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8 - Thyroid and parathyroid (including thyroglossal disorders)

from Part II - Head and neck

Published online by Cambridge University Press:  08 January 2010

By
Jaimie D. Nathan  and
Michael A. Skinner
Edited by
Mark D. Stringer ,
Keith T. Oldham  and
Pierre D. E. Mouriquand
Jaimie D. Nathan
Affiliation:
Duke University Medical Center, Durham, NC, USA
Michael A. Skinner
Affiliation:
Duke University Medical Center, Durham, NC, USA
Mark D. Stringer
Affiliation:
University of Otago, New Zealand
Keith T. Oldham
Affiliation:
Children's Hospital of Wisconsin
Pierre D. E. Mouriquand
Affiliation:
Debrousse Hospital, Lyon
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Summary

Since the first thyroidectomy was reportedly performed by the Moorish surgeon Albucasis in AD 330, the surgical treatment of thyroid and parathyroid disorders has been approached with trepidation. Even with modern technical advances, many regard pathology in this anatomic location only operable by those with significant experience. This notion is especially true in children. The technical difficulties are more pronounced in younger individuals, and these children must survive a lifetime with the end result of their surgeon's work.

In this chapter, the long-term outcome of surgical diseases of the thyroid and parathyroid glands, including thyroglossal disorders, in children is discussed. Graves' disease, the most common of these disorders, is the first entity considered. Malignancies of the thyroid gland are then considered with a discussion of papillary and follicular carcinoma, followed by a review of medullary carcinoma of the thyroid. Next, childhood disorders of the parathyroid glands are discussed, with emphasis on hyperparathyroidism. Finally, we consider the management and long term outcome of thyroglossal disorders, including cysts and sinuses.

Graves' disease

Toxic diffuse goiter or Graves' disease is the most common cause of hyperthyroidism in children. It is more common in girls than boys, with a ratio of approximately 4:1 to 5:1, and the incidence increases throughout childhood with a peak in the adolescent years.

Graves' disease is an autoimmune process mediated by circulating autoantibodies to the thyroid stimulating hormone (TSH) receptor present on the follicular cells of the thyroid gland.

Type
Chapter
Information
Pediatric Surgery and Urology
Long-Term Outcomes
 , pp. 90 - 103
Publisher: Cambridge University Press
Print publication year: 2006

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