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Total thyroidectomy for safe and definitive management of Graves' disease

Published online by Cambridge University Press:  13 June 2013

A Prasai ,
P A Nix ,
M Aye ,
S Atkin  and
R J England
A Prasai
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Hull Royal Infirmary, UK
P A Nix
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Hull Royal Infirmary, UK
M Aye
Affiliation:
Department of Endocrinology, Hull Royal Infirmary, UK
S Atkin
Affiliation:
Department of Endocrinology, Hull Royal Infirmary, UK
R J England*
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Hull Royal Infirmary, UK
*
Address for correspondence: Mr J England, Department of Otolaryngology and Head and Neck Surgery, Castle Hill Hospital, Castle Rd, Cottingham, Hull HU16 5JQ, UK E-mail: [email protected]
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Abstract

Background:

The role of total thyroidectomy in the management of patients with Graves' disease remains controversial. However, there is increasing evidence to support the role of the procedure as a safe and definitive treatment for Graves' disease.

Method:

Patients were identified from a prospective thyroid database of the multidisciplinary thyroid clinic at Hull Royal Infirmary. All case notes were independently reviewed to confirm the data held on the database.

Results:

Over a 7-year period, the senior author has performed 206 total thyroidectomies for Graves' disease. The incidence of temporary recurrent laryngeal nerve palsy and hypoparathyroidism was 3.4 per cent and 24 per cent respectively. There was one case of permanent unilateral recurrent laryngeal nerve palsy, and 3.9 per cent of patients developed permanent hypoparathyroidism. There has been no relapse of thyrotoxicosis.

Conclusion:

In the context of a multidisciplinary thyroid clinic, total thyroidectomy should be offered as a safe and effective first-line treatment option for Graves' disease.

Keywords

Graves' DiseaseThyrotoxicosisThyroidectomy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 7 , July 2013 , pp. 681 - 684
Copyright
Copyright © JLO (1984) Limited 2013 

