Total Versus Subtotal Thyroidectomy in Grave's Disease: A Retrospective Analysis

Grave's disease is a relatively common condition occurring in 0.4% of the Indian Population. The treatment options for Grave's disease are radioactive iodine ablation, administration of anti-thyroid drugs and surgery. Both the non-surgical modalities require long-term continued patient follow up, which is not feasible in the Indian setup. Also, surgery is a rapid, consistent and effective method of making the patient euthyroid.¹⁵ Surgical treatment involves the removal of the thyroid gland either in entirety or a part of it. These procedures aim at reducing the thyroid gland volume to levels well below the "critical mass", which is believed to be the ideal volume of remnant producing no recurrence of hyperthyroidism and minimal hypothyroidism. The ideal surgical modality is still a matter of debate. This is a retrospective study that compares the advantages and disadvantages of total and subtotal thyroidectomy and comes to a conclusion that the former is a better treatment option particularly in the presence of exophthalmos.

Keywords
Grave's disease, Subtotal thyroidectomy, Total thyroidectomy, Critical mass