The thyroid gland is a butterfly-shaped, two-part endocrine (hormone-secreting) gland located in the anterior part of the neck, in front of the trachea. Thyroid hormones are secreted depending on the stimulus from the brain.
What Does Thyroid Disease Mean?
Thyroid disease; is a general term that means the gland makes enough hormones. It is possible to divide thyroid diseases into two;
- Hormone diseases of the thyroid: It is caused by disorders in the production of hormones in the thyroid gland. The most common thyroid diseases are thyroid hormone excess (hyperthyroidism) and deficiency (hypothyroidism).
- Structural diseases of the thyroid: The structure of the thyroid gland is impaired in these diseases. In these diseases, the production of hormones produced by the thyroid gland may be normal or abnormal.
Who Does Thyroid Disease Affect?
Thyroid disease is a common disease in all age groups. It is 5-8 times more common in women than men.
- Having a family history of thyroid disease,
- Some medical conditions (pernicious anemia, type 1 diabetes, primary kidney failure, rheumatoid arthritis, Turner Syndrome etc.)
- People using drugs containing high iodine,
- People who have had thyroid disease or cancer before,
- Women over 60 have a higher risk of developing thyroid disease .
What are the Symptoms of Thyroid Gland Diseases?
- Fatigue
- Shakes in hands
- Sudden weight gain
- Sudden weight loss
- Low
- Still birth
- Infertility
- Look forward (exophthalmia)
- Inability to lose weight despite dieting
- Sudden outbursts of anger
- Extreme irritability
- Constipation
- Diarrhea
- Nausea
- Forgetfulness
- Menstrual irregularity
- Pain in the shoulder, neck, back, waist, arm, leg,
- Muscle cramps,
- Fatigue quickly,
- Reluctance to work,
- Sexual reluctance
- Decreased sexual performance,
- Depression
- Panic attack
- Frequent defecation
- Hoarseness, bifurcation of voice
- Difficulty swallowing
- Difficulty breathing
- Feeling of discomfort in the throat
- Feeling of being stuck in the throat
- Swelling in the throat
- Shortness of breath during sleep (sleep apnea)
- Insomnia
- Snoring
- Hot flashes
- Very cold
- Night sweats
- Excessive sweating
- Fracture of nails
- Peeling of nails
- Cracked nails
- Staining of nails
- Dry skin
- Heart rhythm disorder
- Hair loss in women
- Dandruff in the hair
- Dullness in the hair
What are the Risk Factors in Thyroid Gland Diseases?
Iodine deficiency, genetic factors and structural factors are thought to play a role in thyroid gland diseases.
Especially iodine deficiency is an important factor in thyroid gland diseases. takes place. Studies show that people in Turkey take on average one-fourth of the iodine they need daily. In our country, taking iodine for prevention by people who do not have goiter is an important issue for preventive medicine. Some diseases cause hypothyroidism and hyperthyroidism, which are the most common diseases of the thyroid gland
Those that cause hypothyroidism (underproduction of thyroid hormones):
- Thyroiditis: Inflammation of the thyroid gland and the level of hormones produced decreases.
- Hashimato Thyroiditis
- Post-partum Thyroiditis: It is a temporary condition. It is seen in 5-9% of postpartum women.
- Iodine deficiency
- Dysfunction of the Thyroid Gland: It is seen from birth. If it is not diagnosed early and thyroid hormones are not started, it causes physical and mental retardation.
- Graves' disease,
- Thyroid nodules
- Thyroiditis
- Iodine excess
What is Thyroiditis (Thyroid Inflammation)?
Most of them are germ-free thyroid inflammation. The most common one is "Hashimoto's (Hashimoto's) disease". Approximately 10% of adult women have Hashimoto's disease.
The main types of thyroiditis are:
- Acute suppurative thyroiditis: It is diagnosed with pain in the anterior region of the neck, fever and signs of infection in the blood. It is a bacterial infection. It is a rare painting.
- Subacute thyroiditis (De Quervain's thyroiditis): It is of viral origin. It is usually a painful condition following an upper respiratory tract infection. Serum thyroid hormones are usually quite elevated. It is clinically recognized by pain in the area of the thyroid gland and enlargement of the gland. Laboratory findings are very high sedimentation and low RAIU (radioactive Iodine uptake). Usually with supportive treatment, complete recovery is seen.
