TY - JOUR
T1 - Surgery for fibro-adherent inflammatory thyroid disease
AU - Goldenberg, David
AU - Swegal, Warren
AU - Dunklebarger, Mitchell
AU - Pellitteri, Phillip K.
N1 - Publisher Copyright:
© 2018
PY - 2018/3
Y1 - 2018/3
N2 - Inflammatory thyroid diseases include those which are mediated through autoimmune disorders such as Hashimoto thyroiditis and Graves disease, as well as inflammatory goiter and subacute thyroiditis. In patients with such disorders, the thyroid gland often becomes markedly enlarged with an associated fibro-vascular connective tissue reaction involving the thyroid capsule and surrounding soft tissues. This results in dense, adherent connective tissue which may compress and obscure critical central neck compartment structures and make capsular dissection challenging. Thyroid surgery in patients with fibro-adherent inflammatory thyroid disease is technically challenging and postoperative complication rates are higher for these procedures. Due to these increased risks for complications, operative procedures in these circumstances should be designed with careful consideration of the anatomical changes associated with the underlying inflammatory pathology. Elements important to successful surgical resection include appropriate patient preparation and surgical planning, together with execution of the operative procedure with adaptation to many of the changes induced by inflammation on both the thyroid gland and the surrounding central neck structures.
AB - Inflammatory thyroid diseases include those which are mediated through autoimmune disorders such as Hashimoto thyroiditis and Graves disease, as well as inflammatory goiter and subacute thyroiditis. In patients with such disorders, the thyroid gland often becomes markedly enlarged with an associated fibro-vascular connective tissue reaction involving the thyroid capsule and surrounding soft tissues. This results in dense, adherent connective tissue which may compress and obscure critical central neck compartment structures and make capsular dissection challenging. Thyroid surgery in patients with fibro-adherent inflammatory thyroid disease is technically challenging and postoperative complication rates are higher for these procedures. Due to these increased risks for complications, operative procedures in these circumstances should be designed with careful consideration of the anatomical changes associated with the underlying inflammatory pathology. Elements important to successful surgical resection include appropriate patient preparation and surgical planning, together with execution of the operative procedure with adaptation to many of the changes induced by inflammation on both the thyroid gland and the surrounding central neck structures.
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U2 - 10.1016/j.otot.2017.12.002
DO - 10.1016/j.otot.2017.12.002
M3 - Article
AN - SCOPUS:85041375036
SN - 1043-1810
VL - 29
SP - 2
EP - 9
JO - Operative Techniques in Otolaryngology - Head and Neck Surgery
JF - Operative Techniques in Otolaryngology - Head and Neck Surgery
IS - 1
ER -