title: Management of goitre and small nodule disease by Canadian otolaryngologists.
abstract: OBJECTIVE
  To describe current management practices among Canadian otolaryngologists for small thyroid nodule disease and nodules in the context of goitre.
  
  
  METHODS
  An online survey was e-mailed to all active members of the Canadian Society of Otolaryngology-Head and Neck Surgery (CSOHNS). The responses were anonymous. Information was gathered on practice demographics and individual practices pertaining to diagnostic workup, surgical management, and follow-up of patients with goitre and small nodule disease.
  
  
  RESULTS
  A total of 113 surveys were returned from 431 active CSOHNS members (26% response). The majority of respondents were less than 40 years (54%), resided in Ontario or Quebec (63%), and described their practice as academic (65%). Management of a small thyroid nodule following fine-needle aspiration cytology results reported as benign, nondiagnostic, abnormal, or papillary thyroid cancer was inconsistent. Papillary thyroid cancer was managed by total thyroidectomy (59%), total thyroidectomy plus level VI neck dissection (38%), hemithyroidectomy plus level VI neck dissection (2%), and hemithyroidectomy (1%). Management of goitre was not uniform. Symptomatic goitre management included discharge from practice (6%), follow-up with serial ultrasonography (12%), hemithyroidectomy (15%), and total thyroidectomy (66%). Practice demographics had a significant effect on intraoperative techniques, such as the use of an electromyographic nerve monitor.
  
  
  CONCLUSIONS
  There was a lack of consensus among Canadian otolaryngologists regarding treatment of small thyroid nodules and nodules in the context of goitre. Canadian guidelines for management of small nodule disease may standardize care.
authors.affiliation: Division of Otolaryngology, Department of Surgery, Dalhousie University, Halifax, NS.
authors.forename: Natalie E
authors.initials: NE
authors.lastname: Parks
authors.forename: S Mark
authors.initials: SM
authors.lastname: Taylor
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Trites
authors.forename: Robert D
authors.initials: RD
authors.lastname: Hart
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D002170:Canada; D005260:Female; D006042:Goiter / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010036:Otolaryngology / Q000379:methods*; D012955:Societies, Medical; D011795:Surveys and Questionnaires; D016606:Thyroid Nodule / Q000175:diagnosis / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*; D055815:Young Adult