Equally well qualified surgeons still debate the absolute indications for total thyroidectomy. Many malignant tumors of the thyroid gland are controlled indefinitely by thyroidectomy which is just short of being truly total. The complication rate of total thyroidectomy for a markedly diseased thyroid gland is quite different from that which followed total thyroidectomy conducted in earlier years for certain forms of heart disease. In those patients the gland was entirely normal.
In this issue Shanon suggests increased use of total thyroidectomy even in selected cases of benign disease of the thyroid and, in fact, refers to it as the treatment of choice. He feels that in progressive exophthalmos accompanying exophthalmic goiter there may be a beneficial effect upon the exophthalmos. This remains a debatable issue. In his description of the technique for total thyroidectomy he argues for complete extracapsular dissection on the involved side with intracapsular dissection in the area