Patients with nodular goiter with enlarged glands presenting with thickening of the neck and one or more nodules that can be seen, felt or detected by ultrasound do not necessarily need immediate surgery, most of them can be observed and reviewed regularly. Most of them can be observed and checked regularly. If they are combined with one of the following conditions, they should receive surgery: 1) pressure symptoms – difficulty in breathing or discomfort in swallowing; 2) indication of cancer – hard masses can be felt in the front of the neck, etc.; 3) secondary hyperthyroidism – rapid heartbeat, weight loss -4, affect the aesthetics – the neck is too thick, the mass is obviously protruding; 5, combined with post-thoracic goiter – usually ultrasound, CT findings.