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Objective: To investigate the role of surgery in the treatment of Riedel's thyroiditis, sum up experience, for the purpose of surgery, surgical approach, the effect of surgery, postoperative complications and long-term efficacy overall assessment. Methods: Affiliated to the Second Affiliated Hospital of Dalian Medical University, Dalian University Zhongshan Hospital, 1996-2008, six cases were treated by surgery and pathology confirmed Riedel thyroiditis patients with clinical information, including clinical manifestations, preoperative preparation, surgery, surgery effect, postoperative complications, and follow-up, do a retrospective analysis. Results: 6 patients in the survey, there are 2 males and 4 females, the male to female ratio of 1:2, the average age was 42.5 years. History of thyroid goiter, neck compression symptoms, cervical discomfort or hoarseness. Surveyed some patients with severe symptoms, including hoarseness caused by oppression, cervical discomfort and other symptoms of oppression. One patient underwent preoperative medication, including thyroxine tablets, strong pine, patients taking corticosteroids symptoms of short-term remission after stopping disease recurrence. Applied in all patients after thyroxine or glucocorticoid, did not alleviate the progressive increase of the thyroid. The surgical indications for a high degree of suspicion for malignancy. Preoperative preparation include: laboratory tests measuring thyroid hormone levels, thyroid biopsy, ultrasound. Before surgery, 5 patients with thyroid function is normal, not taking thyroxine tablets; 1 patients with a long history, the early performance of hyperthyroidism, not taking hormone tablets, almost a year and hypothyroidism, clinical manifestations and laboratory scan both hypothyroidism taking thyroxine tablets. Patients do fine needle aspiration biopsy, Hashimoto's thyroiditis is suspected malignant trend; patients fine-needle aspiration biopsies of thyroid tumor cystic degeneration. High index of suspicion for the growth of malignant tumors and invasive disease, before choosing surgery. Surgical approach, most of unilateral thyroid resection 3, unilateral thyroid lobe resection, bilateral subtotal thyroidectomy 1. The use of intraoperative frozen pathology, patients return for thyroid cancer, 5 were benign. All patients were confirmed by surgical specimens were sent for pathological confirmed by pathology Riedel thyroiditis. Fiber outer thyroid inflammation degree of progress in all patients is different. This brief bilateral recurrent laryngeal nerve paralysis complications cases, accounting for 17%, after the anti-inflammatory therapy and speech therapy, short-term symptoms of recurrent laryngeal nerve paralysis be restored within 3 months after surgery. None of the patients with postoperative hypocalcemia. The mean follow-up time of 50 months. All patients were taking thyroid hormone replacement therapy. So far, there is no re-operation in patients with or related treatment. Conclusion: Riedel's thyroiditis is a very rare disease, the incidence rate was 0.07%. The major clinical treatment is medical treatment of glucocorticoid or tamoxifen. Neck compression symptoms, such as breathing and swallowing difficulties, or high index of suspicion should the purposes of surgical treatment in patients with malignant tumors, surgical frozen pathology clearly Riedel's thyroiditis, surgery should be as secure as possible row radical resection.
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