EXOPHTHALMIC GOITER IN CHILDREN*

Abstract

A total of 253 children less than 15 years of age who had exophthalmic goiter have been seen at the Mayo Clinic during the 48-year period, 1908 through 1955. There were 217 girls and 36 boys, a ratio of about 6:1. Observations in this series indicate that the disease in children does not appear to differ significantly from that in adults, although there is less tendency for children to have severe exophthalmos. Exophthalmos that occurs during childhood may persist for years after thyrotoxicosis has been relieved. Diabetes mellitus is observed more frequently among children with exophthalmic goiter than would be expected as a chance occurrence. Exophthalmic goiter during childhood, if adequately treated, does not alter adolescent development. Subtotal thyroidectomy is a satisfactory and safe method of treating exophthalmic goiter in children. There were only 4 hospital deaths among 196 children treated by this means. No surgical death has occurred since 1933 among children treated by this method. Recurrence of hyperthyroidism has not been eliminated by more extensive resection of the thyroid gland. Myxedema, although not considered a serious complication, occurs in a high percentage of patients treated by the extensive subtotal resection of the thyroid gland that is now carried out at this clinic. Hypoparathyroidism, keloid formation in the operative scar, and injury to the recurrent laryngeal nerves rarely occurred in the patients of this series. It is our opinion that a final evaluation of the best method of treating exophthalmic goiter in children must await an extensive experience with the other methods of treatment.