thyroid surgery

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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

  1. 1. Surgery of the thyroid <ul><li>Indications for operation </li></ul><ul><li>Simple diffuse goiter : cosmetic reasons or pressure symptoms </li></ul><ul><li>Nodular goiter : Additional reasons – may undergo toxicity, malignant change. </li></ul><ul><li>Solitary nodule : more chance of malignancy </li></ul>
  2. 2. Indications for operation (contd.) <ul><li>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. </li></ul><ul><li>Toxic nodular goiter </li></ul>
  3. 3. Preoperative treatment <ul><li>Vocal cord assessment </li></ul><ul><li>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 </li></ul>
  4. 4. Subtotal thyroidectomy <ul><li>Both for simple and toxic goiter – the amount of gland removed varies </li></ul><ul><li>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. </li></ul>
  5. 5. Technique <ul><li>Position – the neck extended by a sandbag placed in between the shoulders and the head supported on a ring </li></ul><ul><li>The skin incision – the “collar” incision 2 to 3 cms. Above the sternum extending to the lateral borders of the sternomastoids. </li></ul><ul><li>The flaps are reflected upwards and downwards – upper flap up to the level of thyroid cartilage,lower down to the sternum </li></ul>
  6. 11. Other surgical procedures <ul><li>Hemithyroidectomy (lobectomy) </li></ul><ul><li>Total thyroidectomy </li></ul><ul><li>Excision of the isthmus </li></ul>
  7. 12. Complications of thyroidectomy <ul><li>Haemorrhage </li></ul><ul><li>Respiratory obstruction </li></ul><ul><li>Recurrent laryngeal nerve paralysis </li></ul><ul><li>Hypoparathyroidism </li></ul><ul><li>Hypothyroidism </li></ul><ul><li>Recurrent thyrotoxicosis </li></ul>

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