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Prensa méd. argent ; 106(4): 237-244, 20200000. tab
Article in English | LILACS, BINACIS | ID: biblio-1368101


External division of the superior laryngeal nerve supplies the crico-thyroid muscle to excite length and thickness of the vocal fold. Thus, increasing voice tone. The vicinity with the superior thyroid vessels sets the external branch of the superior laryngeal nerve in danger every time the superior end of the thyroid is dissected. Thus, the aim of present study is to assess the rate and complication of external branch of the superior laryngeal nerve injury post- thyroidectomy when segregated ligation of superior thyroid vessels closes to thyroid capsule without prior nerve identification and without nerve stimulator or intraoperative neuro-monitoring. The presented study is a prospective, non- randomized clinical study included 1450 patients who underwent thyroidectomy which either (total thyroidectomies, near total thyroidectomies or lobectomy and isthmectomy) in the Department of Surgery/AL-Diawania Teaching Hospital in Diawania City, Iraq, between January 2000 and February 2018. All patients underwent thyroidectomy through segregated ligation of superior thyroid artery very closely to thyroid capsule without prior nerve identification and without nerve stimulator or intraoperative neuromonitoring. Postoperative indirect laryngoscopy vocal cord examination with long term follow up through physical examination and clinical history to evaluate nerve integrity. In present study, the total cases with EBSLN injury were 38 (2.6%), in which the transient EBSLN injury occurred in 28 (1.9%) of patients and permanent injury occurred in 10 (0.7%) of patients and majority of cases with EBSLN injury were occur in patients with large size goiter 29 (2%) more than small size goiter 9 (0.6%) And these differences were statistically significant differences, (P<0.005). In addition to, the majority of cases with EBSLN injury were occur in male {25(1.7%)} more than female patients {13(0.9%)} And these differences were statistically significant differences, (P<0.005). Segregated ligation of superior thyroid artery is a safe technical option, cost effective, time preserved and need surgical skills to minimized risk of injury to the external laryngeal nerve

Humans , Thyroid Gland/injuries , Thyroid Gland/pathology , Thyroidectomy , Vocal Cords/injuries , Carotid Artery, External , Cranial Nerve Injuries/complications , Laryngoscopy , Ligation , Prospective Studies
Rev. otorrinolaringol. cir. cabeza cuello ; 80(1): 75-78, mar. 2020. graf
Article in Spanish | LILACS | ID: biblio-1099205


Los cuerpos extraños alojados en la vía aéreodigestiva superior son un motivo de consulta frecuente para el otorrinolaringólogo. Uno de los más frecuentes son las espinas de pescado. En raras ocasiones, éstas migran hacia tejidos adyacentes y generan complicaciones importantes. Presentamos el caso de una paciente que tras la ingesta de pescado manifiesta sensación de cuerpo extraño faríngeo, odinofagia y dolor látero cervical derecho. Dada la ausencia de hallazgos a la exploración física y laringoscópica se realiza una tomografia computarizada cervical, visualizando un cuerpo extraño alojado en la glándula tiroidea. Se interviene mediante cervicotomía media, realizando la extracción de la espina sin complicaciones. El diagnóstico precoz y manejo adecuado es determinante para prevenir complicaciones en estos casos.

Foreign bodies in the aerodigestive tract are commonly confronted in otolaryngology practice. The most frequent are the fish bones. In rare cases they can move and cause numerous complications. We report the case of a patient that manifest the sensation of pharyngeal foreign body, after fish ingestion. She also referred odynophagia and right cervical pain. Physical and laryngoscopic examination were normal. A cervical CT was performed, where a foreign body lodged in the thyroid gland was visualized, median cervicotomy was done and the foreign body was extracted. Early diagnosis and adequate management are crucial to prevent complications in these cases.

