Surgical therapy for goiter usually consists of a strum resection (which is incorrectly called a strumectomy), in which the thyroid gland is removed except for a remnant of varying size. The term strumectomy, on the other hand, refers to the removal of a complete organ under an ectomy. Complete removal of the thyroid gland is … Goiter: Surgical Therapy
To prevent goiter (goiter), attention must be paid to reducing individual risk factors. Risk factors of iodine-deficiency-related goiter/euthyroid goiter and dyshormogenic goiter Behavioral risk factors Diet Intake of strumigenic substances such as: Casava roots Crucifeae family vegetables (cauliflower, Brussels sprouts, savoy cabbage) [thiocyanates]. Milk (from areas with grass containing strumigens). Micronutrient deficiency (vital substances) – … Goiter: Prevention
The following symptoms and complaints may indicate goiter (goiter): Enlargement of the thyroid gland, possibly with the following complications: Dysphagia (dysphagia). Stridor (whistling breathing sound) or dyspnea (shortness of breath) – due to constriction of the trachea. Tracheomalacia (synonym: saber sheath trachea; disease characterized by slackening of the trachea). Upper influence congestion (OES) – congestion … Goiter: Symptoms, Complaints, Signs
Pathogenesis (development of disease) In the majority of cases, goiter is caused by iodine deficiency. This involves an attempt to compensate for insufficient (inadequate) hormone production (TSH increases reactively because insufficient T3 and T4 are produced due to iodine deficiency, thus stimulating hyperplasia (excessive cell formation) of the thyroid gland). According to their function (functional), … Goiter: Causes
General measures Review of permanent medication due topossible effect on existing disease. Conventional non-surgical therapy methods Radioiodine therapy-indications: Recurrent goiter (recurrence of a goiter). Refusal of surgery or if the risk of surgery is high. Multifocal thyroid autonomy – multiple autonomous nodules (synonyms: Hot nodule; focal autonomy; Plummer’s disease); an autonomous adenoma also produces the … Goiter: Therapy
Therapy recommendations for: Iodine-deficiency-related goiter and dyshormogenic goiter (enzyme defect in thyroid hormone synthesis). Goiter with hypothyroidism (hypothyroidism). Goiter with hyperthyroidism (hyperthyroidism) Goiter during pregnancy and lactation Iodine deficiency-related goiter and dyshormogenic goiter Therapeutic target Regression of iodine-deficiency-related goiter with improvement of symptoms. Therapy recommendations Iodine (150 μg/day), L-thyroxine or (the combination of iodide and … Goiter: Drug Therapy
Obligatory medical device diagnostics. Thyroid sonography with duplex/Doppler sonography. Determination of thyroid volume (SD volume)Note in pregnancy: during pregnancy, the mother’s SD volume can double (upper tolerance value: 18 ml) Morphological differentiation of a struma diffusa, struma uni- or multinodosa from other causes of a struma; thyroid malignancies (malignant neoplasms of the thyroid gland): Hypoechogenicity: … Goiter: Diagnostic Tests
Medical history (history of illness) represents an important component in the diagnosis of goiter (goiter). Family history Is there a frequent history of thyroid disease in your family? Social history Current medical history/systemic history (somatic and psychological complaints). Have you noticed any enlargement of the thyroid gland? If so, during what time period did it … Goiter: Medical History
Endocrine, nutritional, and metabolic diseases (E00-E90). Goiter with hypothyroidism (hypothyroidism): Hashimoto’s thyroiditis (autoimmune disease of the thyroid gland). Late stage thyroiditis (inflammation of the thyroid gland). Genetic defects of thyroid hormone synthesis: Defective thyroperoxidase Missing deiodinase Defective iodine transport Thyroid hormone resistance (rare): defect of thyroid hormone receptor → T3↑, T4↑ and TSH normal; usually … Goiter: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by goiter (goiter): Respiratory system (J00-J99) Tracheomalacia (synonym: saber sheath trachea) – disease characterized by slackening of the trachea. Endocrine, nutritional and metabolic diseases (E00-E90). Recurrent goiter – recurrence of thyroid enlargement. Circulatory system (I00-I99) Upper influence stasis* (OES) – symptom … Goiter: Complications
Classification of goiter according to ICD-10 Iodine-deficiency-related diffuse goiter (E01.0). Iodine deficiency-related multinodular goiter (E01.1) Iodine deficiency-related goiter, unspecified (E01.2) Congenital hypothyroidism (hypothyroidism) with diffuse goiter E03.0) Non-toxic diffuse goiter (E04.0) Non-toxic solitary thyroid nodule (E04.2) Non-toxic multinodular goiter (E04.2) Other specified nontoxic goiter (E04.8). Nontoxic goiter, unspecified (E04.9) Hyperthyroidism (hyperthyroidism) with diffuse goiter (E05.0) … Goiter: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; furthermore: Inspection (viewing) of skin and mucous membranes [possible symptoms: Upper influence congestion (OES): congestion of the veins of the head and upper limbs due to compression of the vena cavae. Horner … Goiter: Examination
