thyroid surgery
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  • Full Name Full Name Comment goes here.
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  • title is surgery of colon.but the slides are about thyroid surgery.please set it right.
    All your presentations are short and informative.
    thank you
    Dr.N.P.viswanathan
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thyroid surgery Presentation Transcript

  • 1. Surgery of the thyroid
    • Indications for operation
    • Simple diffuse goiter : cosmetic reasons or pressure symptoms
    • Nodular goiter : Additional reasons – may undergo toxicity, malignant change.
    • Solitary nodule : more chance of malignancy
  • 2. Indications for operation (contd.)
    • Primary thyrotoxicosis : 1) Lack of response to medical treatment 2) Relapse after apparent cure 3) Toxicity of the drugs 4) Large size of the gland or retrosternal extension.
    • Toxic nodular goiter
  • 3. Preoperative treatment
    • Vocal cord assessment
    • Medical treatment with antithyroid drugs for cases of thyrotoxicosis , Lugol`s iodine 0.3 ml three times daily 10 days prior to surgery,Propranolol if needed
  • 4. Subtotal thyroidectomy
    • Both for simple and toxic goiter – the amount of gland removed varies
    • Premedication and Anaesthesia – A good night`s sleep with some sedatives may calm the pt. General anaesthesia with endotracheal intubation advised in most of the cases.
  • 5. Technique
    • Position – the neck extended by a sandbag placed in between the shoulders and the head supported on a ring
    • The skin incision – the “collar” incision 2 to 3 cms. Above the sternum extending to the lateral borders of the sternomastoids.
    • The flaps are reflected upwards and downwards – upper flap up to the level of thyroid cartilage,lower down to the sternum
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  • 11. Other surgical procedures
    • Hemithyroidectomy (lobectomy)
    • Total thyroidectomy
    • Excision of the isthmus
  • 12. Complications of thyroidectomy
    • Haemorrhage
    • Respiratory obstruction
    • Recurrent laryngeal nerve paralysis
    • Hypoparathyroidism
    • Hypothyroidism
    • Recurrent thyrotoxicosis