scholarly journals Solitary nodule thyroid: diagnosis and management

2017 ◽  
Vol 3 (3) ◽  
pp. 611
Author(s):  
M. Deepthi ◽  
P. S. Sukthankar ◽  
K. Narsimloo
Keyword(s):  
Prospective Study ◽  
Total Thyroidectomy ◽  
Medical Therapy ◽  
Multinodular Goiter ◽  
Outpatient Department ◽  
Multinodular Goitre ◽  
Malignant Nodule ◽  
Solitary Nodule ◽  
Benign Nodules ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Solitary nodule can be a true solitary nodule or a dominant nodule of multinodular goitre or ectopic thyroid or unilateral agenesis. Solitary nodule can be benign or malignant. Purpose of evaluation is to differentiate between the two. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">A prospective study of solitary nodule thyroid (STN) patients presenting to ENT outpatient department, for a period of 3 years from September 2012 to 2015.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Out of 67 patients<strong> </strong>enrolled into study, 53 patients had benign true STN, 9 patients had multinodular goiter (MNG) presenting as solitary nodule and 5 had malignant nodule (7.46%). Among the benign nodules, 25 patients had small solitary nodule (&lt;4 cm size). They were treated medically and followed-up for a period of 1 year. 28 patients with large benign solitary nodules (&gt;4 cm size) were taken up for surgery directly. Hemithyroidectomy was done in benign STN patients (39 patients) and total thyroidectomy was done in malignant nodule and MNG patients and followed-up by lifelong L-T<sub>4 </sub>therapy. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Small benign solitary nodules regress with medical therapy alone. In large solitary nodules, and in those nodules not regressing with medical therapy, hemithyroidectomy is adequate. In MNG and malignant nodules, total thyroidectomy is advocated. Hemithyroidectomy and total thyroidectomy patients were followed - up with suppression and supplementation therapy respectively.</span><span lang="EN-IN">This area being fluorotic belt, there is an increased prevalence of goiter. This study gives a concise guideline in evaluation and management of STN for goiter endemic areas.</span></p><p class="abstract"> </p>

A Prospective Study on Post-Operative Complications Following Thyroid Surgery Conducted in a Tertiary Care Hospital in Tirupati

2021 ◽  
Vol 8 (31) ◽  
pp. 2900-2905
Author(s):  
Sadhu Nagamuneiah ◽  
Gandikota Venkata Prakash ◽  
Sabitha P ◽  
Karthik Periyasamy ◽  
Sanjay Raj Kumar Reddy Madduri ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Prospective Study ◽  
Total Thyroidectomy ◽  
General Hospital ◽  
Thyroid Surgery ◽  
Complication Rate ◽  
Wound Complication ◽  
Seroma Formation ◽  
Operative Complications ◽  
A Prospective Study

BACKGROUND Thyroidectomy is a surgical procedure which is commonly performed by surgeons worldwide, but the outcome and complication rates were mainly dependent on the surgeon’s skill and experience, indication and the extent of surgery and the number of thyroid surgeries performed at that particular centre. The aim of this study was to assess the frequency of the postoperative complications after thyroid surgery in Sri Venkateswara Ramnaraian Ruiya Government General Hospital, Tirupati. METHODS A prospective study conducted on 100 patients with thyroid swelling who attended the Sri Venkateshwara Ramnaraian Ruya Government General Hospital, Tirupati. Patient age, sex, rural/urban origin, history, diagnosis, type of surgery, laboratory investigation such as complete blood, serum calcium, thyroid function test, us culture and sensitivity test in wound infections and indirect laryngoscopy for all pre-operative patients and postoperative voice change patients. Outcomes recorded as a complication of thyroid surgery within one week. RESULTS Totally 100 patients were enrolled in the study. Thyroid enlargement was more common in females (F: M =5.6:1) presenting in 3rd and 4th decades mostly with the mean age and standard deviation were 42.92 years and 13.097 years respectively. Total thyroidectomy was the most common procedure performed (44 %) followed by hemithyroidectomy (31 %), subtotal thyroidectomies (29 %) and near total thyroidectomy (5 %). On histopathological examination most common finding was multinodular goiter (54 %) followed by nodular goiter (33 %) and malignancies (10 %). The overall postoperative complication rate was 47 %. The most common postoperative complications after thyroidectomies were seroma formation in wound complication (27 %), followed by hypocalcemia (11 %), recurrent laryngeal nerve (RLN) injury (3 %), and surgical site infection (2 %). Majority of these complications were found to be associated with total thyroidectomy, female population, and in patients with age more than 30 years. CONCLUSIONS Seroma formation in wound complication is the commonest post thyroidectomy complication. Female gender, old age, and extensive thyroid surgery were associated with increased complication rate. KEYWORDS Post-Operative Complications, Thyroid Surgery

scholarly journals Use of prophylactic oral calcium after total thyroidectomy: a prospective study

2017 ◽  
Vol 61 (5) ◽  
pp. 447-454 ◽  
Author(s):  
Erwin Langner ◽  
Alfio José Tincani ◽  
André del Negro
Keyword(s):  
Prospective Study ◽  
Total Thyroidectomy ◽  
Oral Calcium ◽  
A Prospective Study

scholarly journals Hashimoto Thyroiditis and Thyroid Ultrasound: A Prospective Study

