Rare association of primary hyperparathyroidism and toxic multinodular goiter

Factors responsible for major complications following thyroid surgery in 598 patients were studied. Patients with non toxic multinodular goiter involving both lobes of thyroid constituted the maximum bulk subjected to thyroidectomy. The most frequent procedure was bilateral subtotal thyroidectomy. Reactionary hemorrhage occurred in 6 patients, all following bilateral procedures and among them 5 patients developed tension hematoma with respiratory obstruction despite the presence of a drain. Temporary vocal cord palsy was observed in 7 patients whereas one patient subjected to total thyroidectomy with neck dissection for papillary carcinoma of thyroid developed permanent right vocal cord palsy. Temporary parathyroid insufficiency was seen in 51 patients and one patient developed permanent hypoparathyroidism. Incidence of parathyroid insufficiency was higher in bilateral procedures as compared to unilateral ones. There was no operation related death in this series, but complications like hemorrhage, vocal cord palsy and parathyroid insufficiency following thyroid surgery are still a deep concern. Keywords: Complication; Post-operative; Thyroid surgeryOnline: 29-1-2009DOI: 10.3329/bmrcb.v34i3.1973Â Â Â Â Â Bangladesh Med Res Counc Bull 2008; 34: 99-103.Â

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The Rare Coincidence: Nonrecurrent Laryngeal Nerve Pointed by a Zuckerkandl's Tubercle

Case Reports in Medicine ◽

10.1155/2012/143049 ◽

2012 ◽

Vol 2012 ◽

pp. 1-3 ◽

Cited By ~ 5

Author(s):

Emin Gurleyik ◽

Sami Dogan ◽

Omer Gunal ◽

Mevlut Pehlivan

Keyword(s):

Multinodular Goiter ◽

Laryngeal Nerve ◽

Inferior Laryngeal Nerve ◽

Adjacent Structures ◽

Toxic Multinodular Goiter ◽

Posterior Extension ◽

Right Lobe ◽

Nonrecurrent Laryngeal Nerve ◽

The Right ◽

Case Based

The safety of thyroid operations mainly depends on complete anatomical knowledge. Anatomical and embryological variations of the inferior laryngeal nerve (ILN), of the thyroid gland itself and unusual relations between ILN and the gland threaten operation security are discussed. The patient with toxic multinodular goiter is treated with total thyroidectomy. During dissection of the right lobe, the right ILN which has nonrecurrent course arising directly from cervical vagus nerve is identified and fully isolated until its laryngeal entry. At the operation, we observe bilateral Zuckerkandl's tubercles (ZTs) as posterior extension of both lateral lobes. The left ILN has usual recurrent course in the trachea-esophageal groove. The right ZT is placed between upper and middle third of the lobe points the nonrecurrent ILN. The coincidence of non-recurrent ILN pointed by a ZT is rare anatomical and embryological feature of this case. Based on anatomical and embryological variations, we suggest identification and full exposure of ILN before attempting excision of adjacent structures, like the ZT which has surgical importance for completeness of thyroidectomy.

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Evidence-based Management of Toxic Multinodular Goiter (Plummer’s Disease)

World Journal of Surgery ◽

10.1007/s00268-008-9566-0 ◽

2008 ◽

Vol 32 (7) ◽

pp. 1278-1284 ◽

Cited By ~ 42

Author(s):

John R. Porterfield ◽

Geoffrey B. Thompson ◽

David R. Farley ◽

Clive S. Grant ◽

Melanie L. Richards

Keyword(s):

Multinodular Goiter ◽

Evidence Based ◽

Toxic Multinodular Goiter ◽

Plummer's Disease ◽

Plummer’S Disease

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Toxic Multinodular Goiter and Solitary Toxic Adenoma

Atlas of Thyroid Ultrasonography ◽

10.1007/978-3-319-53759-7_12 ◽

2017 ◽

pp. 135-140

Author(s):

Milan Halenka ◽

Zdeněk Fryšák

Keyword(s):

Multinodular Goiter ◽

Toxic Adenoma ◽

Toxic Multinodular Goiter

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Változások a pajzsmirigybetegségek radiojódkezelésében

Orvosi Hetilap ◽

10.1556/650.2016.30322 ◽

2016 ◽

Vol 157 (3) ◽

pp. 83-88

Author(s):

András Konrády

Keyword(s):

Multinodular Goiter ◽

Radioiodine Therapy ◽

Treatment Protocol ◽

Treatment Results ◽

Radioiodine Uptake ◽

Risk Patients ◽

Toxic Multinodular Goiter ◽

Prospective Trials ◽

Immunogenic Hyperthyroidism ◽

Recombinant Human Thyrotropin

Radioiodine therapy for benign and malignant thyroid diseases was introduced about 70 years ago, however, there is still a lack of consensus regarding indications, doses and procedure. This review covers treatment results in immunogenic hyperthyroidism including the problem of orbitopathy. Radioiodine therapy for toxic and non-toxic multinodular goiter is also discussed with striking possibility of enhanching the radioiodine uptake. In this respect the recombinant human thyrotropin should be mentioned. Thyroid cancer treatment protocol has changed, too, due to ineffectivity in low-risk patients. More attention is needed to the carcinogenecity of radioiodine. The numerous problems mentioned above require large and well-designed prospective trials to resolve the fundamental questions. The author emphasizes that radioiodine dose should be administered in doses as low as reasonably achievable. Orv. Hetil., 2016, 157(3), 83–88.

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