ENTtoday
  • Home
  • COVID-19
  • Practice Focus
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Departments
    • Issue Archive
    • TRIO Best Practices
      • Allergy
      • Facial Plastic/Reconstructive
      • Head and Neck
      • Laryngology
      • Otology/Neurotology
      • Pediatric
      • Rhinology
      • Sleep Medicine
    • Career Development
    • Case of the Month
    • Everyday Ethics
    • Health Policy
    • Legal Matters
    • Letter From the Editor
    • Medical Education
    • Online Exclusives
    • Practice Management
    • Resident Focus
    • Rx: Wellness
    • Special Reports
    • Tech Talk
    • Viewpoint
    • What’s Your O.R. Playlist?
  • Literature Reviews
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Events
    • Featured Events
    • TRIO Meetings
  • Contact Us
    • About Us
    • Editorial Board
    • Triological Society
    • Advertising Staff
    • Subscribe
  • Advertise
    • Place an Ad
    • Classifieds
    • Rate Card
  • Search

Changes in the Management of Thyroid Cancer

by Thomas R. Collins • March 10, 2019

  • Tweet
  • Email
Print-Friendly Version

Eric Genden, MDIt is important to explain to patients that there are limitations to imaging and pathology in determining the presence of extrathyroidal extension, a contraindication to hemithyroidectomy. Understanding these limitations is absolutely critical to shared decision-making. —Eric Genden, MD

You Might Also Like

  • Management Issues in Recurrent and Metastatic Thyroid Cancer
  • Total or Hemithyroidectomy for Papillary Thyroid Microcarcinoma?
  • Active Surveillance of Papillary Thyroid Cancer Safe, Effective Alternative to Surgery in Some Patients
  • Changes in Thyroid Cancer Incidence Post-2009 ATA Guidelines
Explore This Issue
March 2019

The group found that the cause of the loss of signal matters a great deal. Thermal and clamping injuries lead to the highest rates of permanent paralysis, while traction and compression, while they have high initial rates of paralysis, have comparatively low rates of permanent paralysis.

When performing neural monitoring, a baseline reading is essential, Dr. Randolph said. During surgery, when the amplitude and latency stay within a normative range, there is virtually no risk of vocal cord paralysis. The INMSG guideline lays out changes in signal that bring different levels of risk, underscoring the importance of respecting changes in electromyography (EMG) signal during the case as these are the warning signs of vocal cord paralysis, he said.

“A surgeon,” the group wrote, “should prioritize concern for the obvious significant medical and psychological morbidity of bilateral vocal cord paralysis and possible tracheotomy over perceived surgical convenience, the routine of doing the ‘planned procedure,’ or the potential perceived impact on surgical reputation by openly acknowledging the surgical complication of ipsilateral loss of signal.”

Gady Har-El, MD, chair of otolaryngology-head and neck surgery at Lenox Hill Hospital in New York City, said using active surveillance raises an ethical question: Since it is a new approach that departs from what has been considered standard for many years, independent review board (IRB) approval might be necessary.

“If I see tomorrow a 40-year-old lady with a small thyroid cancer who meets all of the criteria that are deemed appropriate for active surveillance—and I would like to do active surveillance—can I do it, without IRB approval?” he said. “This obviously has implications, both ethical and medical-legal.”

Dr. Wang and other panelists said IRB approval would be appropriate. “Ideally, an IRB is best for any medical intervention that is not considered standard,” she said. “The question is, is this considered standard of care? And probably not. It is a recommendation if you look in the ATA guidelines, but it’s very vague.”


Thomas R. Collins is a freelance medical writer based in Florida.

Pages: 1 2 3 4 | Single Page

Filed Under: Features, Home Slider Tagged With: Clinical Guidelines, thyroid cancer, treatment, Triological Society Combined Sections Meeting 2019Issue: March 2019

You Might Also Like:

  • Management Issues in Recurrent and Metastatic Thyroid Cancer
  • Total or Hemithyroidectomy for Papillary Thyroid Microcarcinoma?
  • Active Surveillance of Papillary Thyroid Cancer Safe, Effective Alternative to Surgery in Some Patients
  • Changes in Thyroid Cancer Incidence Post-2009 ATA Guidelines

The Triological SocietyENTtoday is a publication of The Triological Society.

The Laryngoscope
Ensure you have all the latest research at your fingertips; Subscribe to The Laryngoscope today!

Laryngoscope Investigative Otolaryngology
Open access journal in otolaryngology – head and neck surgery is currently accepting submissions.

Classifieds

View the classified ads »

TRIO Best Practices

View the TRIO Best Practices »

Top Articles for Residents

  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Why More MDs, Medical Residents Are Choosing to Pursue Additional Academic Degrees
  • What Physicians Need to Know about Investing Before Hiring a Financial Advisor
  • Tips to Help You Regain Your Sense of Self
  • Should USMLE Step 1 Change from Numeric Score to Pass/Fail?
  • Popular this Week
  • Most Popular
  • Most Recent
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Vertigo in the Elderly: What Does It Mean?
    • Experts Delve into Treatment Options for Laryngopharyngeal Reflux
    • Otolaryngologists Have a Major Role to Play in Treating COVID-19 Long-Haulers
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Vertigo in the Elderly: What Does It Mean?
    • New Developments in the Management of Eustachian Tube Dysfunction
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Eustachian Tuboplasty: A Potential New Option for Chronic Tube Dysfunction and Patulous Disease
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Podcasts Becoming More Popular Method of Education for Otolaryngologists
    • How to Embrace Optimism in the Midst of the COVID-19 Pandemic
    • Tips on How to Approach Conversations with Patients about the COVID-19 Vaccine
    • Steps You Should Take to Protect Your Voice and Hearing During Telemedicine Sessions
    • Routine Postoperative Adjunct Treatments Unnecessary for Idiopathic Cerebrospinal Fluid Leaks

Polls

Have you spoken with your patients about receiving the COVID-19 vaccine?

View Results

Loading ... Loading ...
  • Polls Archive
  • Home
  • Contact Us
  • Advertise
  • Privacy Policy
  • Terms of Use

Visit: The Triological Society • The Laryngoscope • Laryngoscope Investigative Otolaryngology

Wiley
© 2021 The Triological Society. All Rights Reserved.
ISSN 1559-4939

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.