2021 ◽  
Author(s):  
Anabela Zunino ◽  
Claudia Vazquez ◽  
Laura Delfino ◽  
Adriana Reyes ◽  
Alicia Lowenstein
Keyword(s):  
Prospective Study ◽  
Thyroid Nodules ◽  
Thyroid Volume ◽  
Hashimoto Thyroiditis ◽  
Needle Aspiration ◽  
Thyroid Peroxidase ◽  
Papillary Thyroid ◽  
Immunological Activity ◽  
Benign Nodules ◽  
A Prospective Study

Abstract Purpose We performed a prospective study in patients with positive thyroid peroxidase antibodies (TPOAb), to describe their ultrasound (US) patterns and the prevalence of thyroid nodules. Methods In 195 consecutive patients, with positive TPOAb, thyroid US was performed by the same physician and equipment and categorized into four echographic patterns (EP). We determined the prevalence of thyroid nodules and their etiology confirmed by cytology or histology. Results The median TPOAb was 526 IUI/ml. EP1 or normal US was present in 9,7%; EP2 or early/indeterminate stage in 29,4%; EP3 or established thyroiditis in 45,4% and EP4 or advanced/late stage in 15,5% of the patients. TPOAb (median = 857 UI / ml) (p = 0.001), TSH and thyroid volume ​​were higher in EP3. A higher degree of fibrosis was associated with TPOAb > 1000 IU/ml(p = 0,003). Thyroid nodules were reported on US at 47,2% of HT. Fine needle aspiration(FNA) was performed in 49/60 nodules. Cytology: BII: 41 patients (83,7%), B V: 1 patient (2%): suspicious for lymphoma; B VI: 3 patients(6,1%) : Papillary thyroid carcinoma. Benign cytology was present in 56% of EP3 (p = 0,048). Conclusions Higher TPOAb, TSH levels, and thyroid volume were associated with EP3. Fibrosis correlated with TPOAb > 1000 IU/ml. In our population, benign nodules were associated with established thyroiditis patterns. The increased inflammation and immunological activity of Hashimoto thyroiditis (HT) could be a favorable environment for growth factors for benign nodular development.

scholarly journals Risk factors of permanent hypoparathyroidism after total thyroidectomy and central neck dissection for papillary thyroid cancer: a prospective study

2020 ◽  
Vol 71 (2) ◽  
pp. 126-133
Author(s):  
Paulina Godlewska ◽  
Małgorzata Benke ◽  
Elżbieta Stachlewska-Nasfeter ◽  
Jacek Gałczyński ◽  
Bartosz Puła ◽  
...  
Keyword(s):  
Risk Factors ◽  
Thyroid Cancer ◽  
Prospective Study ◽  
Total Thyroidectomy ◽  
Neck Dissection ◽  
Central Neck Dissection ◽  
Central Neck ◽  
Permanent Hypoparathyroidism ◽  
Papillary Thyroid ◽  
A Prospective Study

scholarly journals Shear Wave Elastography and Thyroid Imaging Reporting and Data System (TIRADS) for the Risk Stratification of Thyroid Nodules—Results of a Prospective Study

Diagnostics ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. 109
Author(s):  
Manuela Petersen ◽  
Simone A. Schenke ◽  
Jonas Firla ◽  
Roland S. Croner ◽  
Michael C. Kreissl
Keyword(s):  
High Risk ◽  
Risk Stratification ◽  
Prospective Study ◽  
Thyroid Nodules ◽  
Shear Wave Elastography ◽  
Low Risk ◽  
Intermediate Risk ◽  
Risk Class ◽  
Benign Nodules ◽  
A Prospective Study

Purpose: To compare the diagnostic performance of thyroid imaging reporting and data system (TIRADS) in combination with shear wave elastography (SWE) for the assessment of thyroid nodules. Methods: A prospective study was conducted with the following inclusion criteria: preoperative B-mode ultrasound (US) including TIRADS classification (Kwak-TIRADS, EU-TIRADS), quantitative SWE and available histological results. Results: Out of 43 patients, 61 thyroid nodules were detected; 10 nodules were found to be thyroid cancer (7 PTC, 1 FTC, 2 HüCC) and 51 were benign. According to Kwak-TIRADS the majority of benign nodules (47 out of 51, 92.2%) were classified in the low-risk- and intermediate-risk class, four nodules were classified as high-risk (7.8%). When using EU-TIRADS, the benign nodules were distributed almost equally across all risk classes, 21 (41.2%) nodules were classified in the low-risk class, 16 (31.4%) in the intermediate-risk class and 14 (27.4%) in the high-risk class. In contrast, most of the malignant nodules (eight out of ten) were classified as high-risk on EU-TIRADS. One carcinoma was classified as low-risk and one as intermediate-risk nodule. For SWE, ROC analysis showed an optimal cutoff of 18.5 kPa to distinguish malignant and benign nodules (sensitivity 80.0%, specificity 49.0%, PPV 23.5% and NPV 92.6%). The addition of elastography resulted in an increase of accuracy from 65.6% to 82.0% when using Kwak-TIRADS and from 49.2% to 72.1% when using EU-TIRADS. Conclusion: Our data demonstrate that the combination of TIRADS and SWE seems to be superior for the risk stratification of thyroid nodules than each method by itself. However, verification of these results in a larger patient population is mandatory.

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