The treatment of exophthalmic goiter by operation is a comparatively recent procedure and its usefulness as a means of relieving this serious disease is not yet conceded by all. In many cases operation is contraindicated, while in others operative measures result often in complete cure, or almost always in improvement.
The cause of this disease is not yet sufficiently established, but that many cases are caused by an excess of thyroid tissues is self-evident. Yet in some cases (10 per cent.) it is said there is no enlargement of the thyroid and in many the enlargement is not marked. In some cases, again, enlargement of the thyroid is a late symptom in the disease, while in others the enlargement precedes the other symptoms by months and sometimes years. Goiter has been known to exist for years without producing any marked symptoms of this disease and then they appear. The parenchymatous
SHEPHERD FJ. THE SURGICAL TREATMENT OF EXOPHTHALMIC GOITER. JAMA. 1906;XLVII(9):665–670. doi:10.1001/jama.1906.25210090021002d
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