B46. Surgical aspects of hyperthyroidism

Page created on October 21, 2021. Not updated since.

Introduction

For introduction, etiology, clinical features, diagnosis, and non-surgical treatment of hyperthyroidism, see topic 38 of internal medicine.

Surgical treatment of hyperthyroidism

Surgery may be used for both Graves disease, toxic adenoma, and toxic multinodular goitre. The main treatment of hyperthyroidism nowadays consists of antithyroid drugs and radioactive iodine ablation. However, there remain some indications for surgery:

• Very large goitre (> 80 g)
• Goitre causing airway or oesophageal obstruction
• If malignancy cannot be ruled out
• Hyperthyroidism with moderate to severe Graves ophthalmopathy
• Contraindications to antithyroid drugs and radioiodine
• Hyperthyroidism refractory to antithyroid drugs and radioiodine

See also topic B27 for general information on thyroid surgery and preoperative medication for thyroid surgery.