At one time, thyroid disease, particularly in the form of marked enlargements and over activity, was only curable by surgical treatment. In the last 50 years, medical discoveries regarding the thyroid gland have been numerous and have resulted in decreasing the need for surgical treatment. However, surgical treatment is still an essential part of the treatment of many thyroid conditions as bellow:
- Thyroid canceris present or is suspected.
- A fluid-filled (cystic) nodule returns after being drained once or twice.
- Surgery also may be done if you arepregnantor cannot tolerate antithyroid medicines.
- Hyperthyroidism
Hyperthyroidismcannot be treated with medicines or radioactive iodine.Surgery is rarely used to treat hyperthyroidism. It may be used if thethyroidgland is so big that it makes swallowing or breathing difficult or thyroid cancer has been diagnosed or is suspected.
- Goitre
Most euthyroid multinodular goitres do not necessarily require surgery or medical therapy. Serial thyroid ultrasound is useful to follow the size of individual nodules. Larger multinodular goitres require either MRI or CT scan in order to exclude tracheal compression and to assess thyroid size. The definitive treatment for toxic multinodular goitres is biopsy of suspicious nodules or surgical excision, followed by radio-iodine therapy. Surgical treatment is recommended for benign nodules causing compressive symptoms and can be considered for toxic nodular disease and thyroid cysts.
Surgery is indicated in simple goitre if:
- There is clinical or radiological evidence of compression of surrounding structures, especially the trachea.
- There are substernal goitres, which are best removed surgically, as biopsy is difficult and clinical observation without frequent CT or MRI scans is impossible.
- The goitre continues to grow.
- There are cosmetic reasons – for example, large or unsightly.
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