Eleven years after having his thyroid and a goiter removed to treat hyperthyroidism, Dung experienced fatigue, palpitations, shortness of breath during exercise, and a painful, swollen neck. He sought treatment at Tam Anh General Hospital in Ho Chi Minh City. Associate Professor, Doctor Doan Minh Trong of the Breast - Head and Neck Surgery Department, diagnosed Dung with recurrent hyperthyroidism, requiring surgery to remove the goiter. For three months prior to the surgery, Dung took antithyroid medication to stabilize his thyroid hormone levels, reduce the swelling, and regulate his heart rate.

"Surgery for recurrent hyperthyroidism is five times more difficult than the initial procedure," Dr. Trong explained. Scar tissue from the first surgery alters the normal anatomical structure. Larger, older goiters adhere more firmly to surrounding tissue, making dissection prone to heavy bleeding and difficult to visualize. Less experienced surgeons risk severing delicate nerves, potentially causing permanent voice loss. Incomplete goiter removal increases the risk of recurrence.

During Dung's surgery, the surgical team faced challenges accessing the goiter's boundaries due to altered anatomy and significant bleeding, which obscured visibility. They used specialized equipment to control the bleeding and meticulously dissected the goiter to ensure complete removal without rupturing it and preserving the laryngeal nerve and parathyroid gland.

Post-surgery, Dung's breathing was normal, his shortness of breath subsided, and he was discharged 12 hours later in stable condition.

Dr. Trong (right) and the surgical team operating on Dung. Photo: Tam Anh General Hospital

Dr. Trong (right) and the surgical team operating on Dung. Photo: Tam Anh General Hospital

Hyperthyroidism occurs when the thyroid gland produces excessive thyroid hormone. This can cause the thyroid to enlarge, forming a goiter. Untreated hyperthyroidism can lead to tremors, rapid heart rate, persistent fatigue, atrial fibrillation, heart failure, stroke, osteoporosis, and other complications.

Various factors contribute to hyperthyroidism, including Graves' disease (an autoimmune thyroid disorder), which accounts for 70% of cases. Other causes include overactive thyroid nodules, thyroiditis, excessive iodine intake, and overuse of thyroid hormone medication. Treatment primarily involves antithyroid drugs and radioactive iodine. Surgery to remove part or all of the thyroid is recommended when other treatments fail or the condition recurs.

According to Dr. Trong, hyperthyroidism is treatable with proper diagnosis and care. Individuals experiencing symptoms such as persistent fatigue, shortness of breath, swollen goiter, brittle nails, and hair loss should consult an endocrinologist or a head and neck surgeon for diagnosis and appropriate treatment. Surgery is considered for hyperthyroidism when medication and radioactive iodine are ineffective.

Nguyen Tram

*The patient's name has been changed.