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thyroid
Fatigue, weight loss, hot flushes, palpitations, brittle nails, etc. all these signs may mean that you have a thyroid disorder (hyperthyroidism or hypothyroidism). In France, thyroid disorders affect 10% of the population. This tiny gland located at the base of the neck secretes hormones that regulate many vital functions including heart rate, digestion, etc. Some symptoms can serve as a warning to see a doctor. The earlier a thyroid disorder is diagnosed (via a blood test), the sooner it can be treated. Here are the signs of a thyroid condition.

What are the symptoms of hyperthyroidism?

Hyperthyroidism is a disorder related to a dysfunction of the thyroid gland, a butterfly-shaped endocrine gland located at the base of the neck. Hyperthyroidism has different causes, the most common (75-80% of cases) being Graves’ disease, an auto-immune disorder, which mainly affects women and results in an over-production of thyroid hormones.

Symptoms that may indicate potential hyperthyroidism:
  • Persistent fatigue;
  • Unexplained weight loss;
  • Excessive thirst;
  • Oversensitivity (irritability);
  • Insomnia;
  • Diarrhea;
  • Heart palpitations and tremor;
  • Bulging eyes;
  • Visible goiter, due to enlargement of the thyroid gland;
  • Irregular heartbeat;
  • Hot flushes;
  • Polycystic ovary syndrome (hypothyroidism/hyperthyroidism).

All these symptoms may indicate that your thyroid is overactive. Hyperthyroidism can be caused by a number of factors including a benign tumor in the thyroid gland, thyroid cancer, a toxic nodule or a goiter.

What are the symptoms of hypothyroidism?

Hypothyroidism is a thyroid disorder related to a deficiency of thyroid hormones. The secretion of thyroid hormones (T3 and T4) is regulated by the pituitary gland, which produces TSH (Thyroid Stimulating Hormone). The result: metabolism is slowed down.

After the age of 50, women are more exposed to the risk of hypothyroidism.

Here are the main symptoms of hypothyroidism:

  • Persistent fatigue;
  • Unexplained chilliness (always feeling cold);
  • Unexplained weight gain;
  • Decreased appetite;
  • Slowed heart rate;
  • Elevated blood cholesterol level;
  • Painful joints, muscle aches;
  • Changes in menstrual patterns;
  • Unusual constipation;
  • Presence of a goiter (enlarged thyroid gland);
  • Puffy face, bulging eyes;
  • Irritability;
  • Difficulty concentrating, impaired memory;
  • Dry skin (possibly with redness);
  • Fragile, brittle nails;
  • Hair loss;
  • Hoarse or cracked voice.

When the thyroid doesn’t produce enough hormones, there can be a number of causes:

  • Hashimoto’s disease (which leads to destruction of the gland). Hashimoto’s thyroiditis is the most common cause;
  • Iodine deficiency;
  • Post-operative complication of a thyroidectomy (removal of the thyroid gland);
  • Some medications.

Congenital hypothyroidism is a disorder related to abnormal functioning of the thyroid gland right from birth. In developed countries this disorder affects 1 in 3,000 newborns.

Some cases of mild hypothyroidism can be treated with natural precursors of thyroid hormones which are very effective and avoid the side effects of certain thyroid medications. 

Palpation of the neck to better detect the signs

Palpation of the base of the neck is the first step in a thyroid exam to detect any thyroid abnormalities, before referral for an ultrasound.

Palpation of the thyroid gland is done while the patient is seated. The physician gently places his or her hands on both sides of the neck, under the jaw, then slides the fingers downward to the base of the neck where the thyroid gland is located.

The purpose of palpation is to assess the symmetry of the gland and detect any possible enlargement.

The physician then palpates the anterior and posterior cervical lymph nodes.

Thyroid: when is it necessary to operate?

