Chapter 21
Surgery of the Thyroid Gland
Table of Contents
SURGICAL ANATOMY
VASCULAR SUPPLY
NERVES
External branch of the superior laryngeal nerve
PARATHYROID GLANDS
LYMPHATICS
Central Compartment of the Neck
Lateral Compartment of the Neck
INDICATIONS FOR THYROIDECTOMY
SOLITARY THYROID NODULES
LOW-DOSE EXTERNAL IRRADIATION OF THE HEAD AND NECK
HIGH-DOSE EXTERNAL IRRADIATION THERAPY
PREPARATION FOR SURGERY
HYPOTHYROIDISM
HYPERTHYROIDISM
SURGICAL APPROACH TO THYROID NODULES
Non-irradiated Patients
Irradiated Patients
SURGICAL APPROACH TO THYROID CANCER
Papillary Carcinoma
Treatment of minimal papillary carcinoma
Standard treatment of most papillary carcinomas
Controversies
Low-risk papillary cancer
High-risk papillary cancer
FOLLICULAR CARCINOMA
HURTHLE CELL TUMORS AND CANCER
ANAPLASTIC CARCINOMA
MEDULLARY THYROID CARCINOMA
OPERATIVE TECHNIQUE FOR THYROIDECTOMY
Lobectomy or total thyroidectomy
Subtotal thyroidectomy
Alternative technique of standard thyroidectomy
POSTOPERATIVE COMPLICATIONS
Thyroid Storm
Wound Hemorrhage
Injury to the Recurrent Laryngeal Nerve
Hypoparathyroidism
DEVELOPMENTAL ABNORMALITIES OF THE THYROID
THYROID ABNORMALITIES
THYROID HEMIAGENESIS
ECTOPIC THYROID
Lingual Thyroid
Thyroglossal Duct Cysts
Suprahyoid and Infrahyoid Thyroid
Lateral Aberrant Thyroid
Substernal Goiters
Struma Ovarii
Struma Cordis