Whatever the mode, treatment of exophthalmic goiter (Graves' disease) in children has drawbacks. Thyroidectomy presents a special hazard; the larynx is small and breathing difficulty may occur with edema of the larynx or with vocal-cord paralysis. Even after surgery, recurrence of hyperthyroidism has necessitated further therapy in some cases. Moreover, in children, operations on the neck often result in the formation of unsightly keloids. Of patients receiving antithyroid drug therapy, approximately one half require subsequent continuation of this therapy, and some have recurrence of thyrotoxicosis as late as four years after cessation of therapy. For control of the hyperthyroidism in children, radioactive iodine (131I) seems to be the most effective agent, although only continued use and longer observation will reveal the true incidence of hypothyroidism after this therapy. However, if the hypothyroidism does develop, it is easy to treat, and replacement therapy is fully effective. A major objection to
RADIOACTIVE IODINE THERAPY FOR EXOPHTHALMIC GOITER. JAMA. 1965;194(13):1382. doi:10.1001/jama.1965.03090260042014
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