Indications for thyroidectomy in hyperthyroidism
In the United States, thyroidectomy is not commonly performed for hyperthyroidism unless it is secondary to a single hyperfunctioning adenoma or because of a toxic multinodular goiter associated with compressive symptoms or containing a suspicious nodule. Despite the excellent success, low recurrence rate, safety, and more rapid return to a euthyroid state, < 10% of patients with hyperthyroidism undergo thyroidectomy. Possible indications for thyroidectomy in patients with hyperthyroidism include:
1 Failure of antithyroid medications
2 Large goiter and low radioiodine uptake
3 Compression symptoms, such as dysphagia, stridor, or hoarseness
4 Nodules suspicious for cancer
5 Young children (age < 5 years)
6 Pregnant patient who is difficult to treat medically
7 Young female who wants to become pregnant in the near future (< 6 months)
8 Moderate-to-severe Graves’ ophthalmopathy
9 Concomitant primary hyperparathyroidism requiring surgery
10 Cosmetic concerns