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References

1Graves, RJ. Clinical lectures. Lond Med Surg 1835;7:515–23Google Scholar
2Stålberg, P, Svensson, A, Hessman, O, Åkerström, G, Hellman, P. Surgical treatment of Graves' disease: evidence-based approach. World J Surg 2008;32:1269–77CrossRefGoogle ScholarPubMed
3Patwardhan, NA, Moront, M, Rao, S, Rossi, S, Braverman, LE. Surgery still has a role in Graves' hyperthyroidism. Surgery 1993;114:1108–13Google Scholar
4Glinoer, D, Hesch, D, Lagasse, R, Laurberg, P. The management of hyperthyroidism due to Graves' disease in Europe in 1986. Results of an international survey. Acta Endocrinol Suppl (Copenh) 1987;285:3–23Google ScholarPubMed
5Metso, S, Jaatinen, P, Huhtala, H, Luukkaala, T, Oksala, H, Salmi, J. Long-term follow-up study of radioiodine treatment of hyperthyroidism. Clin Endocrinol (Oxf) 2004;61:641–8CrossRefGoogle ScholarPubMed
6Vaidya, B, Williams, GR, Abraham, P, Pearce, SH. Radioiodine treatment for benign thyroid disorders: results of a nationwide survey of UK endocrinologists. Clin Endocrinol (Oxf) 2008;68:814–20CrossRefGoogle ScholarPubMed
7Solomon, B, Glinoer, D, Lagasse, R, Wartofsky, L. Current trends in the management of Graves' disease. J Clin Endocrinol Metab 1990;70:1518–24CrossRefGoogle ScholarPubMed
8Torring, O, Tallstedt, L, Wallin, G, Lundell, G, Ljunggren, JG, Taube, A et al. Graves' hyperthyroidism: treatment with antithyroid drugs, surgery, or radioiodine–a prospective, randomized study. J Clin Endocrinol Metab 1996;81:2986–93Google ScholarPubMed
9Palit, TK, Miller, CC 3rd, Miltenburg, DM. The efficacy of thyroidectomy for Graves' disease: a meta-analysis. J Surg Res 2000;90:161–5CrossRefGoogle ScholarPubMed
10Lowery, AJ, Kerin, MJ. Graves' ophthalmopathy: the case for thyroid surgery. Surgeon 2009;7:290–6CrossRefGoogle ScholarPubMed
11Barakate, MS, Agarwal, G, Reeve, TS, Barraclough, B, Robinson, B, Delbridge, LW. Total thyroidectomy is now the preferred option for the surgical management of Graves' disease. ANZ J Surg 2002;72:321–4CrossRefGoogle ScholarPubMed
12Shapiro, SJ, Friedman, NB, Perzik, SL, Catz, B. Incidence of thyroid carcinoma in Graves' disease. Cancer 1970;26:1261–703.0.CO;2-P>CrossRefGoogle ScholarPubMed
13Terzioğlu, T, Tezelman, S, Onaran, Y, Tanakol, R. Concurrent hyperthyroidism and thyroid carcinoma. Br J Surg 1993;80:1301–2CrossRefGoogle ScholarPubMed
14Nix, P, Nicolaides, A, Coatesworth, AP. Thyroid cancer review 1: presentation and investigation of thyroid cancer. Int J Clin Pract 2005;59:1340–4CrossRefGoogle ScholarPubMed
15Abraham, P, Avenell, A, Park, CM, Watson, WA, Bevan, JS. A systematic review of drug therapy for Graves' hyperthyroidism. Eur J Endocrinol 2005;153:489–98CrossRefGoogle ScholarPubMed
16Patel, NN, Abraham, P, Buscombe, J, Vanderpump, MP. The cost effectiveness of treatment modalities for thyrotoxicosis in a U.K. center. Thyroid 2006;16:593–8CrossRefGoogle Scholar
17Berglund, J, Christensen, SB, Dymling, JF, Hallengren, B. The incidence of recurrence and hypothyroidism following treatment with antithyroid drugs, surgery or radioiodine in all patients with thyrotoxicosis in Malmö during the period 1970-1974. J Intern Med 1991;229:435–42CrossRefGoogle ScholarPubMed
18Tamai, H, Kasagi, K, Takaichi, Y, Takamatsu, J, Komaki, G, Matsubayashi, S et al. Development of spontaneous hypothyroidism in patients with Graves' disease treated with antithyroidal drugs: clinical, immunological, and histological findings in 26 patients. J Clin Endocrinol Metab 1989;69:49–53CrossRefGoogle ScholarPubMed
19Cooper, DS, Goldminz, D, Levin, AA, Ladenson, PW, Daniels, GH, Molitch, ME et al. Agranulocytosis associated with antithyroid drugs. Effects of patient age and drug dose. Ann Intern Med 1983;98:26–9CrossRefGoogle ScholarPubMed
20Franklyn, JA, Maisonneuve, P, Sheppard, M, Betteridge, J, Boyle, P. Cancer incidence and mortality after radioiodine treatment for hyperthyroidism: a population-based cohort study. Lancet 1999;353:2111–5CrossRefGoogle ScholarPubMed
21Franklyn, JA, Maisonneuve, P, Sheppard, MC, Betteridge, J, Boyle, P. Mortality after the treatment of hyperthyroidism with radioactive iodine. N Engl J Med 1998;338:712–8CrossRefGoogle ScholarPubMed
22Metso, S, Jaatinen, P, Huhtala, H, Auvinen, A, Oksala, H, Salmi, J. Increased cardiovascular and cancer mortality after radioiodine treatment for hyperthyroidism. J Clin Endocrinol Metab 2007;92:4008CrossRefGoogle ScholarPubMed
23Friguglietti, CU, Lin, CS, Kulcsar, MA. Total thyroidectomy for benign thyroid disease. Laryngoscope 2003;113:1820–6CrossRefGoogle ScholarPubMed
24Hussain, M, Hisham, AN. Total thyroidectomy: the procedure of choice for toxic goitre. Asian J Surg 2008;31:59–62CrossRefGoogle ScholarPubMed
25Harrison, B, Kinsman, R. National Thyroid/Parathyroid Database Report 2003. Oxfordshire, UK: Dendrite Clinical Systems, 2004Google Scholar
26Frilling, A, Goretzki, PE, Grussendorf, M, Erbslöh, M, Röher, HD. The influence of surgery on endocrine ophthalmopathy. World J Surg 1990;14:442–5CrossRefGoogle ScholarPubMed
27Winsa, B, Rastad, J, Akerström, G, Johansson, H, Westermark, K, Karlsson, FA. Retrospective evaluation of subtotal and total thyroidectomy in Graves' disease with and without endocrine ophthalmopathy. Eur J Endocrinol 1995;132:406–12CrossRefGoogle ScholarPubMed
28Grodski, S, Stalberg, P, Robinson, BG, Delbridge, LW. Surgery versus radioiodine therapy as definitive management for Graves' disease: the role of patient preference. Thyroid 2007;17:157–60CrossRefGoogle ScholarPubMed
29Gaujoux, S, Leenhardt, L, Tresallet, C, Rouxel, A, Hoang, C, Jublanc, C et al. Extensive thyroidectomy in Graves' disease. J Am Coll Surg 2006;202:868–73CrossRefGoogle ScholarPubMed
30Maung, KH, Hayworth, D, Nix, PA, Atkin, SL, England, RJ. Thyroidectomy does not cause globus pattern symptoms. J Laryngol Otol 2005;119:973–5CrossRefGoogle Scholar
31Werga-Kjellman, P, Zedenius, J, Tallstedt, L, Traisk, F, Lundell, G, Wallin, G. Surgical treatment of hyperthyroidism: a ten-year experience. Thyroid 2001;11:187–92CrossRefGoogle ScholarPubMed
32Razack, MS, Lore, JM Jr, Lippes, HA, Schaefer, DP, Rassael, H. Total thyroidectomy for Graves' disease. Head Neck 1997;19:378–833.0.CO;2-X>CrossRefGoogle ScholarPubMed
33Cooper, DS, Doherty, GM, Haugen, BR, Kloos, RT, Lee, SL, Mandel, SJ et al. Management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid 2006;16:109–42CrossRefGoogle ScholarPubMed