HIGH INCIDENCE OF THYROTOXICOSIS IN MIDDLE AND ADVANCED AGED PATIENTS WHO UNDERWENT THYROID SURGERY IN AN ENDEMIC GOITRE AREA OF IODINE DEFICIENCY

Abstract

The aim of this study is to evaluate the results of endemic goiter surgery performed in our hospital which is located in an area of endemic iodine deficiency. The pathogenesis of endemic goiter is different, and functional status of the thyroid differs with progression of the disease. Results of patients undergoing thyroid surgery in a region of iodine deficiency may provide important contribution to epidemiological studies. Demographic features of patients, status of thyroid function, indications for surgery, and findings of operation and pathological examination were analysed in 149 consecutive endemic goiter cases underwent thyroid surgery. Results obtained from patients with thyrotoxicosis were compared with those from patients with nontoxic goiter. Female/ male ratio was 6/1 and mean age 46.5 in the series. More than half of the patients were between 41-60. Eighty patients (53.8%) had thyrotoxicosis. Mean age of thyrotoxic cases was 50 years, which was significantly higher than that of nontoxic cases (p=0.0005). Fifty-four percent of thyrotoxic cases were over 50 years of age, while 77 % of nontoxic cases were below 50 (p=0.0001). Multinodular goiter has constituted indication for surgery in 92.5% with toxic and 88.4% with nontoxic cases. Surgical methods varied from unilateral total lobectomy to bilateral total thyroidectomy. No operative mortality was noted. We conclude that goiter prevalence, incidence of nodular goiter increase in middle aged patients in endemic iodine deficiency regions. Autonomy of solitary and multiple nodules was resulted with thyrotoxicosis in middle and advanced ages for whom nodlar formation was the main indication for surgery. High incidence of hyperthyroidism is a prominent finding in middle and advanced aged patients underwent thyroid surgery in endemic iodine deficiency regions.