Humans , Female , Middle Aged , Thyroid Gland/injuries , Foreign Bodies/surgery , Foreign Bodies/diagnostic imaging , Thyroid Gland/surgery , Bone and Bones , Tomography, X-Ray Computed , Foreign-Body Migration/surgery , Foreign-Body Migration/diagnostic imaging , Seafood
Int. arch. otorhinolaryngol. (Impr.) ; 22(3): 256-259, July-Sept. 2018. tab
Article in English | LILACS | ID: biblio-975574


Abstract Introduction There is difference of opinion about the placement of the drain in thyroid surgeries, and, to the best of our knowledge, the efficacy of drainless total thyroidectomy regarding various parameters of thyroid lesions has not been well-established. Objective To report our experience with drainless total thyroidectomy, and to define an appropriate patient population for its performance. Methods This is a retrospective case analysis of the patients who underwent total thyroidectomy for intrathyroidal lesions with or without central neck dissection in a tertiary referral hospital (number = 74). The patients, who had undergone total thyroidectomy without any drain insertion, were analyzed, and the relationships among various parameters of thyroid lesions were noted in relation to seroma and hematoma formation. Results Seroma formation was noted only in 5 out of 74 patents (6.75%). All of the seromas that occurred were observed in patients with thyroid lesions < 4 cm, and 4 out of 5 seromas were observed in patients with a malignant pathology. There was no statistically significant difference in seroma formation between patients younger or older than 50 years of age. The nature of the lesion, whether benign or malignant, did not affect the formation of seroma. Of interest is the fact that none of the 10 patients who had central neck dissection performed as part of their treatment developed seroma. Conclusions Drainless total thyroidectomy is safe across all age groups for patients harboring either benign or malignant thyroid pathologies. However, caution is to be observed in opting for drainless total thyroidectomy in patients with large lesions (> 5 cm)

Humans , Male , Female , Adult , Middle Aged , Aged , Thyroid Gland/injuries , Thyroidectomy/methods , Postoperative Complications/epidemiology , Neck Dissection/methods , Thyroid Diseases/surgery , Thyroid Neoplasms/surgery , Drainage , Incidence , Retrospective Studies , Treatment Outcome , Seroma/epidemiology , Hematoma/epidemiology
Rev. cuba. cir ; 55(4): 271-278, oct.-dic. 2016. tab
Article in Spanish | LILACS | ID: biblio-844826


Introducción: el tiroides es una glándula donde se asienta con frecuencia la enfermedad nodular tanto benigna como maligna. En muchas ocasiones, se presenta con criterio de intervención quirúrgica. De ella se derivan complicaciones tales como el hipoparatiroidismo posoperatorio, la lesión de los nervios laríngeos superiores, y recurrentes, así como hematoma del sitio operatorio todo lo cual nos motivó a realizar el presente trabajo. Objetivos: identificar las complicaciones derivadas de las tiroidectomías y relacionarlas con las variantes anatómicas y la extensión de la tiroidectomía. Método: se estudiaron un total de 234 intervenciones realizadas sobre el tiroides en nuestro centro desde febrero de 2012 hasta octubre de 2015. Se aplicó el método de porcientos para el cálculo de todas las variables. Se obtuvo la información existente en las historias clínicas y los informes operatorios. Resultados: la mayoría de las tiroidectomías realizadas en nuestro centro son las de afecciones benignas. Las variantes anatómicas anómalas del laríngeo recurrente se evidenciaron en algunos casos. Hubo una lesión recurrencial temporal y otra permanente para un 0,42 por ciento respectivamente. Se apreciaron tres hipoparatiroidismo temporales, con 1,28 por ciento, y una lesión vascular de arteria tiroidea media anterior anómala. Conclusiones: las afecciones benignas aún son las más frecuentes en el tiroides. El conocimiento de la anatomía del tiroides y sus variantes son vitales para realizar tiroidectomías. Las complicaciones como el hipoparatiroidismo y la lesión recurrencial se relacionan con la extensión de esta(AU)

