabetes mellitus, 16.1% had hypertension, %16.1 had cancer, 12.9% had cardiovascular disease, 9.7% had acute gastroenteritis, 38.7% had urinary tract infection, 9.7% had pneumonia. [endocrine-abstracts.org]

    In 2011 I injured my neck in an auto incident as well and the next month I began feeling funny and soon I was very ill because I developed hypertension and hyperthyroidism. The side effects of the meds were making me so depressed. [medhelp.org]

Jaw & Teeth

  • Dental Caries

    Radiation to the mouth and jaw can cause permanent dry mouth, resulting in an increased number of dental caries and damage to the jawbone. Radiation to the lungs can cause lung inflammation (radiation pneumonitis). [merckmanuals.com]

Skin

  • Dry Skin

    When you have hypothyroidism, certain body functions slow down and may lead to fatigue, dry skin, and memory problems. Hypothyroidism is diagnosed with a blood test. You may experience a variety of symptoms—some resembling other health issues. [endocrineweb.com]

    Typically a clinician also feels a patient's neck to assess the size of the thyroid gland and checks for other physical signs of hypothyroidism, such as brittle nails and dry skin. [health.harvard.edu]

    If cells are damaged and thyroid hormone levels fall, you might show symptoms of hypothyroidism, such as: Fatigue Unexpected weight gain Constipation Depression Dry skin Difficulty performing physical exercise Decreased mental ability to concentrate and [my.clevelandclinic.org]

    skin. 10 The overlap in presentation likely contributes to the tendency to overlook endocrine dysfunction and focus solely on TBI. [rainbowrehab.com]

  • Brittle Hair

    […] loss, dull and brittle hair Loss of hair in the outer edge of eyebrows Dull-looking and thin skin Inflammation in wrist (carpal tunnel), chronic tendonitis and joint pains Muscle cramps, aches and pains, such as fibromyalgia Read about simple diet and [juicing-for-health.com]

Psychiatrical

  • Loss of Libido

    increased risk for heart attacks, strokes, high blood pressure, diabetes, loss of libido, menstrual irregularities, premature menopause, obesity, loss of lean body mass, muscular weakness, and a number of other medically documented conditions. [lifeextension.com]

Face, Head & Neck

  • Neck Mass

    Neck ultrasonography is non-invasive and gives critical information about the overlying thyroid gland and will often show an enlarged mass behind the thyroid consistent with an enlarged parathyroid gland. [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]

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]

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]

After starting treatment, it may take several weeks or months for hormone levels to adjust to the normal range. On average, total treatment time is between 1 and 2 years, but it can take longer. [medicalnewstoday.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]

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]

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]

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]

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]

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]

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2.1
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