Indications for thyroidectomy in hyperthyroidism

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