The term goiter refers to abnormal enlargement of the thyroid gland. This can range from an enlarged normal appearing thyroid gland, to a gland that is composed of innumerable nodules. Goiters can present with symptoms of compression or symptoms of increased or decreased thyroid hormone.
Thyroid artery embolization (TAE) is a minimally invasive treatment that has recently begun to be utilized for treatment of enlarged goiters. It uses a technique called embolization, which involves placing an IV in the artery in the groin.
A catheter is then placed and used to perform a study called an angiogram, which involves looking at the blood supply of the enlarged thyroid gland. The blood vessels are carefully studied, sometimes a special CT scan is performed during the procedure to ensure accuracy of the blood vessels studied.
The blood vessels are then blocked by small particles that are specifically created and sized for this purpose. Once blocking (embolization) is complete, the process of thyroid gland size reduction begins.
Surgery involves total or near total thyroidectomy is the typical approach. This is the preferred method of addressing this issue. Long term there is a small chance of thyroid goiter regrowth. However, there are some disadvantages, this includes general anesthesia, skin incision, risk of hypothyroidism, hypoparathyroidism and injury to the laryngeal nerve.
Radioiodine ablation is a method that utilizes a large dose of radioactive iodine that is absorbed by the thyroid gland and as a result causes injury and reduction in the size of the gland. The treatment is noninvasive and straightforward, however the disadvantages that accompany this include incomplete treatment, large radiation exposure and loss of thyroid function.
