Surgical Diseases of the Thyroid and Parathyroid Glands

  • Barbara Kinder


As Olshansky et al. pointed out,1 senescence is the product of evolutionary neglect, not design. The laws of natural selection favor those whose genetic makeup ensures that they survive long enough to reproduce successfully. Expression of other, also genetically linked traits that emerge after reproductive age (certain cancers, cardiovascular disease, degenerative conditions such as osteoarthritis) are not susceptible to evolutionary pressure. Thus medical and technologic advances have permitted more people to reach and move beyond the reproductive age into senescence, where they encounter disabling and life-threatening diseases that have escaped evolutionary scrutiny. A major challenge for geriatric medicine includes the recognition, treatment, and ultimately prevention of these processes to provide an acceptable quality of life for aging citizens.


Thyroid Hormone Thyroid Nodule Parathyroid Gland Recurrent Laryngeal Nerve Primary Hyperparathyroidism 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Olshansky SJ, Carnes BA, Grahn D. Confronting the boundaries of human longevity. Am Sci 1998;86:52–61.Google Scholar
  2. 2.
    Lamberts SWJ, VandenBald AW, VanderLely AJ. The endocrinology of aging. Science 1997;278:419–423.PubMedCrossRefGoogle Scholar
  3. 3.
    Gambert SR. Environmental and physiologic variables. In: Braverman LE, Utiger RD (eds) The Thyroid, 6th ed. Lip-pincott: Philadelphia, 1991:347–357.Google Scholar
  4. 4.
    Tunbridge WMG, Evered DC, Hall R, et al. The spectrum of thyroid disease in the community: the Wickham survey. Clin Endocrinol (Oxf) 1977;7:481–493.CrossRefGoogle Scholar
  5. 5.
    Vanderpump MPJ, Tunbridge WMG, French JM, et al. The incidence of thryoid disorders n the community: a twenty-year follow-up of the Wickham survey. Clin Endocrinol (Oxf) 1995;43:55–68.CrossRefGoogle Scholar
  6. 6.
    Powe NR, Danese MD, Ladenson PW. Decision analysis in endocrinology and metabolism. Epidemiol Clin Decis Making 1997;26:89–111.Google Scholar
  7. 7.
    Larsen PR, Davies TF, Hay ID. The thyroid gland. In: Wilson JD, Foster DW, Kronenberg HM, Larsen PR (eds) Williams Textbook of Endocrinology, 9th ed. Saunders: Philadelphia, 1998:389–517.Google Scholar
  8. 8.
    Wallace K, Hofmann MT. Thyroid dysfunction: how to manage overt and subclinical disease in older patients. Geriatrics 1998;53:32–41.PubMedGoogle Scholar
  9. 9.
    Chuang CC, Wang ST, Wang PW, et al. Prevalence study of thyroid dysfunction in the elderly of Taiwan. Gerontology 1998;44:162–167.PubMedCrossRefGoogle Scholar
  10. 10.
    Sawin CT, Geller A, Wolf PA, et al. Low serum thyrotropin concentrations as a risk factor for atrial fibrillation in older persons. N Engl J Med 1994;331:1249–1252.PubMedCrossRefGoogle Scholar
  11. 11.
    Parle JV, Franklyn KW, Jones SC, et al. Prevalence and follow up of abnormal thyrotropin (TSH) concentrations in the elderly in the United Kingdom. Clin Endocrinol (Oxf) 1991;34:77–83.CrossRefGoogle Scholar
  12. 12.
    Lahey FA. Non-activated (apathetic) type of hyperthyroidism. N Engl J Med 1981;204:747–748.CrossRefGoogle Scholar
  13. 13.
    Iervasi G, Clerico A, Bonini A, et al. Acute effects of amio-darone on thyroid function in patients with cardiac arrhythmia. J Clin Endocrinol Metab 1997;82:275–280.PubMedCrossRefGoogle Scholar
  14. 14.
    Gavin L. Thyroid storm. Med Clin North Am 1991;75: 179–191.PubMedGoogle Scholar
  15. 15.
    Burman KD. Thyroid disease and osteoporosis. Hosp Pract 1997;32:71–86.Google Scholar
