The document provides an overview of the anatomy and functions of the thyroid gland, detailing its structure, types of disorders, and related symptoms. It categorizes thyroid disorders into hypofunction, hyperfunction, goiter, nodules, and neoplastic changes, along with investigation techniques and treatment options including medical and surgical interventions. Surgical indications are outlined, emphasizing the need for preoperative assessments and potential complications associated with thyroidectomy.

1. DISEASES OF THYROID
GLAND

2. ANATOMY OF THYROID
GLAND
 The gland as seen from the front is more nearly the
shape of a butterfly.
 composed of 2 encapsulated lobes, one on either
side of the trachea, connected by a thin isthmus.
 The thyroid extending from the level of the fifth
cervical vertebra down to the first thoracic. The gland
varies from an H to a U shape, overlying the second
to fourth tracheal rings.

3. TYPES OF THYROID
DISORDERS
 Hypofunction
 Hyperfunction
 Enlargements
1. Diffuse __ termed goiter
regardless of functional status.
2. Nodule.

4. HISTORY
signs & symptom of hypo or hyperthyroidism
pressure symptom as dysphagia ,dysphonia
,dyspnea &choking sensation
Change in voice
presence of mass and its duration
,progression& pain.
H/O exposure to radiation , diet , drugs
Family hx.

5. PHYSICAL
EXAMINATION
 Inspection
 palpation
 percussion
 Auscultation

6. CLASSIFICATION
 Simple goiter (euthyroid)
1. Diffuse hyperplastic:
 physiological
 Pubertal
 pregnancy
1. Multinodular goiter
 Toxic
1. Diffuse __ graves’ disease
2. Multinodular
3. Toxic adenoma

7. CLASSIFICATION- cont...
 Neoplastic
1- Bengin
2- Malignant
 Inflammatory
1- Autoimmune :
 Chronic lymphocytic thyroditis
 Hashimoto’s disease
2- Granulomatous
 De quervain’s thyroditis
3- Fibrosing
 Riedel’s thyroiditis
4- Infective
 Acute (bacterial , viral thyroiditis ‘subacute thyroiditis’)
 Chronic ( tuberculous , syphilitic )
 Other
1- amyloid.

8. INVESTIGATION
 chest and neck x-ray:
- Show descend of thyroid gland to thorax and
mediastanal shifting in retrosternal goitre.
 iodine isotopes
- By i.v injection of I131. Then, use gama rays to show
hot and cold nodules.
 CT scan
- Show thyroid size and if there is compression to
trachea
 Endoscopic investigation:
-bronchoscopy: show compression and infiltration of trachea by
tumer
 Biopsy:
-fine needle aspiration biopsy.
-true-cut biopsy.

9. TREATMENT OPTIONS
 Medical Treatment
 Surgical Treatment

10. MEDICAL TREATMENT
1. Antithyroid drugs
 carbimazole
 propylthiouracil.
It use to treat hyperthyroidism.
2. Beta-adernergic blockers
 propranolol
it is control sympathetic over activty to control cardiovascular feature.
3. Radioactive iodine
 Taken orally in solution
 Given for 8-12 wks.
 Use for recurrent hyperthyroidism

11. SURGICAL TREATMENT
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
 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

12. SURGICAL TREATMENT
(cont…)
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

13. SURGICAL TREATMENT
(cont…)
surgical procedures
Subtotal thyroidectomy
Hemithyroidectomy (lobectomy)
Total thyroidectomy
Excision of the isthmus

14. COMPLICATIONS OF
THYROIDECTOMY
 Haemorrhage
 Respiratory obstruction
 Recurrent laryngeal nerve
paralysis
 Hypoparathyroidism
 Hypothyroidism
 Recurrent thyrotoxicosis