Thyroidectomy involves making a small incision at the base of the neck. The need for surgery (thyroidectomy) can arise in two situations: when medication alone does not succeed in stopping enlargement of the gland (causing problems with swallowing), and when there is a toxic nodule (symptoms of thyroid cancer).

Surgery for suspicious nodules involves removing all or part of the thyroid gland.

Before surgery, the physician orders several exams including an ultrasound and Doppler (to assess the vascularization of toxic nodules and for cytological puncture).

When is surgery needed?


  • A large nodule measuring more than 4 cm;
  • Presence of several nodules forming a goiter;
  • Nodule filled with fluid;
  • When a risk of thyroid cancer is suspected.

In some thyroid cancers, radioactive iodine therapy is recommended to complete the surgery.

What are the benefits of the new FLUOBEAM® LX?

In the field of endocrine surgery, significant progress has been made in medical imaging. The new FLUOBEAM® LX is an innovative system designed to improve the quality of thyroid surgery. Developed by FLUOPTICS©, the FLUOBEAM® LX is a state-of-the-art imaging system enabling surgeons to clearly see the parathyroid glands in real time thanks to the autofluorescence of these glands.

This innovative protocol allows surgeons to first identify the parathyroid glands so as to locate them and preserve them during resection of the thyroid.

The surgeon may also decide to inject indocyanine green during surgery to locate the vessels that perfuse the parathyroid glands, and thereby preserve their vascularization during thyroid resection.

Lastly, at the end of surgery the surgeon can check the perfusion of the parathyroid glands using another injection of indocyanine green.

10 times more sensitive than any other system on the market, the FLUOBEAM® LX provides surgeons with clear, precise information to better meet medical needs and operate in the best possible conditions.

Each year, 45,000 people undergo thyroid surgery, a common procedure but one which has certain risks, such as hypocalcemia. Thanks to the progress made by FLUOPTICS© in the field of medical imaging, the rate of postoperative complications of thyroidectomy has dropped from 20 to 5%. With this innovative system, surgeons have a reliable, easy to use tool enabling them to clearly and accurately identify the parathyroid glands and avoid inadvertently damaging or excising them.
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Thyroid, thyroid

Thyroidectomy (partial or total removal of the thyroid gland) is performed in around 45,000 patients in France each year, and in millions of people worldwide. Like any type of surgery, this procedure has risks and can cause postoperative complications.

FLUOPTICS© opens up new perspectives in endocrine surgery with its FLUOBEAM® imaging system based on autofluorescence technology, enabling detection of parathyroid glands in autofluorescence. By making It possible to view the parathyroid glands in real-time during surgery, it assists the surgeon and makes surgery safer. Today, FLUOPTICS© goes a step further with its launch of FLUOBEAM® LX, a device exclusively dedicated to thyroid and parathyroid surgery. A major innovation whose aim is to significantly reduce some of the risks inherent to this type of procedure.

To read more about it : How is thyroid dysfunction detected?

Thyroid surgery: what are its characteristics?

A thyroidectomy is the total or partial removal of the thyroid gland. This surgery is indicated in different situations, such as thyroid cancer, suspicious toxic nodules or cancerous cells, enlarged goiter, etc. It is performed under general anesthesia and involves making a small horizontal incision at the base of the neck. The thyroid gland, which produces the hormones T3 and T4, is responsible for regulating many vital bodily functions including metabolism, body temperature and heart rate.
A patient who has a total thyroidectomy must receive lifelong hormone replacement therapy (based on TSH level which is progressively adjusted).

What are the complications?

Thyroid surgery can cause a number of postoperative complications, mainly due to inadvertent damage to the pharyngeal nerves (the nerves of the vocal cords) which are exposed during surgery, or due to injury to the parathyroid glands, which are very small and difficult to see.