  16. 16.
    Bartalena L, Marcocci C, Bogazzi F, et al. Relation between therapy for hyperthyroidism and the course of Graves’ ophthalmopathy. N Engl J Med 1998;338:73–78.PubMedCrossRefGoogle Scholar
  17. 17.
    Hamoir E, Meurisse M, Defechereux T, et al. Surgical management of amiodarone-associated thyrotoxicosis: too risky or too effective? World J Surg 1998;22:537–543.PubMedGoogle Scholar
  18. 18.
    Torring O, Tallstedt L, Wallin G, et al. Graves’ hyperthyroidism: treatment with antithyroid drugs, surgery, or radioiodine: a prospective, randomized study. J Clin Endocrinol Metab 1996;81:2986–2993.PubMedCrossRefGoogle Scholar
  19. 19.
    DeGroot LJ, Gorman CA, Pinchera A. Radiation and Graves’ ophthalmopathy. J Clin Endocrinol Metab 1995;90: 339–349.CrossRefGoogle Scholar
  20. 20.
    Hermus AR, Huysmans DA. Treatment of benign nodular thyroid disease. N Engl J Med 1998;388:1438–1447.Google Scholar
  21. 21.
    Dayan CM, Daniels GH. Chronic autoimmune thyroiditis. N Engl J Med 1996;338:297–306.Google Scholar
  22. 22.
    Brent GA. In: Van Middlesworth L (ed) The Thyroid Gland: A Practical Clinical Treatise. Year Book: Chicago, 1986: 83–110.Google Scholar
  23. 23.
    Ghareib H. Fine needle aspiration biopsy of thyroid nodules: advantages, limitations, and effect. Mayo Clin Proc 1994;69:44–49.CrossRefGoogle Scholar
  24. 24.
    Burrow GN. The thyroid: nodules and neoplasia. In: Felig P, Baxter JD, Gishman LA (eds) Endocrinology and Metabolism, 3rd ed. McGraw Hill: New York, 1995:521–553.Google Scholar
  25. 25.
    Melliere D, Scada F, Etienne G. Goiter with severe respiratory compromise: evaluation and treatment. Surgery 1988; 103:368–373.Google Scholar
  26. 26.
    Newman E, Shah A. Substernal goiter. J Surg Oncol 1995;60:207–212.PubMedCrossRefGoogle Scholar
  27. 27.
    Hsu B, Reeve TS, Guinea AI, et al. Recurrent substernal nodular goiter: incidence and management. Surgery 1996; 120:1072–1075.PubMedCrossRefGoogle Scholar
  28. 28.
    LaRosa GL, Lupo L, Giuffrida D, et al. Levothyroxine and potassium iodide are both effective in treating benign solitary cold nodules of the thyroid. Ann Intern Med 1995;122:1–8.CrossRefGoogle Scholar
  29. 29.
    Schneider AB, Bekerman C, Leland J, et al. Thyroid nodules in the follow up of irradiated individuals: comparison of thryoid ultrasound with scanning and palpation. J Clin Endocrinol Metab 1997;82:4020–4027.PubMedCrossRefGoogle Scholar
  30. 30.
    Schlumberger KJ. Papillary and follicular thyroid carcinoma. N Engl J Med 1998;338:297–306.PubMedCrossRefGoogle Scholar
  31. 31.
    Rosai J, Carcangiu ML, Dellelis RA. Tumors of the Thryoid Gland. Armed Forces Institute of Pathology: Washington, DC, 1992:1–343.Google Scholar
  32. 32.
    Mazzaferri EL, Jhiang SM. Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer. Am J Med 1994;97:418–428.PubMedCrossRefGoogle Scholar
  33. 33.
    DeGroot LJ, Kaplan EL, McCormick M, et al. Natural history, treatment, and course of papillary carcinoma. J Clin Endocrinol Metab 1990;71:414–424.PubMedCrossRefGoogle Scholar
  34. 34.
    Ladenson PW, Braverman LE, Mazzaferri EL, et al. Comparison of administration of recombinant human thyrotropin with withdrawal of thryoid hormone for radioactive iodine scanning in patients with thyroid carcinoma. N Engl J Med 1997;337:888–896.PubMedCrossRefGoogle Scholar
  35. 35.
    Lips CJM, Lansvater RM, Hoppener JWM. Clinical screening as compared with DNA analysis I of families with multiple endocrine neoplasia. N Engl J Med 1994;331:828–835.PubMedCrossRefGoogle Scholar
  36. 36.
