الفهرس | Only 14 pages are availabe for public view |
Abstract In this essay, a mention of the development and anatomical features of the thyroid gland was first spotted upon. Then, a shift to the pathology of simple nodular goiter mentioning the macroscopic and microscopic features. The simple nodular goiter, the etiology of which is multifactorial and we mention some about epidemiology and natural history . As for SNG Its management is still the cause of considerable controversy, a good history must be taken with a full clinical examination and we stress on Assessment of risk of malignancy. Laboratory investigations including T3, T4, TSH, Thyroid auto antibodies, serum Calcitonin, and serum Thyroglobulin. FNAC has replaced other methods, and became the first and routine method which must be used in diagnosis of thyroid nodules. It has a great accuracy in identification of different pathologic types and in differentiating benign from malignant lesions, except in the follicular tumor group. Ultrasonography of the thyroid gland is used to classify the nodules into solid, cystic, or mixed. It give a great help in Biopsy guidance. However, it admits a little help in determining the pathological types of the nodule. The single nodule, if identified by palpation, will often be reclassified as a dominant (or prominent) nodule within a multinodular thyroid gland if sonography is used. Although surgical treatment is curative especially in large-sized nodule, it has disadvantages including general anesthesia, post-operative scar formation and iatrogenic hypothyroidism. Levothyroxine therapy is the most widely used approach, but its clinical efficacy and safety are controversial. In addition, thyroid hormone suppressive therapy may develop or accelerate atrial fibrillation and osteoporo¬sis. Radioiodine is the therapy of choice for toxic nodules or for symptomatic nodular goiters when surgery is not possible. U.S. guided interstitial laser photocoagulation could become a useful non surgical alternative in treatment of SNG in patients who cannot or will not undergo surgery. The endoscopic approach provides a superior cosmetic result when compared to conventional thyroidectomy and results in a quicker return to normal activity. Also provides fantastic magnification of thyroid anatomy, including the recurrent laryngeal nerve, superior laryngeal nerve and the parathyroid glands Percutaneous ethanol injection (PEI) therapy is a procedure to treat various types of nodular thyroid diseases. Since PEI therapy in benign nodular and cystic thyroid diseases was introduced, it has drawn attention as a novel therapeutic modality. We tried to discuss how safe and effective is PEI therapy and so unnecessary operation can be avoided. We start with historical preview about PEI and effect of ethanol on simple nodular goiter, different techniques in percutaneous ethanol injection, precautions, side effects, complications and different studies evaluating the role of percutaneous ethanol injection in the management of simple nodular goiter . |