Annals of Thyroid

Htar Htar Aung

Ismail Abdul Sattar Burud

Amardev Singh Thanu

Aqil M. Daher

Farida Hussan

Relation of external branch of the superior laryngeal nerve and superior thyroid artery: a systematic review and meta-analysis

喉上神经外支与甲状腺上动脉关系：系统综述与Meta分析

Ahmed Elnahla

Abdallah S Attia

Emmanuelle Ruiz

Scott Mayer

Grace Lee

Emad Kandil

Active surveillance for well-differentiated thyroid cancer

分化型甲状腺癌的主动监测

Abstract: Transoral endoscopic thyroidectomy vestibular approach (TOETVA) is the latest described remote access approach to surgery of the central neck. The unique benefit of TOETVA is that it is completely scarless as incisions are made in the vestibule of the oral cavity. Since the first case series was published in 2016, the number of cases has exponentially grown. Multiple studies have documented the morbidity and quality of life impact of having a visible transcervical scar. In addition, the recent literature has reported increased quality of life with TOETVA as well as improved cosmesis when compared to the traditional open approach and other remote access approaches. These benefits have led to the rapid initial adoption of TOETVA by surgeons, in contrast to slower uptakes seen with the other popular remote access approaches. Currently TOETVA is being performed internationally. As of May 2020, over 1,880 cases from 17 different countries have been reported. We performed a literature review of TOETVA outcomes and report complication rates to be similar to standard open thyroidectomy, with low rates of novel complications such as mental nerve injury (MNI) and carbon dioxide embolism. TOETVA should be considered a safe approach to thyroid surgery as it provides excellent cosmesis while demonstrating non-inferiority in terms of risk to the patient [recurrent laryngeal nerve (RLN) palsy, bleeding, infection, hypoparathyroidism (HP)]. Larger prospective studies should be done in the future to compare TOETVA to traditional thyroidectomy in terms of quality of life, voice outcomes and oncologic equivalency.

Victoria E. Banuchi

Sarita S. Ballakur

Jonathon O. Russell

Ralph P. Tufano

Benefits and risks of scarless thyroid surgery

无疤甲状腺手术的益处与风险

: Metformin is a medication that has been used for almost a century for the treatment of type II diabetes. Relatively recent studies have discovered metformin to have utility for the treatment and prevention of number malignancies. Metformin has demonstrated in population studies to reduce papillary thyroid cancer however, the specific effect of metformin on papillary thyroid cancer in humans has not been previously reported. Herein we present the first clinical evidence of anti-tumor effect of metformin on papillary thyroid cancer resulting in clinical regression. This was found in a 35-year-old female who noticed a lump in her neck and was found to have a thyroid nodule. On biopsy, her nodule was proven to be papillary thyroid carcinoma. The patient chose to take metformin in lieu of surgical removal of her thyroid. Repeated monitoring demonstrated clinical regression of her carcinoma, with the size of her nodule decreasing from 1.4×1.1×1.2 to 0.66×0.52×0.67 cm3, or an 88% reduction in volume. There was also no evidence of any progression to her lymph nodes. This opens a potentially new treatment modality for papillary thyroid cancer which traditionally has had the mainstay treatment options of surgery and radioactive iodine, however more work is needed to be done to confirm the generalizable results for this one case.

David Reznick

Maria Luisa Policarpio-Nicolas

Edwina C. Moore

Eren Berber

Regression of papillary thyroid cancer using metformin: a case report

二甲双胍治疗甲状腺乳头状癌的病例报告

Abstract: Parathyroid fluorescence has emerged as a useful adjunct for the detection and preservation of parathyroid glands during both thyroidectomy and parathyroidectomy. When viewed under near-infrared light, parathyroid tissue has autofluorescent properties, which can be used to identify the parathyroid glands and distinguish them from the surrounding cervical tissues, including lymph nodes, thyroid, and fat. This near-infrared autofluorescence (NIRAF) is based on intrinsic fluorophores within parathyroid tissue and does not evaluate tissue viability. However, the addition of an intravascular fluorescent contrast, such as indocyanine green, can help evaluate gland perfusion. These techniques are safe, require no radiation, and can be easily integrated into the surgical workflow. Though long-term clinical outcomes data, including improvement of post-thyroidectomy hypoparathyroidism and cure of hyperparathyroidism using parathyroid NIRAF and contrast-enhanced parathyroid fluorescence is currently lacking, promising data is emerging that these techniques may improve parathyroid identification and preservation during cervical surgery. They may also be particularly useful in teaching trainees. In this article, we describe the techniques of probe-based and image-based detection of parathyroid NIRAF, as well as contrast-enhanced parathyroid fluorescence. We explore the current literature surrounding these modalities, discuss advantages and limitations of the various techniques, and provide practical guidance for their use and integration into surgical practice.

