Most patients with diffuse hyperthyroidism or Graves’ disease are now treated with radioactive iodine. This method has the advantage of simplicity and safety, although a longer period of time is required to correct the hyperthyroidism than is necessary with surgery. Operating on a toxic thyroid gland is more difficult than excising a solitary adenoma. The gland is larger and more vascular, especially if the patient has been prepared with propylthiouracil or methimazole. With the use of propranolol for the preoperative preparation of a toxic patient, the symptoms of hyperthyroidism disappear quite rapidly and the thyroid gland is less vascular than is the case after the more traditional preparatory medications. Nevertheless, even a skilled thyroid surgeon experiences a 5% morbidity rate, including laryngeal nerve damage (less than 1%) and permanent hypoparathyroidism (less than 1%). Transient postoperative hypoparathyroidism may occur in an additional 5% —10% of cases.
KeywordsThyroid Cancer Thyroid Gland Thyroid Nodule Parathyroid Gland Recurrent Laryngeal Nerve
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