Chirurgie des hyperthyroïdies: à propos de 60 cas

Hyperthyroidism includes several diseases characterized by high level of circulating thyroid hormones. Thyroidectomy is one of the main treatment options. We conducted a retrospective study to evaluate the epidemiological, clinical, therapeutic, evolutionary features of patients who had undergone surgery for hyperthyroidism in the ENT Department at the Avicenne Military Hospital in Marrakech. Data were collected from medical records of 60 patients. There was a female predominance and the average age was 52 years. Clinical manifestations were dominated by thyrotoxicosis in all patients. Clinical examination allowed the identification of 47 cases of toxic or pretoxic multiheteronodular goitre (78.33% of cases), 5 cases of Graves disease (8.33% of cases) and 8 cases of toxic adenoma (13.33% of cases). All patients underwent medical preparation. Total thyroidectomy was performed in 50 patients (83.33%) and loboisthmectomy in 10 patients (16.33%). Postoperative complications were: transient laryngeal paralysis in one case (1.6%), transient hypoparathyroidism in nine cases (15%), definitive hypoparathyroidism in one case (1.6%) and compressive hematoma in one case (1.6% of cases). Surgical treatment of bleeding and adherent toxic goiters should be performed by an experienced surgeon who must remain vigilant to minimize morbidity mainly caused by laryngeal paralysis and hypoparathyroidism.