[Indications and procedures in conservative goiter treatment].

A review of the literature shows that thyroid hormone therapy causes 13 to 40% of euthyroid goiters to disappear and brings about a reduction in goiter size in another 30 to 50%. The hormonal treatment is more successful with smaller goiters. Uninodular goiters respond on the average less well than diffuse and multinodular goiters. In Switzerland, about 33% of adult persons have goiters, albeit mostly of small size. This renders impracticable investigation or treatment of all goiters. It is recommended that only goiters which are esthetically disturbing or which cause pressure symptoms be treated. An operation must always be performed when there is suspicion of thyroid cancer or in the presence of threatening pressure symptoms. In all the other cases, thyroid hormone therapy may be tried. If an operation cannot be performed for cardiac or other reasons, radioiodine will relieve pressure symptoms due to goiter in over 65% of cases.