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Surgical Thyroidectomy in the Management of Exophthalmic Goiter

Oliver H. Beahrs, MD; S. Barry Sakulsky, MD
Arch Surg. 1968;96(4):512-516. doi:10.1001/archsurg.1968.01330220028005.
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FOR MANY YEARS, surgical thyroidectomy was the only effective form of therapy in the treatment of exophthalmic goiter or Graves' disease. Since strong iodine solution (Lugol's Solution) has been used in preoperative preparation, the procedure has been very safe, and the mortality has been low (less than 0.1% in many series). The operation has been effective in at least 95% of the cases. Unfortunately, the operation results in morbidity of some medical significance in a few cases, the complications being primarily occasional vocal cord paralysis, tetany due to hypoparathyroidism, and myxedema.1-3 Although these complications occur infrequently and can be managed satisfactorily, they are contraindications to further surgical treatment in this disease. This is especially so now that radioactive iodine(131I) has been established as an effective modality in the management of Graves' disease and is less true when iodine or the antithyroid drugs such as propylthiouracil or methimazole


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