Surgical treatment of Graves’ disease in children and adolescents

2021 ◽  
Author(s):  
Mohamed Masmoudi ◽  
Regaig Marwa ◽  
Thabet Wadii ◽  
Mehdi Hasnaoui ◽  
Mighri Khalifa
Keyword(s):  
Surgical Treatment ◽  
Children And Adolescents ◽  
Graves Disease

The Surgical Treatment of Graves’ Disease in Children and Adolescents

2011 ◽  
Vol 35 (11) ◽  
pp. 2428-2431 ◽  
Author(s):  
C. Chiapponi ◽  
U. Stocker ◽  
Th. Mussack ◽  
J. Gallwas ◽  
K. Hallfeldt ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Children And Adolescents ◽  
Graves Disease

Graves' disease in children and adolescents. Late results of surgical treatment

1996 ◽  
Vol 134 (6) ◽  
pp. 710-715 ◽  
Author(s):  
Claes Rudberg ◽  
Henry Johansson ◽  
Göran Åkerström ◽  
Torsten Tuvemo ◽  
F Anders Karlsson
Keyword(s):  
Surgical Treatment ◽  
Medical Treatment ◽  
Children And Adolescents ◽  
Down's Syndrome ◽  
Antithyroid Drug ◽  
Down’S Syndrome ◽  
Late Results ◽  
Graves Disease

Rudberg C, Johansson H, ÅÅ G, Tuvemo T, Karlsson FA. Graves' disease in children and adolescents. Late results of surgical treatment. Eur J Endocrinol 1996;134:710–5. ISSN0804–4643 All children and adolescents with Graves' disease in the county of Uppsala (catchment area population 250000) treated between 1970 and 1994 were evaluated in a retrospective study. The material comprised 31 patients with a mean age of 11 years (range 4–16), 29 (94%) of whom were girls, and four (13%) of the patients had Down's syndrome. Treatment was primarily conservative and surgery was considered if prolonged medical treatment failed. Lasting remission after antithyroid drug therapy (median 6.5 years; range 4.5–8 years) was noted in 6/31 patients (19%), three (10%) of whom subsequently developed hypothyroidism. Twenty-four of the remaining patients (77%) ultimately underwent subtotal (N=20) or total thyroidectomy (N=4) after experiencing one or more episodes of recurrent hyperthyroidism during medical treatment (median 6 years; range 0.5–11 years). After surgery one patient developed permanent hypocalcemia requiring low-dose vitamin D supplementation. During a postoperative follow-up period of 12.2 years (median: range 1–17 years), there were two cases of recurrent thyrotoxicosis, 1 and 10 years after surgery. The results underline that gender and Down's syndrome are risk factors of juvenile Graves' disease and that the disorder often is difficult to control by long-term medical therapy. In such cases thyroid surgery offers a safe and prompt reversal of the thyrotoxicosis. A proportion of the patients may ultimately develop hypothyroidism, substantiating a need for long-term follow-up of persons afflicted with Graves' disease early in life. F Anders Karlsson, Department of Medicine, University Hospital, S-751 85 Uppsala. Sweden

Hydrosyringomyelia Associated with a Chiari I Malformation in Children and Adolescents

Neurosurgery ◽  
1990 ◽  
Vol 26 (4) ◽  
pp. 591-597 ◽  
Author(s):  
Toyohiko Isu ◽  
Yoshinohu Iwasaki ◽  
Minoru Akino ◽  
Hiroshi Abe
Keyword(s):  
Surgical Treatment ◽  
Children And Adolescents ◽  
Foramen Magnum ◽  
Chiari I Malformation ◽  
Motor Deficits ◽  
Foramen Magnum Decompression ◽  
Axial Section ◽  
Lower Cranial Nerve ◽  
Thoracic Level ◽  
Initial Symptoms

Abstract The clinical presentation, radiological features, and results of surgical treatment were analyzed in 17 cases of hydrosyringomyelia associated with a Chiari malformation, in children and adolescents younger than 20 years of age. The initial symptoms were a skeletal abnormality (71%), such as scoliosis (11 patients) or pes cavus (1 patient), pain or numbness (24%), and motor weakness (6%). Frequently seen signs on admission were sensory deficit (100%), scoliosis (85%), muscle weakness (64%), muscle atrophy (35%), and lower cranial nerve palsy (35%), The characteristic neurological findings were unilateral sensory and motor deficits (65%) with decreased or absent deep tendon reflexes on the same side. The localization of the syrinx on the axial section varied according to the level, even in the same patient. In 11 patients with unilateral sensory disturbances or unilateral sensory and motor deficits, the syrinx was located in the region corresponding to the posterolateral portion on the same side as that of sensory disturbance at the cervical or thoracic level. On the other hand, in 6 patients with bilateral sensory and motor deficits, the syrinx was located in the central portion and extended into the posterolateral portion of the more affected side. A syringosubarachnoid shunt was placed in 16 patients, foramen magnum decompression without closure of the obex was performed in 1 patient, ventriculoperitoneal shunt in 1 patient, terminal syringostomy in 1 patient, and foramen magnum decompression with terminal syringostomy in 1 patient. In 15 of 17 patients (88%), the neurological symptoms improved after an average follow-up of 4 years and 1 month. We think that as a surgical treatment, placement of a syringosubarachnoid shunt is effective.

