Goiter is an enlarged thyroid gland in the front of the neck, butterfly-shaped and supported on the trachea. This growth can be uniform, diffuse goiter, or associated with the occurrence of one or more nodules, nodular or multinodular goiter.
The multinodular goiter is a very common condition, caused by different reasons: deficit in the supply of iodine intake goitrogens (such as cauliflower, Brussels sprouts, nuts, etc.), drugs (such as perchlorates, colchicine, thiocyanate) birth defects and autoimmune phenomena.
Symptoms of multinodular goitre
In its early stages, multinodular goiter is usually asymptomatic, but the progressive growth of nodules ago with symptoms of compression: dysphagia occurs when performed on the esophagus; dyspnea on the trachea; dysphonia, compression of the recurrent laryngeal nerves, acting on the vocal cords. In most cases they retain thyroid function, but in advanced stages there may be alteration thereof with the onset of hypothyroidism or hyperthyroidism.
Diagnosis of multinodular goitre
Given their limited clinical study, diagnosis is usually accidental, following a neck exploration or performing a cervical ultrasound for other reasons.
The diagnostic test is the quintessential cervical ultrasound, which describes the number, size, appearance and characteristics of thyroid nodules and the presence of associated cervical lymphadenopathy, which would suspect malignancy. Other tests used in the study of goiter include: scintigraphy, CT or MRI.
The method of Fine needle aspiration (FNA) allows to know the nature of the nodule. It is recommended be performed under ultrasound guidance, allowing the most suspicious nodule puncture. Recall that the multinodular goiter is associated by 5% to thyroid cancer.
Multinodular goitre treatment
The definitive treatment in general surgery for multinodular goiter surgical treatment, but not all require surgery multinodular goiters. The indications are suspected malignancy, compressive symptoms, endotorácico growth, functional impairment or childhood.
The surgical technique is to make total thyroidectomy, in which the entire thyroid gland is removed and therefore the disease. It is a delicate surgery by the existence of structures vital to the voice, laryngeal, or nerves calcium metabolism, parathyroid, which must be respected. It is therefore recommended that the surgery be performed by experts in the field. This surgery involves the need for replacement therapy for life, but the patient generally well tolerated.