The Goiter is an enlarged thyroid gland. He or thyroid is an endocrine gland located in the front of the neck around the trachea and thyroid hormone production or Thyroxine is the hormone that regulates the body's metabolism.
Types of goiter
Basically there are two types of goiter:
- diffuse goiter in which the entire gland is“diffusely” increased in size and usually is related to a malfunction of the gland. Hyperthyroidism or hypothyroidism
- nodular goiter. The growth in this case is caused by the occurrence of one or more nodules (tumors or lumps ). When a single nodule (nodular goiter ) displayed may be an adenoma, carcinoma benign or malignant (7-15 %). When multiple nodules appear, talk about Multinodular Goiter (4 % malignant) When growing goiter is inserted into the chest below the clavicle and the sternum we call endothoracic Goiter.
The symptoms produced by the growth itself, thyroid gland are due to its volume and compression of neighboring structures. So they are:
- Appearance of a more or less aesthetic lump in the front of the neck
- Discomfort or difficulty breathing, coughing, snoring etc. By compression of the trachea.
- Difficulty swallowing by compression of the esophagus
- When growth is fast can cause pain or tightness. There are other symptoms that are secondary not the“bulk&rdquo ;, but the cause of goiter can be symptoms of hyper or hypothyroidism or signs of malignancy as afonia by invasion of the laryngeal nerve, appearance of metastases in the lymph, etc.
Causes and Risk Factors
Causes depend on the type of goiter, as we mentioned in the case of diffuse goiter usually occurs as a result of malfunction, or hyper hipotiroidism or.
Sometimes the thyroiditis, which is an inflammation of the thyroid autoimmune often, also may be associated with the appearance of goiter.
Formerly it was very common to see people with giant goiters were usually caused by deficit of iodine and were prevalent in certain areas of Spain in which no iodine in water or diet who ate its inhabitants was: we talked about endemic goiter. Today with the addition of iodine to salt, have virtually disappeared.
Also in many cases there is a genetic predisposition which favors the appearance of both benign multinodular goiters and the thyroid cancer. We do not know the reason why goiters are much more frequent in the female.
The radiation is a risk factor for the appearance of nodules in the thyroid and especially some thyroid cancers. This I learned 20 to 30 years after the nuclear explosions in Hiroshima and Nagasaki. We also learned that radiotherapy does more than 40 years was used for the treatment of facial acne, sinusitis and other pathologies of the face and neck was a risk factor for the appearance of thyroid cancer. For this reason, they stopped making treatment and makes more than 40 years.
As is the treatment or intervention
The treatment of goiter, as the case may be through diet, medication, surgery or radioisotope. The surgery can be more or less extensive depending on the reason for the intervention. When we operate because the patient has a unique benign nodule, usually we remove only one of the two lobes (right or left ) of the thyroid. If the patient has a cancer, we remove all the thyroid and lymph around and usually is made after treatment with radioactive iodine. Patients who have a multinodular goiter They are also removes the entire thyroid gland. As in other fields of surgery, whenever we do less invasive or aggressive operations, with smaller scars and using new technologies.
How is the recovery
Thyroid surgery is less painful than abdominal surgery. It is usually painless, the patient can start the diet, speak up and usually the same day of surgery. The hospital stay is one to three days and 8-10 days can make a practically normal activity.