The risks of thyroid surgery are:

  • Hypoparathyroidism (or hypocalcemia): when the parathyroid hormones can no longer regulate calcium levels after thyroid surgery (because the parathyroid glands were accidentally damaged or excised during surgery). In 90% of cases, this complication is reversible.
  •  
  • Postoperative hematoma: this is a very rare complication which can be serious if the hematoma compresses the trachea.
  •  
  • Hoarseness and difficulty swallowing: these are very common postoperative complications due to the position of the inferior pharyngeal nerves. These symptoms can last for up to eight weeks after surgery.    
  • Laryngeal dyspnea: breathing problems caused by a decrease in the caliber of the laryngheal branch (extremely rare).
  •  
  • Postoperative hemorrhage: very rare.

Although these complications are rare if one looks at the total number of thyroid surgeries performed, they nonetheless occur in nearly 200,000 patients worldwide!

 

FLUOBEAM® imaging system

 

The FLUOBEAM® fluorescence imaging system has made great strides in thyroid surgery. Since 2015, it has been used in more than 2,000 thyroid surgeries to guide the identification of the parathyroid glands in autofluorescence. In close to 30% of cases, FLUOBEAM® Identified the parathyroid glands before the surgeon could even see them! Indeed, due to their small size, the parathyroid glands can be difficult to locate, even for a skilled surgeon, which may cause them to be accidentally damaged or excised. Thanks to their detection by autofluorescence, FLUOBEAM® makes surgery safer. One study showed that the rate of postoperative hypocalcemia could be reduced from 20 to 5%!

Used across several surgical indications – breast reconstruction, endocrine surgery, hepatic surgery – this polyvalent system has been roundly applauded by the scientific community.

The first imaging system approved (in Europe and the United States) for looking at the parathyroid glands by autofluorescence, intraoperative fluorescence imaging technology was designed to be used in a variety of surgical procedures and so there is still room for improvement in this particular indication. Therefore, based on the experience acquired over several years of FLUOBEAM® use, FLUOPTICS© has devised a solution dedicated to thyroid and parathyroid surgery.

FLUOBEAM LX: a breakthrough innovation for thyroid surgery

FLUOBEAM LX: a tailor-made device for thyroid and parathyroid surgery

To better meet the needs of surgeons, FLUOPTICS© is introducing the new FLUOBEAM® LX, specifically developed and dedicated to thyroid and parathyroid surgery in order to provide optimal ease of use in this indication. At least 10 times more sensitive than any other system on the market, it allows the detection of parathyroid glands in autofluorescence with suitable Image fluidity (25 images per second), a large depth of field and a use compatible with the ambient lighting of the operating theatre.

Designed to be held effortlessly above the operative field, and controlled with one hand by the surgeon, FLUOBEAM® LX is a true third eye which makes thyroid surgery safer.

Benefits for patients

FLUOBEAM® LX is a significant technological advance in the field of thyroid surgery. Above all it helps reassure patients, who are often worried about undergoing thyroidectomy. The FLUOBEAM® LX system dedicated to thyroid surgery could greatly reduce certain postoperative risks: reduced rate of auto-transplantation, postoperative hypocalcemia, hoarseness and swallowing problems, etc.

 

Benefits for surgeons

In the operating theatre, FLUOBEAM® LX facilitates the surgeon’s work by assisting the surgeon in accurately identifying the parathyroid glands (located near the thyroid gland), enabling them to be seen in real-time and preserved during surgery.  An even more powerful imaging system that means surgeons can operate in optimal conditions for more accurate surgical decisions.

FLUOPTICS©: 10 years of research and innovation

The European expert in fluorescence imaging guided surgery, FLUOPTICS© , in collaboration with research teams from around the world, has developed a line of products (the fruit of 10 years of research) enabling real-time visualization during surgery of physiological and pathophysiological phenomena, whichh are often invisible to the naked eye, to improve the quality of surgery.

 

With the new FLUOBEAM® LX, FLUOPTICS© takes another technological leap forward in thyroid surgery to better address patients’ health issues and make surgery safer. An improved imaging solution designed exclusively for the specifics of thyroid and parathyroid surgery, to better guide surgeons.

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