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Clinical Challenges
May 2013

Surgical Approaches to the Thyroid Gland: Which Is the Best for You and Your Patient?

Author Affiliations

Author Affiliation: Department of Otolaryngology–Head and Neck Surgery, Georgia Regents University, Augusta.

JAMA Otolaryngol Head Neck Surg. 2013;139(5):515-517. doi:10.1001/jamaoto.2013.289

Hypothesis: Novel surgical approaches to the thyroid gland are appropriate and safe in a modern endocrine practice.

It turns out that the question of which surgical approach is best has many different answers, which depend in no small measure on the characteristics of the patient and the characteristics of the surgeon. This is because the most fundamental change that has occurred in the field of thyroid and parathyroid surgery is the capacity to customize the surgery to the patient and his or her disease characteristics (eg, the approach to a 2-cm follicular neoplasm in a slender, 28-year-old woman should be different from the approach for a 4.5-cm papillary cancer with aggressive features in an obese 68-year-old man). This capacity to personalize the procedure has been facilitated by the remarkable technological advances in surgery that have eventually found their way to the thyroid compartment, and have spawned the development of novel and creative ways of safely removing the thyroid gland.