Claire E. Graves

Quan-Yang Duh

Fluorescent technologies for intraoperative parathyroid identification

甲状旁腺术中识别的荧光技术

Andrey Valerievich Ushakov

Ultrasound signs of large segmental thyroid regeneration in Hashimoto’s thyroiditis: a case report of two cases

桥本甲状腺炎中大节段甲状腺再生的超声表现：两例病例报告

Thyroid nodules, pseudonodules and large segments: from empirics to reality

甲状腺结节、假结节及大段组织：从经验到现实

Background: Patients with thyroid nodules commonly present to clinical attention. The usual evaluation includes a through history and physical examination, laryngoscopy, ultrasonography, and a fine-needle aspiration cytology (FNAC) when there is a suspicion of malignancy. This case report highlights the entity of pseudo-nodules that can resolve spontaneously with conservative management. Case Description: A 58-year-old Chinese female in Singapore presented with an episode of left anterior neck pain and swelling that started spontaneously and lasted a month. Thyroid function tests showed subclinical hyperthyroidism without antibodies against thyroglobulin, thyroid peroxidase, and thyrotropin receptor. Ultrasonography of the neck showed two right-sided thyroid nodules (2.5 and 1.1 cm) with intermediate risk of malignancy. Thyroid scintigraphy revealed overall reduced tracer uptake with photopenia of the right mid-to-lower pole. She was diagnosed with subacute thyroiditis and managed conservatively with non-steroidal anti-inflammatory drugs (NSAIDs). During subsequent reviews, her thyroid nodules nearly completely resolved 9 months later and her thyroid function normalized. Conclusions: Our patient's clinical course, imaging, and laboratory work-up supports a diagnosis of De Quervain's thyroiditis. Inflammatory pseudonodules can be found in this condition and are known to resolve spontaneously. Except for marked hypoechogenicity, the pseudonodules do not display other suspicious features on ultrasonography. As thyroid nodules are increasingly diagnosed, it is timely to remember the entity of inflammatory pseudonodules which can spontaneously resolve. Clinicians should recognize this diagnosis to avoid performing unnecessary FNAC or generating excessive concerns about cancer in their patients.

Cheng Yit Zachary Kok

Huiling Liew

Hau Wei Khoo

Hao Li

Thyroid nodules that disappear—a case report on pseudonodules in thyroiditis

消失的甲状腺结节——甲状腺炎中假性结节的病例报告

Background: Thyroid nodules are encountered in 19–68% of the population and in most cases require observation due to the risk of malignancy. Spontaneous intrathyroidal hemorrhage is a rare phenomenon that occurs in case of trauma or ulceration of a large vessel. The management of this patient group depends, first of all, on the severity of bleeding and airway obstruction. In order to assess the degree of compression provided by surrounding tissues, the most optimal method is ultrasonography. Decompression can be performed by ultrasound-guided puncture or drain placement in case of fluid collection. In most cases, bleeding stops with the use of conventional therapy. In case of dyspnea, an increase in the neck size and volume of hematoma, hemodynamic instability, an emergency intubation and surgical intervention is indicated.

出版信息	出版商: AME Publishing Company，出版周期: ，期刊类型: journal，开源期刊: 否
基本数据	创刊年份: 2019，原创研究文献占比: ，自引率:， Gold OA占比:

Annals of Thyroid

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Relation of external branch of the superior laryngeal nerve and superior thyroid artery: a systematic review and meta-analysis

Active surveillance for well-differentiated thyroid cancer

Benefits and risks of scarless thyroid surgery

Regression of papillary thyroid cancer using metformin: a case report

Fluorescent technologies for intraoperative parathyroid identification

Relation of external branch of the superior laryngeal nerve and superior thyroid artery: a systematic review and meta-analysis

Ultrasound signs of large segmental thyroid regeneration in Hashimoto’s thyroiditis: a case report of two cases

Thyroid nodules, pseudonodules and large segments: from empirics to reality

Thyroid nodules that disappear—a case report on pseudonodules in thyroiditis

Spontaneous thyroid hemorrhage management: a case report

ISSN	2522-6681
h-index	4