Riedel's Thyroiditis Clinical Analysis Of Surgical Treatment

Objective: Discuss RT(Riedel's thyroiditis) in surgical treatment of past experiences, the purpose of the surgery, surgical methods, surgical results, postoperative complications and long-term results have a general assessment.Methods: The collection of the Second Affiliated Hospital of Dalian Medical University and Zhongshan Hospital of Dalian University from 1996 to 2008 have been between six cases of surgery and pathology proved to be RT in patients with clinical information, including clinical presentation, preoperative preparation, surgical approach, surgical results, conducted a survey of postoperative complications, and carried out a follow-up, do a retrospective analysis.Results: In the investigation of the 6 patients, 2 men and 4 women, male to female ratio is 1:2, with an average age of 42.5 years old. Including a history of thyroid goiter, neck compression symptoms, anterior or discomfort, such as hoarseness. Part of the investigation of patients with serious symptoms, including hoarseness caused by oppression, repression anterior discomfort and other symptoms. Some patients received preoperative medication, including taking hormone tablets, glucocorticoids. Of these, one cases of patients taking glucocorticoids after the symptoms have a short-term remission, but after stopping, disease recurrence. Or in the application of a glucocorticoid hormone, after all the patients, there is no mitigation for the increased thyroid. A high degree of surgical indications for suspected malignancy. Preoperative preparation, including: laboratory tests measuring levels of thyroid hormones, thyroid biopsy, ultrasound and so on. Preoperatively, 5 patients with normal thyroid function, not taking thyroxine tablets; One cases of patients with a longer history, the performance of early hyperthyroidism, not taking hormone tablets, and the performance of nearly 1 year for hypothyroidism, clinical performance and laboratory tests are indications hypothyroidism taking thyroxine tablets. 1 cases of patients have done a fine needle aspiration biopsy of suspected malignant transformation of Hashimoto's thyroiditis have a trend; 1 cases of fine needle aspiration biopsy in patients with thyroid tumors prompted for cystic change.In a highly suspected to be malignant and invasive growth of the disease before choosing surgery. Surgery, the unilateral subtotal thyroidectomy 3, Unilateral lobectomy of thyroid gland 2, bilateral subtotal thyroidectomy 1. The use of intraoperative frozen pathology, 1 case of return for thyroid cancer, 5 cases of benign lesions. All patients were surgically excised specimens sent to pathology, confirmed by pathology to RT. Thyroid fiber outside the progress of inflammation in all patients are different. This temporary paralysis of bilateral recurrent laryngeal nerve complications 17%, in the language of anti-inflammatory treatment and after the correction, short-term symptoms of recurrent laryngeal nerve paralysis in the three months after the restoration of both. Did not occur in patients with postoperative hypocalcemia. The average follow-up period was 50 months. All the patients were taking hormone replacement therapy. So far, no patients re-operation or treatment carried out.Conclusion: Riedel's thyroiditis is a very rare disease, the incidence rate was only 0.07%. Current clinical treatment is the major glucocorticoid, or medical treatment such as tamoxifen. For the emergence of symptoms of neck compression, such as breathing and swallowing difficulties, or highly suspected in patients with malignant tumors, the treatment should be surgery, surgical pathology, such as frozen clear to Riedel's thyroiditis, surgery should be the safety of the line as far as possible radical resection.