title: Nodular recurrence and hypothyroidism following partial thyroidectomy for benign nodular thyroid disease in children and adolescents.
abstract: OBJECTIVE
  Diagnostic and therapeutic processing of a thyroid nodule in children and adolescents may require lobectomy-isthmusectomy (LI) or nodule-resection (NR). Very few data in the literature report the long-term evolution of the remaining thyroid lobe in a defined pediatric population. In this study, we aimed to answer the following questions: Does a nodule recurrence occur in the remainder lobe? Is a post-operative thyroxine treatment necessary?
  
  
  METHODS
  This retrospective study describes 28 patients under 18 who underwent LI (22 cases) or NR (6 cases) from January 2004 to March 2012. Ten of them were lost to follow up, 18 could be assessed (4 NR (22%) and 14 LI (78%) - mean follow-up 45±31 months). All patients benefited of post-operative thyroid ultrasonography, and regular endocrinologic follow-up. The following data were analysed: emergence of new thyroid nodules, evolution of pre-existing nodules, occurrence of post-operative hypothyroidism and requirement for completion thyroidectomy.
  
  
  RESULTS
  The mean age at the time of surgery was 14.3±1.9 years. Two patients (11%) had pre-existing nodules in the remaining thyroid gland, none of which showed an increase in size after surgery. De novo nodules developed in five patients (27.8%). Three patients who underwent LI (21.4%) needed thyroxine treatment for post-operative hypothyroidism. One patient (5.5%) needed completion thyroidectomy.
  
  
  CONCLUSIONS
  In this children and adolescents population, after performing LI or NR, remaining thyroid tissue stays free of nodules in 72.2% of the cases. A post-operative thyroxin treatment is necessary in 21.4% of cases after LI.
authors.affiliation: Service d'ORL et Chirurgie Cervico Faciale, CHU de Montpellier, Université Montpellier 1, Hôpital Gui de Chauliac, 80 avenue Augustin Fliche, 34295 Montpellier Cedex 5, France. Electronic address: mohamed.akkari.orl@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Akkari
authors.affiliation: Service d'ORL et Chirurgie Cervico Faciale, CHU de Montpellier, Université Montpellier 1, Hôpital Gui de Chauliac, 80 avenue Augustin Fliche, 34295 Montpellier Cedex 5, France.
authors.forename: D
authors.initials: D
authors.lastname: Schmitt
authors.affiliation: Service d'Endocrinologie Pédiatrique, CHU de Montpellier, Université Montpellier 1, Hôpital Arnaud de Villeneuve, 371 avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France.
authors.forename: C
authors.initials: C
authors.lastname: Jeandel
authors.affiliation: Service des maladies endocriniennes, CHU de Montpellier, Université Montpellier 1, Hôpital Lapeyronie, 371 avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France.
authors.forename: I
authors.initials: I
authors.lastname: Raingeard
authors.affiliation: Service d'ORL et Chirurgie Cervico Faciale, CHU de Montpellier, Université Montpellier 1, Hôpital Gui de Chauliac, 80 avenue Augustin Fliche, 34295 Montpellier Cedex 5, France.
authors.forename: C
authors.initials: C
authors.lastname: Blanchet
authors.affiliation: Service d'ORL et Chirurgie Cervico Faciale, CHU de Montpellier, Université Montpellier 1, Hôpital Gui de Chauliac, 80 avenue Augustin Fliche, 34295 Montpellier Cedex 5, France.
authors.forename: C
authors.initials: C
authors.lastname: Cartier
authors.affiliation: Service d'ORL et Chirurgie Cervico Faciale, CHU de Montpellier, Université Montpellier 1, Hôpital Gui de Chauliac, 80 avenue Augustin Fliche, 34295 Montpellier Cedex 5, France.
authors.forename: R
authors.initials: R
authors.lastname: Garrel
authors.affiliation: Service d'ORL et Chirurgie Cervico Faciale, CHU de Montpellier, Université Montpellier 1, Hôpital Gui de Chauliac, 80 avenue Augustin Fliche, 34295 Montpellier Cedex 5, France.
authors.forename: B
authors.initials: B
authors.lastname: Guerrier
authors.affiliation: Service d'ORL et Chirurgie Cervico Faciale, CHU de Montpellier, Université Montpellier 1, Hôpital Gui de Chauliac, 80 avenue Augustin Fliche, 34295 Montpellier Cedex 5, France.
authors.forename: M
authors.initials: M
authors.lastname: Makeieff
authors.affiliation: Service d'ORL et Chirurgie Cervico Faciale, CHU de Montpellier, Université Montpellier 1, Hôpital Gui de Chauliac, 80 avenue Augustin Fliche, 34295 Montpellier Cedex 5, France.
authors.forename: M
authors.initials: M
authors.lastname: Mondain
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007037:Hypothyroidism / Q000209:etiology*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D011183:Postoperative Complications / Q000601:surgery; D012189:Retrospective Studies; D016606:Thyroid Nodule / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects*; D013974:Thyroxine / Q000627:therapeutic use*
chemical_list: D013974:Thyroxine
keywords: Children; Hypothyroidism; Lobectomy–isthmusectomy; Nodule resection; Post-operative thyroxin treatment; Thyroid nodule