scholarly journals Surgical Treatment of Graves' Disease: Comparison between Total Thyroidectomy and Subtotal Thyroidectomy

2009 ◽  
Vol 77 (2) ◽  
pp. 82 ◽  
Author(s):  
Tae-Yon Sung ◽  
Yon Seon Kim ◽  
Sook Hyun Lee ◽  
Jong Ho Yoon ◽  
Suk-Joon Hong
Keyword(s):  
Surgical Treatment ◽  
Total Thyroidectomy ◽  
Subtotal Thyroidectomy ◽  
Graves Disease

scholarly journals Outcomes of ophtalmologic surgical procedures of esotropia in children and adolescents

2008 ◽  
Vol 65 (8) ◽  
pp. 627-631
Author(s):  
Tamara Kljakovic-Avramovic ◽  
Miroslav Vukosavljevic ◽  
Sinisa Avramovic
Keyword(s):  
Surgical Treatment ◽  
Prospective Study ◽  
Children And Adolescents ◽  
Deviation Angle ◽  
Group Iii ◽  
Military Medical Academy ◽  
Group I ◽  
Medical Academy ◽  
Group Ii ◽  
Common Manifestation

Background/Aim. Esotropia is the most common manifestation form of strabism accompanied by refraction deviations and amblyopia. The aim of this prospective study was to present the outcomes of surgical treatment of esotropia in children and adolescents. Methods. Within the period from January 1st 2006 to February 1st 2007 at the Clinic for Ophtalmology, Military Medical Academy, Belgrade a total of 25 patients with esotropia (34 eyes) and previously corrected refraction anomaly and treated amblyopia were operated on. The patients were 4-19-year of age. All of the patients were submitted to a complete ophtalmologic and orthoptic examination prior to the surgery, and a month, three months and six months after the surgery. The surgery was performed under general anesthesia. Out of the total number of the patients nine were operated on both eyes, while 16 patients on one eye with amblyopia or frequent esodeviation. Nine patients were submitted to retroposition of the inner straight muscle, two to myectomy of the outer straight muscle, while in 14 of the patients a combination of retroposition and myectomy was performed. The patients were divided into three groups according to the preoperative angle at the distance and followed-up accordingly after the surgery. Deviation angle at the distance in the group I was 18-25 DP, in the group II 26-35 PD, while in the group III it was 36-60 PD. Results. The most numerous, group I (12 patients; 48%), a month following the surgery showed angle reduction by 55.58%, after three months 63.25%, and after six months 63.92%. The group II consisted of 8 patients (32%) showed angle reduction by 70.75% a month following the surgery, by 76% after three months, and by 79.12% after six months. The group III (5 patients; 20%) showed angle reduction by 72.20% a month following the surgery, 79.20 after three months, and 80.12% after six months following the surgery. Conclusion. The best postoperative outcomes after a month, three and six months were obtained in the group of patients with the highest esodeviation angle at the distance solved by the surgery on both eyes. Timely surgical treatment befell into major precondition for developing and maintaining the elements of binocular vision in the operated on patients. .

scholarly journals CLINICAL CASE OF NEONATAL THYROTOXICOSIS

2018 ◽  
Vol 63 (5) ◽  
pp. 183-187
Author(s):  
M. R. Shaydullina ◽  
A. R. Shakirova ◽  
A. A. Zinatullina
Keyword(s):  
High Risk ◽  
Children And Adolescents ◽  
Growth Retardation ◽  
Intrauterine Growth Retardation ◽  
Clinical Case ◽  
Heart Rhythm ◽  
The Body ◽  
Graves Disease ◽  
Intrauterine Growth ◽  
Neonatal Thyrotoxicosis

Neonatal thyrotoxicosis is 1% of all cases of thyrotoxicosis in children and adolescents and it is mostly determined by the mother’s Graves’ disease. The most dangerous manifestations of neonatal thyrotoxicosis are intrauterine growth retardation, tachycardia, and heart rhythm disturbances. Timely diagnostics and beginning of treatment are of great importance due to the high risk of fatal cardiac disruption in the acute phase of the disease and its serious consequences for the body. The article presents a clinical case of a patient with neonatal thyrotoxicosis diagnosed only at the age of 1 month, despite the mother’s burdened anamnesis; it contains a plan for diagnostic search and tactics of child management.

