Enlargement of the thyroid gland, which surrounds the trachea from the front and side in the front of the neck, for a reason other than inflammation and cancer, is called goiter. It determines the metabolic rate with the hormone it secretes. If the hormone it produces decreases, our body's working speed decreases; if it secretes more hormones, its working speed increases. Goiter disease includes different clinical pictures. We can divide goiter diseases into three main groups; 1. Hypothyroidism: Conditions in which the thyroid gland secretes less hormone. Since the hormone secreted by the gland is insufficient, the body's speed slows down, movements become slower, and the senses become numb. These patients are treated by giving the required hormone in the form of medication.
2. Hyperthyroidism (thyrotoxicosis): Conditions in which the thyroid gland secretes too much hormone: This group is also called toxic goiter. Due to the excess thyroid hormone in the body, the body's working speed has increased. Complaints such as tremors in the hands, nervousness, and heart palpitations are observed. There are three types of goiter in this group;
3. Goiter patients without hormone imbalance: In all three groups, the shape of the thyroid gland can be a nodule-free growth, a single or multiple nodular structure.
Complaints of goiter patients also vary depending on the type of disease. In types where hormones are produced in excess (toxic goiter), shaking and sweating in the hands, heart palpitations, irritability, eyes bulging out of their sockets, diarrhea, increased appetite, inability to gain weight and menstrual irregularities are observed. In cases where hormones are produced insufficiently, slowing down of movements and emotions, dry hands, dryness and loss of hair, and menstrual irregularities are observed. Different clinical complaints may also occur in patients without hormonal imbalance. In all of these diseases, the thyroid gland may enlarge and nodules may form. The thyroid gland produces hormones using the element iodine. Goiter is common in places where this element is deficient. Goiter disease can be prevented by correcting iodine deficiency. Simply having an ultrasound to check the amount of hormones in the blood and see the structure of the thyroid gland is usually sufficient for diagnosis. After these two tests, if necessary, other tests such as scintigraphy and needle biopsy are performed. Not every goiter disease requires surgery. Surgery is required in some cases:
1. The enlarged goiter in the neck creates an aesthetic problem.
2. The enlarged disease destroys the esophagus and compression of the trachea.
3. Goiter causes hormone imbalance.
4. Cancer is detected or cancer is suspected. Considering all patients with goiter, there is a 15% chance of developing cancer. Some types of the disease require drug treatment, some require radioactive iodine treatment (destruction of the thyroid gland with radiation), and some require surgery. Just as the diseases of goiter are various, so are its surgeries. The thyroid gland has two parts. During surgery, one or both of these parts may be removed, or some of both parts may be removed. How much thyroid gland will be removed, that is, which of these surgery options will be applied, is planned according to the type of disease. Especially in goiter disease with many nodules, if thyroid tissue remains after surgery, it may grow over time and cause the goiter to recur. For this reason, it is important to plan the surgery according to the disease. Depending on the type of surgery, many patients may have to use thyroid hormone extract (medicine). All goiter patients, whether operated on or not, should be checked at regular intervals, depending on their disease.
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