SURGICAL-TREATMENT OF GRAVES-DISEASE IN PATIENTS YOUNGER THAN 18 YEARS

Eighty-two children and adolescents (18 males, 64 females; median age 14 years) surgically treated for Graves' disease at a single instituti on between 1979 and 1993 were retrospectively reviewed. Most of the pa tients (74%) coming to thyroidectomy had been treated medically for a period ranging from 2 to 80 (median 15) months. Bilateral subtotal thy roid resection was the most frequently performed procedure (86%). Post operatively, no permanent recurrent laryngeal nerve palsy or permanent hypocalcemia occurred. Operative mortality was zero. With a median fo llow-up of 8.3 years, recurrent hyperthyroidism occurred in five patie nts (6%), one of whom required reoperation. Most children and adolesce nts with Graves' disease can be rendered euthyroid by nonsurgical trea tment options. However, prolonged and ineffective medical treatment sh ould be avoided in these patients who are in the formative gears of th eir lives. Surgical treatment, when indicated and employed, offers you ng patients with Graves' disease a safe, rapid, definitive, cost-effec tive treatment with a high success rate.