scholarly journals Results obtained after the surgical treatment of Graves’ disease depending on the levels of anti-thyroid antibodies

2021 ◽  
Author(s):  
S. L. Shliakhtych ◽  
V. R. Antoniv
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Surgical Technique ◽  
Hormone Receptors ◽  
Thyroid Stimulating Hormone ◽  
Endocrine Surgery ◽  
Graves Disease ◽  
Autoimmune Thyroid ◽  
Early Postoperative Complications ◽  
Surgery Duration

Graves' disease (GD) is a hereditary autoimmune disease which is characterized by persistent abnormal hypersecretion of thyroid hormones and thyrotoxicosis syndrome development. GD affects from 0.5 % to 2.0 % of population in different regions. 46 % of these patients develop ophthalmopathy. GD is a common cause of disabilities in patients under 60 years of age. In recent years, the incidence of GD in Ukraine has increased by 9.9 % — from 106.2 to 117.9 per 100,000 individuals. This can be connected with the improved diagnostic possibilities and active disease detection as well as with the increased number of autoimmune thyroid disorders. The recent studies focus on prevention of specific complications and recurrences of GD after surgery. Objective — to compare the levels of antibodies to the thyroid‑stimulating hormone receptors (TSHR‑Ab) during different postoperative periods as well as the incidence of early and late complications depending on the surgical technique used for the treatment of GD. Materials and methods. The results of surgical treatment of 130 patients, with GD were compared. 29 male patients and 101 female patients aged from 19 to 76 (average — 44.1 ± 3.2 years), receiving their treatment for GD in Kyiv Center of Endocrine Surgery during 2010—2018, were randomly selected and divided into two groups. At the time of operation the duration of disease was from 1 to 30 years (average — 4.6 ± 1.2 years). Group  1 included 65 patients that underwent total thyreoidectomy (TT) and group 2 included 65 patients that underwent subtotal thyreoidectomy (ST). The following parameters were compared: surgery duration, the incidence of early postoperative complications, including bleedings and damage to the recurrent laryngeal nerves, and late outcomes of surgical treatment (persistent hypoparathyreoidism disorder and disorder recurrences) depending on the method of surgery (ST or TT). Furthermore, the patterns of the TSHR‑Ab level reduction were studied for different postoperative periods. Results. The comparison of surgical outcomes following TТ and ST didn’t reveal any statistically significant differences in such evaluation criteria as the average surgery duration, the average volume of intraoperative blood loss and the average duration of the postoperative inpatient treatment. The comparative assessment of the thyroid stump volume and the average amount of drained discharge showed statistically significant differences for TТ. It allows considering TТ as a surgery which causes less complications than ST. The studied parameters of early postoperative complications had no significant differences for ST and TТ. The long‑term (5 years) postoperative level of TSHR‑Ab was statistically significantly lower in patients after TT and made up 1.15 ± 0.13 IU/L (thus corresponding to the normal level). Conclusions. Total thyroidectomy is an optimal surgical technique and is more appropriate compared with subtotal thyroid gland resection. It should be noted that TT provides lower risk of complications due to significantly lower level of TSHR‑Ab in late postoperative period.  

scholarly journals Problems of diagnostics and treatment of diffuse — toxic goiter (Graves’ disease)

2019 ◽  
Vol 14 (2) ◽  
Author(s):  
Saydiganikxodja I. Ismailov ◽  
Komila Kh. Khayitboyeva
Keyword(s):  
Surgical Treatment ◽  
Iodine Deficiency ◽  
Diagnostic Methods ◽  
Graves Disease ◽  
Minimal Risk ◽  
Familial Predisposition ◽  
Advantages And Disadvantages ◽  
Radioiodine Ablation ◽  
Treatment Indications ◽  
Toxic Goiter

The article is devoted to prevalence, contemporary diagnostic methods and treatment of Grave’s disease. Advantages and disadvantages of different treatment options are discussed. The cause of the disease can be environmental conditions, infectious diseases, severe operational intervention, drugs, trauma, especially brain traumas, iodine deficiency and radiation damage of thyroid in iodine deficiency conditions, familial predisposition. The ideal treatment of Graves’ disease should ensure a fairly rapid elimination of clinical symptoms of thyrotoxicosis, return to an euthyroid state, with minimal risk of complications. The relapse rate of the disease can reach up to 80 %, using conservative treatment. The radioiodine ablation is relatively simple, non-invasive, effective and cheap. There are special indications for surgical treatment. Indications for surgical treatment: 1) large goiter (the volume of the thyroid gland is more than 45 ml); 2) frequent recurrences of thyrotoxicosis and failure of the drug and RIT; 3)malignancy of goiter; 4) allergic and toxic (leukopenic) reactions to thyreostatics. Patients with Graves’ disease should referred to a specialized center with multidisciplinary team.

Sign in / Sign up

Export Citation Format

Share Document