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Christchurch, New Zealand

Brownlie B.E.W.,Thyroid Clinic | Hunt P.J.,Thyroid Clinic | Turner J.G.,Thyroid Clinic
New Zealand Medical Journal | Year: 2010

Aim: To assess our experience in the management of juvenile thyrotoxicosis. Method: Retrospective review of thyroid clinic records of juvenile (<16y) thyrotoxic (JT) patients treated at thyroid clinic between 1972 and 1999. Long-term (>8y) treatment outcome was assessed. Results: During the 28-year period, 34 JT patients were diagnosed and treated-30 girls and 4 boys, median age 13 years (5.6-15.9 y). Thirty-two children had Graves' disease and two had toxic nodular goitre. All patients were initially treated with carbimazole, and no major adverse reactions occurred. One Graves' disease child later developed severe ophthalmopathy. During long-term follow-up, 12 of the 32 Graves' patients remain in remission after antithyroid drug treatment alone, but 4 of these 12 patients are currently receiving thyroxine replacement. Fifteen patients were surgically treated (median age 16 y), and six patients received radioiodine therapy (median age 18 y) including one patient with post-thyroidectomy relapse. The two Apatients with toxic nodular goitre were treated by thyroidectomy. Conclusion: Juvenile thyrotoxicosis is relatively rare and not always due to Graves' disease. More than a third of children with Graves' disease achieved long-term remission following antithyroid drug therapy, and remaining patients required definitive therapy. ©NZMA. Source

Hurtado-Lopez L.-M.,Thyroid Clinic | Diaz-Hernandez P.I.,Thyroid Clinic | Basurto-Kuba E.,Thyroid Clinic | Zaldivar-Ramirez F.R.,Thyroid Clinic | Pulido-Cejudo A.,Thyroid Clinic
Thyroid | Year: 2016

Background: This study investigated whether visual localization of the external branch of the superior laryngeal nerve (EBSLN) coincides with its localization via intraoperative neuro-monitoring (IONM) during thyroidectomy and whether its use influences the frequency of injuries. Methods: A prospective, comparative, cross-sectional, observational study was performed in 240 superior thyroid poles. The metrics were visual identification of the EBSLN and its corroboration with IONM. The frequency of EBSLN injuries was also determined. Statistical analysis was achieved via kappa and chi-square tests, as well as odds ratios (OR). Results: Of the 240 superior thyroid poles, IONM identified 234 (97.5%) EBSLN, whereas 190 (79.1%) were identified visually: OR = 10.35 [CI 4.37-24.65] p < 0.0001. Of the 190 EBSLN identified visually, 150 were confirmed through IONM. Indeed, their structure corresponded to an EBSLN to yield a kappa with a linear weighting value of 0.362. The standard error was 0.0467 [CI 0.2686-0.4554], indicating a fair agreement between the visual and IONM classification. Conclusion: IONM identified 97.5% of EBSLN cases. It was higher than the visual identification. There were no injuries to EBSLN identified through IONM. © Copyright 2016, Mary Ann Liebert, Inc. 2016. Source

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