Who performs thyroid surgery: a review of current otolaryngological practice

Abstract

Thyroid surgery has been traditionally a general surgical practice, but recently more otolaryngologists have been offering a thyroid service. We have quantified thyroid surgery performed by the different specialties, and looked more closely at the practice of otolaryngologists. Data was obtained from the Department of Health for UK thyroid surgery in all specialties for the year 1998-99 and validated against a survey of members of the British Association of Otolaryngologists-Head & Neck Surgeons (BAO-HNS). The use of investigations of a simple clinical case (solitary thyroid nodule) was compared with best practice. General surgeons still perform the majority of thyroid surgery (83%) but ENT surgeons now perform significant numbers (15.4% of all cases), which translates to 1499 cases per annum. A total of 102 BAO-HNS members were performing thyroid surgery with an average case-load of 19.1 per year. In total, 35% of ENT surgeons see thyroid patients in multidisciplinary clinics. The choice of investigation is consistent with European guidelines. ENT surgeons are doing significant amounts of thyroid surgery and the numbers appear to be increasing. The formation of multidisciplinary teams including general surgeons and otolaryngologists who are committed to subspecialization can only improve both training and treatment outcomes.

A cross-specialty survey to assess the application of risk stratified surgery for differentiated thyroid cancer in the UK

“…In terms of study population, a previous report on thyroid surgery in 1998-1999 stated that 15.4% of thyroid surgery was carried out by ENT surgeons, with 35% of ENT surgeons seeing thyroid outpatients. 37 As forecast in the same paper, the proportional distribution of specialty affiliation in our survey (52% ENT, 58% endocrine) indicates that the proportion of ENT surgeons with a thyroid practice has increased significantly. It has been hypothesised that ENT surgeons, with normal practice involving extensive head and neck dissections for squamous carcinoma, may perform more extensive surgery for DTC but this has not been assessed previously.…”

Emerging Trends in the Performance of Parathyroid Surgery

“…Our prior investigation, which focused on thyroid surgery, demonstrated that graduating otolaryngology residents perform nearly twice as many thyroidectomies on average compared with GS residents 7 . Similarly, a study from the United Kingdom 8 found that, although thyroidectomies were historically performed exclusively by general surgery, from 1998 to 1999, 15.4% of thyroid procedures were performed by otolaryngologists and that number appeared to be increasing.…”

Who should perform thyroid surgery? United Kingdom (UK) and United States (US) perspectives with recommendations

“…In the UK, approximately 60% of thyroid operations are performed by surgeons with a training background in general surgery and 40% by head and neck surgeons with a background in otolaryngology [9,10]. This has increased from 1998 when only 15% of thyroid operations in the UK were performed by head and neck surgeons [11]. In the US, division of labour in thyroid surgery has traditionally been centre dependant [1].…”