Updates in The Management of Thyroid Diseases
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Transcript of Updates in The Management of Thyroid Diseases
Updates In Thyroid Diseases
Abd Hamid Mat Sain Consultant Surgeon
Columbia Hospital Seremban
Thyroid vs Goitre(Thyroid Swelling)
Who treats Thyroid diseases?
• Physicians
• Endocrinologists
• Surgeons
• Head and Neck Surgeons
• Oncologists
• General Practitioners/Family Physicians
Symptoms and Signs of Thyroid Diseases
• (Anatomy)Structural effects/Local
• (Physiology)Hormonal effects/Systemic
• Systemic Structural effects
Clinical diagnosis of Thyroid Diseases
• Hypothyroidism/Euthyroidism(Non-toxic)
• Hyperthyroidism(Toxic)
• Smooth generalised Goitre
• Multinodular Goitre
• Solitary Nodule/(Goitre)-Left or Right
Goitre Work up• Ultrasound
• (CT scan)
• Thyroid Function Tests
• Thyroid Antibodies
• Fine Needle Aspiration Cytology
• (Radio-isotope)
Pathological Diagnosis of Thyroid diseases
• Atrophy
• Thyroiditis
• Cyst
• Colloid goitre
• Adenoma
• Carcinoma
Table 1
Solitary Nodule Multi-Nodular
Male Very High Low
Female High Very Low
Risk of Thyroid Cancers in Nodular Goitres
Medical Rx of Thyroid Diseases
• Hyperthyroidism
• beta blocker
• Hypothyroidism
Indications for Thyroidectomy
• Cosmesis
• Compressive Symptoms
• Diagnostic
• Benign Neoplasm
• Cancer
• (Failed Medical Treatment)
Thyroidectomies• Lobectomy
• Total Thyroidectomy (Near)
• Completion Thyroidectomy
• Radical Thyroidectomy
• (Partial/Subtotal Thyroidectomy)
Complications of Thyroidectomy
• Bleeding
• Numbness & Cramps ; Ca
• Hoarseness
• Infections
Post Thyroidectomy-Long term Sequelae
• Hypothyroidism—>Euthyroid
• Recurrence
• Thyroiditis
New Trends
• Endoscopic Thyroidectomy
• Local Anaesthesia
• Acupuncture Anaesthesia
Conclusions• Thyroid diseases are common
• Correct diagnosis based on clinical features and pathology types
• Primary Care and Specialists treat thyroid diseases
• Post thyroidectomy sequelae are common but serious complications are rare