The reevaluation of treatment of childhood thyrotoxicosis by Buckingham et al (see p 112) points up areas in which improvement has been made and others that are ripe for change. That the 14 patients operated on by nine different surgeons in the early years of the study had a different outcome than did the 64 children in whom thyroidectomy was carried out by Dr Buckingham himself is not surprising. Thyrotoxicosis in childhood is a relatively rare disease. When, in one of the country's largest centers, only about five patients come to operation per year, it makes good sense to concentrate the surgical experience of this technically difficult operation. No doubt the fact that there was no mortality, permanent hypoparathyroidism, or recurrent laryngeal nerve damage in the series reflects the wisdom of assigning responsibility for managing this serious and capricious disorder to a small group of senior physicians.
Buckingham and his
CRAWFORD JD. Hyperthyroidism in ChildrenA Reevaluation of Treatment. Am J Dis Child. 1981;135(2):109–110. doi:10.1001/archpedi.1981.02130260001001
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