The SIVUH is a major Regional Centre for management of diseases of the Thyroid Gland, including thyroid nodules, thyroid cancer, and disorders of thyroid function (over- or under-active thyroid glands). Patients are managed both by an ENT Surgeon, and an Endocrinologist (Medical Consultant Specializing in Endocrine Disorders, including Thyroid Gland disorders).
The most common reason for referral to the department of Otolaryngology at SIVUH for patients with thyroid disorders is the presence of a thyroid nodule or goiter. Thyroid nodules are common findings (10% of the population), particularly in older females (50% of females over 50 years old have thyroid nodules). While the vast majority of these (>95%) are benign, roughly 5% may represent thyroid cancer. Thus, any patient presenting with a thyroid nodule or swelling of the thyroid gland should be seen by an Otolaryngologist. Such patients referred to the SIVUH will be given an appointment to see a consultant within 1-2 weeks.
The first-line assessment for all thyroid nodules is FNA, which is a procedure which involves passing a very fine needle into the thyroid nodule to draw off some cells, which are then sent to the laboratory for analysis. In cases where it is difficult to feel the nodule, the procedure is usually performed under ultrasound guidance. Depending on the findings of the FNA, a decision is made whether or not to proceed with surgery to remove part or all of the thyroid gland.
Other indications for thyroid surgery and hence referral to the SIVUH Department of Otolaryngology include gross enlargement of the thyroid gland causing cosmetic deformity; enlargement of the thyroid gland extending deep to the sternum (breastbone), causing possible airway compression; and hyperthyroidism (overactive thyroid) not responsive to medical treatment.