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In Reply.—In response to the letter from Tzardis and Lekacos, I can say that I certainly have had no problem with their practice of totally removing the thyroid gland in cases of Graves' disease. As indicated in our article, we do expose and identify the recurrent laryngeal nerve as well as the parathyroid glands on both sides so it is then a simple matter to remove the thyroid gland completely.
In our article, we describe a technique that we have been using more recently called the "superior pole partial thyroidectomy." After all of the previously mentioned structures have been identified, we base a small residual of thyroid on the superior pole vessels and bring it through the strap muscles to the anterior border of the sternocleidomastoid muscle. This thyroid mass can then be adjusted under local anesthesia should this become necessary; it seldom is. Some patients specifically request
HOOVER L. Thyroid Disease-Reply. Arch Otolaryngol Head Neck Surg. 1992;118(5):552. doi:10.1001/archotol.1992.01880050106026
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