    Burney RE, Jones KR, Coon JW, et al. Assessment of patient outcomes after operation for primary hyperparathyroidism. Surgery 1996;120:1013–1019.PubMedCrossRefGoogle Scholar
  37. 37.
    Pasieka JL, Parsons LL. Prospective surgical outcome study of relief of symptoms to following surgery in patients with primary hyperparathyroidism. World J Surg 1998;22:513–519.PubMedCrossRefGoogle Scholar
  38. 38.
    Ohrvall U, Lundgren H, Eriksson E, et al. Dementia-like symptoms related to primary hyperparathyroidism in the elderly. Presented at 30th World Congress of Surgery, Aca-pulco, Mexico, August 1997.Google Scholar
  39. 39.
    Chen H, Parkerson J, Udelsman R. Parathyroidectomy in the elderly: do the benefits outweigh the risks? World J Surg 1998;22:531–536.PubMedCrossRefGoogle Scholar
  40. 40.
    Melton LJ. How many women have osteoporosis now? J Bone Miner Res 1995;10:175–177.PubMedCrossRefGoogle Scholar
  41. 41.
    Kleerekoper M. Clinical course of primary hyperparathyroidism. In: Bilezikian JP, Levine MA, Marcus R (eds) The Parathyroids. Raven: New York, 1994:471–483.Google Scholar
  42. 42.
    Muir JW, Baker LR. Hypercalciuria and recurrent urinary stone formation despite successful surgery for primary hyperparathyroidism. Br Med J 1978;738:1–3.Google Scholar
  43. 43.
    Maschio G, Vecchioni R, Tessitore N. Recurrence of autonomous hyperparathyroidism in calcium nephrolithiasis. Am J Surg 1980;68:607–609.Google Scholar
  44. 44.
    McGeown MG. Effect of parathyroidectomy on the incidence of renal calculi. Lancet 1961;1:586–587.PubMedCrossRefGoogle Scholar
  45. 45.
    Silverberg SJ, Bone HG, Marriott TB, et al. Short term inhibition of parathyroid hormone secretion by a calcium receptor agonist in patients with primary hyperparathyroidism. N Engl J Med 1997;337:1506–1510.PubMedCrossRefGoogle Scholar
  46. 46.
    McKane WR, Khosla J, Egan KS, et al. Role of calcium intake in modulating age-related increases in parathyroid function and bone resorption. J Clin Endocrinol Metab 1996;81: 1699–1703.PubMedCrossRefGoogle Scholar
  47. 47.
    Thompson N, Eckhauser F, Harness J. The anatomy of primary hyperparathyroidism. Surgery 1982;92:297–299.Google Scholar
  48. 48.
    Hobbiger HE, Allen JG, Greatorex RG, et al. The laryngeal mask airway for thyroid and parathyroid surgery. Anesthesia 1996;51:972–974.CrossRefGoogle Scholar
  49. 49.
    LoGerfo P. Local/regional anesthesia for thyroidectomy: evaluation as an outpatient procedure. Presented at the American Association of Endoscopic Surgery, 19th Annual Meeting, 1998, paper 9.Google Scholar
  50. 50.
    Schwartz AE, Clark OH, Itnarle P, et al. Thyroid surgery: the choice. J Clin Endocrinol Metab 1998;83:1097–1105.PubMedCrossRefGoogle Scholar
  51. 51.
    Mack E. Management of patients with substernal goiter. Surg Clin North Am 1995;75:377–395.PubMedGoogle Scholar
  52. 52.
    Mitchell BK, Merrell RC, Kinder BK. Localization studies in patients with hyperparathyroidism. Surg Clin North Am 1995;75:483–498.PubMedGoogle Scholar
  53. 53.
    Kaplan E, Yashiro T, Salti G. Primary hyperparathyroidism in the 1990s. Ann Surg 1992;215:300–317.PubMedCrossRefGoogle Scholar
  54. 54.
    Bondeson A, Bondeson L, Ljungberg O, et al. Surgical strategy in nonfamilial primary parathyroid hyperplasia: long-term follow-up of thirty-nine cases. Surgery 1985;97:569–573.PubMedGoogle Scholar
  55. 55.
    LiVolsi V. Embryology, anatomy, and pathology of the parathyroids. In: Bilezikian JP, Levine MA, Marcus R (eds) The Parathyroids. Raven: New York, 1994:1–14.Google Scholar