Introduction: The thyroid gland is the frequent location of the nodular illness either benign or malignant. In many occasions, the surgical procedure is the main criterion to treat the disease. Some of the complications associated to surgery are postoperative hypoparatyroidism, upper laryngeal nerve injure, mostly outer branch; recurrent laryngeal nerve, and hematoma in the surgical site. Objectives: To identify the most frequently illnesses affecting the thyroid. Method: A total of 234 surgeries performed in the thyroid in our center from February 2012 to October 2015 were studied. The percentage method was used to estimate all the variables. Required information was taken from the medical histories and the surgery reports. Results: Most of the thyroidectomies performed in our center were on benign lesions. The anomalous anatomical variants of the recurrent laryngeal nerve were evident in some cases. There was one temporary recurrent lesion and one permanent, accounting for 0.42%, respectively. Three cases of temporary hypoparathyroidism for 1.28% and a vascular lesion in the anomalous anterior medial thyroid artery were reported. Conclusions: Benign illnesses are still the most frequent ones in the thyroid gland. The knowledge about the thyroid anatomy and its variants are vital to perform thyroidectomies. Hypoparathyroidism and recurrent laryngeal lesion are the complications related to the extension of thyroidectomy(AU)

Humans , Hypoparathyroidism/complications , Thyroid Gland/injuries , Thyroidectomy/adverse effects
Arq. bras. endocrinol. metab ; 56(3): 190-194, Apr. 2012. tab
Article in Portuguese | LILACS | ID: lil-626271


OBJETIVO: Determinar a variação da CPK sérica em função do TSH e T4 livre (FT4) e avaliar a CPK sérica nos estados patológicos da tireoide (hipertireoidismo e hipotireoidismo), em relação ao eutireoidismo. MATERIAIS E MÉTODOS: Analisaram-se, retrospectivamente, 6.230 exames laboratoriais de 2007 a 2011, com as dosagens de TSH e CPK. Destas, 3.369 com dosagens de FT4. Avaliou-se a correlação entre CPK com TSH e com os estados patológicos da tireoide. RESULTADOS: A correlação entre TSH e CPK foi positiva (r = 0,065), enquanto entre CPK e FT4 foi inversamente proporcional (r = -0,091, p < 0,05). Do total, 586 (9,4%) medidas foram de hipertireoidismo com mediana (intervalo) do CPK de 98 U/L (27 a 1.113) e 556 (8,9%), hipotireóideos com CPK de 114 U/L (25-4.182). CONCLUSÃO: Houve correlação positiva entre CPK sérica e TSH e negativa com FT4, sendo a CPK menor no grupo com hipertireoidismo e maior no grupo de hipotireoidismo.

OBJECTIVE: To determine serum CPK variation based on TSH e free T4 (FT4), and to assess serum CPK in pathological states of the thyroid (hyperthyroidism and hypothyroidism), in relation to the euthyroidism. MATERIAL AND METHODS: We evaluated retrospectively 6,230 laboratory results of TSH and CPK from 2007 to 2011. From these, 3,369 had free T4 results. We evaluated the correlation between CPK and TSH and the pathological states of the thyroid. RESULTS: The correlation between TSH and CPK was positive (r = 0.065), while that between CPK and FT4 was negative (r = -0.091, p < 0.05). From the total of results analyzed, 586 (9.4%) were measures of hyperthyroidism, with a median (range) of CPK of 98 U/L (27 to 1,113), and 556 (8.9%) were of hypothyroidism, with CPK of 114 U/L (25-4,182). CONCLUSION: A positive correlation was found between serum CPK and TSH, and a negative correlation between CPK and FT4. CPK was lower in the group with hyperthyroidism, and greater in that with hypothyroidism.

Humans , Creatine Kinase/blood , Hyperthyroidism/physiopathology , Hypothyroidism/physiopathology , Thyroid Gland/physiopathology , Thyrotropin/blood , Thyroxine/blood , Analysis of Variance , Biomarkers/blood , Hyperthyroidism/metabolism , Hypothyroidism/blood , Muscle, Skeletal/metabolism , Muscle, Skeletal/physiopathology , Retrospective Studies , Thyroid Gland/injuries
Rev. venez. oncol ; 23(3): 154-164, jul.-sept. 2011. ilus, tab
Article in Spanish | LILACS | ID: lil-618747