- Painless thyroiditis: It is frequently seen in women who have just given birth. There is no clinical pain. Sedimentation is also generally normal. Here, too, thyroid hormones rise. However, hypothyroidism, that is, low levels of hormones can also be seen.
- Hashimoto's thyroiditis: It is an autoimmune disease. It is a common cause of goiter (enlarged thyroid gland) and hypothyroidism (underactive thyroid). It is common in women. Familial transmission can be seen. Other autoimmune diseases may also be associated with it. Pernicious anemia due to vitamin B12 deficiency, Sjögren's syndrome, chronic active hepatitis, Rheumatoid arthritis, Vitiligo are the main ones. It has symptoms such as weakness, hair loss, weight gain, depressive state, forgetfulness, palpitation, constipation, edema, difficulty in perception, dry skin. In its treatment, thyroid hormone is given for a long time, even for life.
How to Diagnose Thyroid Diseases?
Diagnosis of thyroid diseases; blood tests and urine tests can be provided by ultrasound, biopsy and scintigraphy. Blood tests: The levels of stimulating hormones coming from the brain are determined to make the hormone levels in the blood and the production of hormones.
Thyroid stimulating hormone (TSH): It is produced in the brain. It comes to the thyroid gland and ensures the secretion of thyroid hormones. It is a regulator of thyroid hormone balance.
T4 (thyroxine): It is a thyroid hormone. It is used in the follow-up of treatment. If it is lower than normal, there is hypothyroidism, if it is high, there is hyperthyroidism.
T3 (triiodothyronine): It helps to diagnose hyperthyroidism or to determine its severity. If it is lower than normal, it indicates hypothyroidism. However, it is often used in the diagnosis and treatment of hyperthyroidism.
Free T4 and T3: Thyroid hormones After the bee is secreted, they circulate in the blood by binding to proteins. Free T3 and T4 are non-protein bound hormones. The balance of free hormones with bound hormones is also an important indicator in thyroid diseases.
Thyroid antibodies: They are used to detect thyroid diseases related to immune system (autoimmune) causes. used in the diagnosis of hyperplasia and medullary thyroid cancer.
Thyroglobulin: It is used in the diagnosis of thyroiditis and in the follow-up of thyroid cancer treatment.
Thyroid scintigraphy: Examines thyroid function. It is also used to determine the types of thyroid nodules (cold, hot, warm), if any. Cold nodules hold a lower rate of radioactive material than the surrounding tissues, do not produce hormones, and there is a risk of cancer. Hot nodules are nodules that hold more radioactive material than the surrounding tissues and are thought to produce hormones. Warm nodules have normal activity.
Thyroid fine needle biopsy: It is the removal of a tiny piece from the nodule with a fine needle. By examining this piece in detail, it can be determined whether the nodules are benign or malignant (cancer). applicable. These are;
- Patients with thyroid cancer known by needle biopsy or suspected thyroid cancer by biopsy,
- Patients with nodules that are thought to be benign but whose diameter is getting larger and cause pressure symptoms on the neck ,
What is the Role of Robotic Surgery in Thyroid Diseases?
Robotic surgery is of great importance in thyroid surgeries. The surgeon can reach his height with the help of robotic arms from a 5 cm incision he will create under the armpit. The robot's arms move thanks to the surgeon's hand movements. While the human hand can rotate 180 degrees, the physician can create more than 360 degree rotations thanks to robotic arms. In robotic surgeries, the surgeon can easily operate even in a narrow area. It can move and see that area in 3D.
What are the Benefits of Robotic Thyroid Surgery?
- The patient's recovery is better because the neck muscles are not cut. It is fast.
- The patient has less pain.
- There is no scar on the patient's neck. It provides an aesthetic advantage.
- Nerves that move the patient's vocal cords can be preserved.
- Patient's parathyroid glands can be preserved.
When is Robotic Thyroid Surgery Performed?
Robotic thyroid surgery can be applied in operations ranging from unilateral thyroid nodule surgery to total thyroidectomy.
With Robotic Thyroid Surgery, the nerves that move the vocal cords can be preserved.
The functionality of the parathyroid glands is not impaired. By separating it from the thyroid, accidental ingestion is prevented. The parathyroid glands maintain calcium in the bones and maintain the metabolic balance in the body. Thus, hypocalcemia (calcium deficiency) can be prevented.
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