Large Goiter: A large goiter may either cause aesthetic defects in the neck area or difficulty in breathing or difficulty in swallowing.  If the goiter, which is composed of multiple thyroid nodules, is not large, and if cancer is not suspected as a result of examinations, surgery is not performed.


Internal Goiter: Goiter that is extending into the thoracic cavity is called internal goitre.  Growth of the part extending into the chest cavity can cause respiratory distress in progress of time.  The enlarged thyroid with an extension can be usually removed through a neck incision.  In 1% of patients, the surgery may need to be carried out by opening the thoracic cavity.


Toxic Goiter: Thyroid nodules may secrete excessive amount of thyroid hormone and thus cause hyperthyroidism.  Surgical treatment is recommended after hormones are reduced to normal levels by medical treatment.  Radioactive iodine therapy is usually not recommended for these patients.


Basedow Disease: It is the state of excessive amount of hormone secretion due to a mechanism related to the immune system, 10% of the patients can have ophthalmologic findings (protruded eyeballs).  Some of these patients are treated surgically.


Thyroid Cancer: The detection of "cancer suspicion" or "cancer" as a result of ultrasound and needle biopsy in thyroid nodules unquestionable requires surgery. The type of thyroid cancer is determined by pre-operative needle biopsy and then the surgical technique is selected according to the type and size of the cancer.

          

A patient who had surgery due to a large goitre causing shortness of breath.

                

Bilateral thyroid surgery (Bilateral total thyroidectomy).