  56. 56.
    Billingsley K, Fraker D, Doppman J, et al. Localization and operative management of undescended parathyroid adenomas in patients with persistent primary hyperparathyroidism. Surgery 1994;116:982–990.PubMedGoogle Scholar
  57. 57.
    Wang C. Parathyroid re-exploration. Ann Surg 1987;186: 140–145.CrossRefGoogle Scholar
  58. 58.
    Kern KA, Shawker TH, Doppman JL, et al. The use of high-resolution ultrasound to locate parathyroid tumors during reoperations for primary hyperparathyroidism. World J Surg 1987;11:579–583.PubMedCrossRefGoogle Scholar
  59. 59.
    Worsey MJ, Carty SE, Watson CG. Success of unilateral neck exploration for sporadic primary hyperparathyroidism. Surgery 1993;114:1024–1030.PubMedGoogle Scholar
  60. 60.
    Wang CA. Unilateral neck exploration for primary hyperparathyroidism. Arch Surg 1990;125:985–990.Google Scholar
  61. 61.
    Miccoli P, Bendinelli C, Vignali C, et al. Endoscopic parathyroidectomy: report of an initial experience. Surgery 1998;124:1077–1079.PubMedCrossRefGoogle Scholar
  62. 62.
    Denham DW, Norman J. Cost-effectiveness of preoperative sestamibi scan for primary hyperparathyroidism is dependent solely upon the surgeon’s choice of operative procedure. J Am Coll Surg 1998;186:293–305.PubMedCrossRefGoogle Scholar
  63. 63.
    Irvin GL, Dembrow VD, Prudhomme DL. Clinical usefulness of an intraoperative “quick parathyroid hormone” assay. Surgery 1993;114:1019–1023.PubMedGoogle Scholar
  64. 64.
    Nussbaum S, Thompson A, Hutcheson A, et al. Intraoperative measurement of parathyroid hormone in the surgical management of hyperparathyroidism. Surgery 1988;194: 1121–1127.Google Scholar
  65. 65.
    Metz D, Jensen R, Allen B, et al. Multiple endocrine neoplasia type I: clinical features and management. In: Bilezikian J, Levine M, Marcus R (eds) The Parathyroids. Raven: New York, 1994:591–646.Google Scholar
  66. 66.
    Thompson N. The surgical management of hyperparathyroidism and endocrine disease of the pancreas in the multiple endocrine neoplasia type I patient. J Intern Med 1995;238:269–280.PubMedCrossRefGoogle Scholar
  67. 67.
    Tissel L, Hedman I, Hansson G. Clinical characteristics and surgical results in hyperparathyroidism caused by water-clear hyperplasia. World J Surg 1981;5:565–571.CrossRefGoogle Scholar
  68. 68.
    Wells S, Gunnells J, Shelbourne J, et al. Transplantation of the parathyroid glands in man: clinical indications and results. Surgery 1975;78:34–44.PubMedGoogle Scholar
  69. 69.
    Niederle B, Roka R, Brennan M. The transplantation of parathyroid tissue in man: development, indications, technique, and results. Endocr Rev 1982;3:245–279.PubMedCrossRefGoogle Scholar
  70. 70.
    Brandi ML, Aurbach GD, Fitzpatrick LA, et al. Parathyroid mitogenic activity in plasma from patients with familial multiple endocrine neoplasia type 1. N Engl J Med 1986; 314:1287–1293.PubMedCrossRefGoogle Scholar
  71. 71.
    Punch J, Thompson N, Merion R. Subtotal parathyroidectomy in dialysis-dependent and post-renal transplant patients. Arch Surg 1995;130:538–543.PubMedCrossRefGoogle Scholar
  72. 72.
    Neonakis E, Wheeler MH, Krishana H, et al. Results of surgical treatment of renal hyperparathyroidism. Arch Surg 1995;130:643–648.PubMedCrossRefGoogle Scholar
  73. 73.
    Koonsman M, Hughes K, Dickerman R, et al. Parathyroidectomy in chronic renal failure. Am J Surg 1994;168: 631–634.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2001

Authors and Affiliations

  • Barbara Kinder

There are no affiliations available

Personalised recommendations