Falk S A
University of Rochester School of Medicine, New York.
Otolaryngol Clin North Am. 1990 Jun;23(3):361-80.
Surgery for the treatment of hyperthyroidism is rapid and permanent, highly safe, and highly successful and has an important and complementary role with medical therapy and 131I. In Grave's disease cases total thyroidectomy, performed only if parathyroid glands are preserved, prevents recurrent hyperthyroidism. Bilateral subtotal thyroidectomy or total lobectomy with contralateral subtotal lobectomy are done if at least one parathyroid cannot be preserved on each side. In terms of recurrent laryngeal nerve preservation, all three operations are equally safe if the nerve is positively identified and traced throughout its course.
手术治疗甲亢迅速且效果持久,安全性高,成功率高,在药物治疗和碘-131治疗中具有重要的补充作用。在格雷夫斯病病例中,仅在保留甲状旁腺的情况下进行全甲状腺切除术,可预防甲亢复发。如果每侧至少有一个甲状旁腺无法保留,则进行双侧次全甲状腺切除术或一侧全叶切除术加对侧次全叶切除术。就喉返神经保留而言,如果能在全程明确识别并追踪该神经,那么这三种手术的安全性是相同的。