Evaluar la posibilidad de resección de las lesiones de la glándula parótida por incisiones periauriculares (grupo I) y valorar las complicacionesin mediatas derivadas de esta técnica, resultados cosméticos y dolor posoperatorio, comparándolas con el abordaje preauricular-transcervical (grupo II). Los 61 pacientes, de ambos sexos, entre julio de 2006 a julio de 2009, fueron sometidos a este estudio prospectivo, aleatorizado doble ciego, evaluando dos grupos, categorizados grupo I yII, haciendo comparaciones en cuanto a dolor posoperatorio según la escala analógica de niveles de dolor, complicaciones relacionadas al nervio facial, posibilidad de resección indistintamente del tipo histológico, del lóbulo afectado, y por último, la satisfacción cosmética. Los 59 pacientes completaron este estudio, no obteniendo diferencias estadísticamente significativas en cuanto al dolor posoperatorio, ni en cuanto a las complicaciones, pero si en lo referido a la visualización de la cicatriz operatoria; 96% de los pacientes (grupo I), refirió satisfacción con el resultado cosmético en comparación con 65% del grupo II; siendo estadísticamente significante. No hubo diferencias en cuanto a la presentación de dolor ni complicaciones posoperatorias en cuanto al abordaje periauricular en comparación a los que se les realizó el abordaje preauricular-transcervical. Fue mayor la manifestación de satisfacción cosmética en el abordaje periauricular, la cual recomendamos, porque no produce dificultades técnicas, indistintamente del sexo, edad, tipo histológico o ubicación de la lesión dentro de la glándula parótida.

To evaluate the possibility of resection of the lesions of the parotid gland by the incisions around the ear (Group I) and assess immediate complications arising fromthis technique, the cosmetics results and the post operative pain, comparing them with the ahead ear - transcervical approach (Group II). In 61 patients of both sex, from July 2006 to July 2009, were subjected to this prospective study, and randomized double blind, evaluating the two groups, categorized group I and II, making comparisons on post operative by the analog levels of the pain, complications related to the facial nerve, possibility of resection regardless of the histological type, the affected lobe, and finally, the cosmetic satisfaction. The 59 patients that completed this study, no statistically significant differences we found in the post operative pain getting. There were no differences also on complications, but if in connection with the post operative scar, the 96%patients (Group I), spoke to us, their satisfaction with the cosmetic outcome compared with 65% of Group II; that being statistically significant. There was no differences as regards the presentation of the painor the post operating complications in the around ear compared to the ahead ear - transcervical approach. The manifestation of cosmetic satisfaction in around ear were approach, we recommend it because it does not produce technical difficulties, without any distinction of sex, age, histological type, or location into the parotid gland.

Humans , Male , Adult , Female , Parathyroid Glands/anatomy & histology , Parathyroid Glands/surgery , Parathyroid Glands/pathology , Thyroid Gland/injuries , Rhytidoplasty/methods , Sweating, Gustatory/pathology
Rev. venez. cir ; 60(4): 169-172, dic. 2007. tab, graf
Article in Spanish | LILACS | ID: lil-539996


Describir nuestra experiencia en la punción aspiración con aguja fina de tiroides utilizando ultrasonido tiroideo y/o control citológico inmediato para así evaluar la sensibilidad de los mismos en apoyo a este procedimiento. Se revisaron historias clínicas de 242 pacientes entre enero 2005 y abril 2007 en los cuales se realizaron 130 punciones guiadas por ultrasonido, 126 con control citológico inmediato y ambos en 26 pacientes; evaluando el número, tamaño y distribución de los nódulos, caraterísticas ecográficas, número de láminas, diagnóstico citológico y correlación con el diagnóstico definitivo. Se encontró mayor prevalencia de nódulos únicos entre 1 y 4 cm; ubicándose principalmente en el lóbulo derecho siendo más frecuentes las lesiones complejas. Para valorar los diagnósticos citológicos, fueron agrupados como maligno, hipercelular o hipocelular, consiguiendo porcentajes de 12 por ciento, 81 por ciento respectivamente. De las muestras hipocelulares 15 fueron guiadas por ultrasonido y 5 con control citológico inmediatos, en 3 casos se utilizaron ambos métodos. La sensibilidad de las punciones guiadas por ultrasonido fue de 88 por ciento y de los casos en los que se utilizó control citológico inmediato del 96 por ciento. El 20 por ciento de los pacientes fueron llevados a cirugía, siendo compatible el diagnóstico citológico con el definitivo en 88 por ciento de los mismos. La punción aspiración con aguja fina de tiroides es un método adecuado para suministrar información de los nódulos tiroideos, cuya sensibilidad aumenta al utilizar soporte citológico y ultrasonográfico. Estudios posteriores deben realizarse con el objetivo de valorar la relación costo beneficio en cada caso.

