How we do it: surgery should be considered equally with I131 and thionamide treatment as first-line therapy for thyrotoxicosis.
Radioiodine and thionamide treatment are the most frequently used treatment modalities for thyrotoxicosis in Europe and North America with surgery being reserved for selected cases. * In our clinic patients were offered all three modalities via simultaneous interview with an endocrinologist and a surgeon, with international risk benefit data for radioiodine and thionamide therapy, and local risk benefit data for total thyroidectomy provided. * When given the choice, at least 15% of patients opted for total thyroidectomy over the other modalities. * In our series of 100 consecutive surgical patients there was a 4% malignancy rate. * Total thyroidectomy should be offered equally, with radioiodine and thionamide treatment, as a first line treatment modality in the management of thyrotoxicosis.
England
R J A
RJ
Departments of Otolaryngology Head and Neck Surgery and Endocrinology, Hull Royal Infirmary, UK. rjaeathome@aol.com
Kamath
M B
MB
Jabreel
A
A
Dunne
G
G
Atkin
S L
SL
D000293:Adolescent; D000328:Adult; D000368:Aged; D013956:Antithyroid Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D013965:Thyroidectomy; D013971:Thyrotoxicosis / Q000601:surgery / Q000628:therapy*; D016896:Treatment Outcome
D013956:Antithyroid Agents; D007457:Iodine Radioisotopes