The thyroid gland is located on the anterior side of the middle of the neck and has left and right lobes, roughly just below the laryngeal nodes on both sides. The adult thyroid gland weighs about 40 grams and cannot be seen or touched under normal circumstances, and although the thyroid gland is small, it has important functions for people. The thyroid gland has the function of synthesizing, storing and secreting thyroxine, an amino acid containing iodine.
Its main functions are to.
1. increasing oxygen consumption and heat production in tissue cells throughout the body.
2.Promote the decomposition of proteins, carbohydrates and fats.
This role is related to the age of the body, the younger the age, the greater the impact of thyroxine deficiency, before birth embryonic deficiency often affects the brain and intellectual development, can lead to dementia, after birth not only on the brain, but also on the growth and development of long bones have a great impact, can lead to cretinism.
The thyroid gland, because of its special location, will also have other effects on people if lesions occur. The posterior medial side of the lateral lobe is adjacent to the larynx, trachea, pharynx, esophagus and nerves, and the posterior lateral side of the lateral lobe is adjacent to the large arteries and nerves of the neck. When the thyroid gland is enlarged, it can compress the above adjacent tissues and organs with corresponding manifestations. The thyroid gland is fixed to the wall of the larynx and trachea by a membrane outside the thyroid gland, so the thyroid gland can move up and down with the larynx when swallowing, so doctors always ask patients to swallow when checking the thyroid gland to determine if it is enlarged.
Thyroid disorders can be broadly classified into the following categories.
1. Metabolic diseases
Nodular goiter.
(1) Environmental iodine deficiency, resulting in insufficient ingested iodine to synthesize enough thyroxine to meet the needs of the body.
(2) Increased need for thyroxine, mostly seen in women during puberty, pregnancy or menopause, with a temporary increase in the need for thyroxine, which is a physiological goiter that shrinks on its own after adulthood or pregnancy.
(3) Impaired synthesis and secretion of thyroxine. These conditions lead to a deficiency of thyroxine, and the body compensates for this by producing enough thyroxine to meet the body’s needs, causing goiter.
Nodular goiter is most commonly seen in female patients. The main manifestation of the disease is the enlargement of the thyroid gland to varying degrees and the compression of the surrounding organs by the enlarged thyroid gland. Subsequently, one or more nodules may appear within the enlarged gland, which is often referred to as a nodular goiter. When bleeding occurs within the nodule, it can cause the nodule to enlarge rapidly. The enlarged thyroid gland may compress the trachea, esophagus, or nerves, causing difficulty breathing, swallowing, or hoarseness. Prolonged pressure can lead to softening of the tracheal cartilage, with serious consequences. Sometimes compression of the large neck veins causes impaired venous return to the head and neck, resulting in facial bruising and swelling. Nodular goiter can also turn into hyperthyroidism and develop malignant changes. Diagnosis of nodular goiter is generally not difficult and can be made by palpation, ultrasound, and nuclear scan. Currently, iodized salt is consumed throughout the country for prevention, and the incidence has dropped significantly, but the disease is still a relatively common one.
Surgery should be performed promptly in the following cases.
① enlargement of the thyroid gland causing symptoms by compression of the trachea, esophagus or nerves.
② Huge thyroid gland affecting work and life.
(iii) post-thoracic goiter.
④ secondary hyperthyroidism.
⑤ When malignant change of goiter is suspected.
Hyperthyroidism
Hyperthyroidism is a disease characterized by an abnormal increase of thyroxine in the body due to the malfunction of the normal control mechanism of thyroxine secretion caused by various reasons. The main manifestations of hyperthyroidism include enlargement of the thyroid gland, impatience, agitation, insomnia, fear of heat, excessive sweating, damp skin, excessive appetite but weight loss, weight loss, panic attacks, and a rapid pulse rate of more than 100 beats per minute during sleep and rest. Endocrine disorders, such as menstrual disorders, weakness and easy fatigue. A blood test for thyroxine (also known clinically as thyroid function) and a measurement of thyroid iodine uptake can make the diagnosis. There are three methods of treatment, including anti-thyroid medication, 131I radiotherapy, and surgical removal. Each method has its own characteristics and is chosen according to the patient and the patient’s wishes.
2. Inflammatory thyroid diseases
(1) Subacute thyroiditis. It is also called thyroiditis or giant cell thyroiditis. This disease often occurs after a viral upper respiratory tract infection, where the virus infects the thyroid gland and causes an inflammatory response due to necrosis of the thyroid cells. The disease usually starts on one side of the thyroid gland and soon expands to other parts. The patient may have fever. Thyroid function and thyroid iodine uptake tests are useful for diagnosis. Treatment with hormones combined with thyroxine is usually effective.
(2) Chronic lymphocytic thyroiditis. Also known as Hashimoto’s goiter, it is an autoimmune disease and is the most common cause of an enlarged but hypothyroid thyroid gland. It manifests as a painless diffuse major thyroid gland, symmetrical, with a relatively hard texture, and larger glands can produce symptoms of compression. Blood sampling for thyroid autoantibodies in the blood and thyroid iodine uptake rate tests can be diagnosed. Treatment is based on thyroxine supplementation, and the pressure can be surgically removed.
3. Tumor diseases
(1) Thyroid adenoma. The main difference between adenoma and nodular goiter is that adenoma remains a single nodule after several years, while a single nodule in nodular goiter evolves into multiple nodules after a period of time. . The pathological diagnosis after surgery is, of course, the most accurate. Because about 20% of thyroid adenomas can develop into hyperthyroidism, and about 10% of patients will develop malignancy, early thyroidectomy should be performed.
(2) Thyroid cancer. It is the most common malignant tumor of the thyroid gland, accounting for about 1% of all malignant tumors in the body. According to the pathological types of tumors, there are four types: papillary carcinoma and vesicular carcinoma, which account for more than 80% of thyroid cancer and have a better prognosis, and undifferentiated carcinoma and medullary carcinoma, which are rare but have a poor prognosis. The main manifestation of thyroid cancer is a lump found in the thyroid gland with hard and fixed texture, uneven surface and little up and down mobility with swallowing. In advanced stage, hoarseness, difficulty in breathing and swallowing may occur, and local lymph node metastasis enlargement and distant organ metastasis may also occur. Diagnosis requires palpation, ultrasound, nuclear scan, etc., sometimes combined with thyroid puncture for pathological examination. For papillary thyroid cancer and follicular thyroid cancer, which account for more than 80% of cases, the prognosis is closely related to age. Early surgery is the main treatment method.
The thyroid gland is superficially located and lesions are easy to detect. If you find enlargement or symptoms related to thyroid function, you should consult a doctor early. Thyroid nodules can occur in about 4% of adults and have a good prognosis if treated promptly.