Humans , Male , Adolescent , Adult , Female , Child , Middle Aged , Aged, 80 and over , Thyroid Gland/cytology , Thyroid Gland/injuries , Thyroid Nodule/pathology , Thyroid Nodule/prevention & control , Ultrasonography , Biopsy, Fine-Needle/methods , Cost-Benefit Analysis , Medical Records , Punctures/methods
Braz. j. vet. res. anim. sci ; 43(6): 747-753, 2006. tab, ilus
Article in Portuguese | LILACS | ID: lil-463915


O objetivo do presente estudo foi avaliar a ultra-sonografia das glândulas tireóides em animais com hipotireoidismo primário. Foram utilizados dez cães hipotireoideos, diagnosticados, através de anamnese, exame físico e exames laboratoriais, tais como dosagens séricas de T4 total, T4livre, TSH, colesterol e triglicérides; e 10 cães eutireoideos A ultra-sonografia cervical revelou nítida redução do volume total da glândula tireóide em todos os animais hipotireoideos, estatisticamente significante (p<0,05), em comparação aos animais considerados eutireoideos, denotando, assim, a existência de atrofia glandular, secundária ao hipotireoidismo.

The aim of this study is to evaluate cervical ultrasonography as methods for diagnosis of hypothyroidism. Twenty dogs were distributed in 2 groups: 10 dogs with hypothyroidism, and 10 healthy dogs as a control group. All dogs were submitted to ultrasonographic examination in the cervical area. To confirm hypothyroidism diagnosis, total T4, free T4 and TSH hormones samples were obtained and, also, cholestherol and triglycerides. Hypothyroid animals submitted to cervical ultrasonography showed marked reduction in the total volume of the thyroid gland, with statistical significance (p<0.05), in comparison to normal dogs. This alteration demonstrated the gland atrophy secondary to hypothyroidism.

Dogs , Thyroid Gland/anatomy & histology , Thyroid Gland/injuries , Hypothyroidism/diagnosis , Hypothyroidism , Hypothyroidism/veterinary
Rev. cuba. endocrinol ; 15(1)ene.-abr. 2004.
Article in Spanish | LILACS, CUMED | ID: lil-388310


En la década de los años 80, con el desarrollo alcanzado en la tecnología de producción de anticuerpos monoclonales y en la concepción de un diseño de ensayo no competitivo tipo sandwich o de "2 sitios", comenzó el auge de los métodos inmunométricos (IMAs) en sus diferentes tipos en dependencia de la señal y reacción que la desencadena. Inicialmente fueron desarrollados los métodos inmunorradiométricos (IRMAs) de naturaleza isotópica y casi simultáneamente con estos los IMAs de naturaleza no isotópica. Entre estos últimos se encuentran los ensayos inmunoenzimométricos (IEMAs), los inmunofluorimétricos (IFMAs), los inmunoluminométricos (ILMAs) en sus subtipos de inmunoquimioluminiscentes (ICMAs), inmunobioluminiscentes (IBMAs) e inmuoelectroquimioluminiscentes (IECMAs). Los IMAs de naturaleza no isotópica han permitido el incremento de la automatización. Los IRMAs y IEMAs son considerados métodos de 2da. generación, y los IFMAs, ICMAs, IBMAs e IECMAs son de tercera generación(AU)

