What should I do if I find nodular changes in my thyroid? Do I have to have surgery? There are risks associated with thyroid surgery, and for some diseases such as nodular goiter, the problem cannot be solved once and for all, and often recurs after surgery. The following conditions often require surgery: 1. single solid thyroid nodule >1cm in diameter; 2. single solid nodule <1cm in diameter, but ultrasound indicates nodule with gravelly, punctate calcification; 3. retrosternal goiter; 4. nodular goiter with large nodules and localized pressure on airway, esophagus or nerves with related symptoms; 5. sudden increase in thyroid nodule within a short period of time; 6. single nodule with acoustic 7. ultrasound, nuclear scan and other ancillary tests with high suspicion of malignant lesions; 8. puncture nodules with definite malignant lesions nodular goiter with large nodules and local compression of airway, esophagus or nerves with related symptoms; 9. sudden increase in thyroid nodules within a short period of time; 10. single nodule with hoarseness, dysphagia and other compression symptoms.