Humans , Male , Female , Thyroid Gland/injuries , Thyroid Hormones , Thyrotropin , Immunologic Techniques/methods
Rev. venez. oncol ; 15(2): 100-107, abr.-jun. 2003. ilus
Article in Spanish | LILACS | ID: lil-396813


Los tumores metastásicos localizados en la glándula tiroides son muy infrecuentes. El carcinoma de células renales es el responsable de muchas de las metástasis a la glándula tiroides y comúnmente ocurre muchos años después de haberse removido la lesión primaria. El primer caso fue descrito por Elliot y Frantz en 1960. Reportamos el caso de una paciente femenina de 66 años de edad con un carcinoma de células renales metastásico a la glándula tiroides que apareció catorce años después de una nefrectomía radical

Adult , Female , Carcinoma, Renal Cell/surgery , Carcinoma, Renal Cell/therapy , General Surgery , Thyroid Gland/surgery , Thyroid Gland/injuries , Neoplasm Metastasis , Treatment Outcome , Medical Oncology , Venezuela
Salus militiae ; 25(1): 10-16, ene.-jun. 2000. tab
Article in Spanish | LILACS | ID: lil-310613


Se realizó un trabajo prospectivo entre marzo de 1998 a junio de 1999 en el Servicio de Cirugía General del Hospital Militar "Dr. Carlos Arvelo", Caracas Venezuela, analizando el estudio ecosonográfico (transductor lineal de 7,5 mghz, equipo General Electric, advantage III) tiroideo de 51 pacientes y correlacionándolo con 44 punciones aspiraciones con aguja fina (citológico) y con 13 biopsias (histológicas) quirúrgicas. Se agruparon a los pacientes en tres grupos; Nº1: imagen única hipoecoica con microcalcificaciones, Nº2: imagen única hipoecoica con halo ecolúcido sin microcalcificaciones con o sin zonas ecolúcidas en su interior (ecomixta), Nº3: imágenes multiples hipoecoicas con o sin halo ecolúcido; con o sin zonas ecolúcidas en su interior. Los pacientes del grupo Nº1 se catalogaron como procesos malignos, y los de los grupos restantes como procesos benignos. Del grupo Nº1 se obtuvo 4 casos, que correspondieron todos a adenocarcinoma papilar; del grupo Nº2 se encontraron 22 pacientes, con un solo caso de adenocarcinoma de células de Hurthle (falso negativo). Del grupo Nº3 se hallaron 25 pacientes, con diagnóstico de tumores benignos por citología e histología. La sensibilidad de la imagen B fue de 83 por ciento y la especificidad del 100 por ciento

Humans , Male , Female , Adolescent , Adult , Middle Aged , Carcinoma, Papillary , Thyroid Gland/cytology , Thyroid Gland/injuries , Goiter , Hyperplasia , Thyroid Nodule/surgery , Thyroid Nodule/pathology , Ultrasonography , Medicine , Venezuela
Article in English | WPRIM | ID: wpr-155364


We have reviewed 1066 thyroid lesions and compared the relative incidence of the so called 'palpation thyroiditis' between autoimmune thyroiditis and normal thyroid parenchyme surrounding the nodular thyroid lesion and also discussed the pathogenesis of palpation thyroiditis. The typical histopathologic features of 'palpation thyroiditis' were seen in 275 cases among 467 adenomatous goiters and in none of the autoimmune thyroiditis. We here in this paper suggest that the so called 'palpation thyroiditis' is not merely a secondary phenomenon to mechanical follicular damage by vigorous palpation, but this lesion more likely develops in conditions where certain types of physiologic alteration has occurred in follicular basement membrane, just like a pathogenesis of subacute granulomatous thyroiditis.

Adenocarcinoma/complications , Adenoma/complications , Carcinoma, Papillary/complications , Diagnosis, Differential , Goiter, Nodular/complications , Humans , Iatrogenic Disease , Palpation/adverse effects , Thyroid Gland/injuries , Thyroid Neoplasms/complications , Thyroiditis/diagnosis , Thyroiditis, Autoimmune/pathology