Schneider et al reported the Thyroidectomy Difficulty Scale to evaluate a patient undergoing thyroidectomy. The authors are from the University of Wisconsin in Madison.
Patient selection: thyroidectomy
Parameters:
(1) vascularity
(2) friability of tissue
(3) mobility of gland and periglandular fibrosis
(4) size of the thyroid gland
|
Parameter |
Finding |
Points |
|
vascularity |
normal |
1 |
|
|
|
2 |
|
|
moderate |
3 |
|
|
|
4 |
|
|
extensive |
5 |
|
friability of the tissue |
easy to retract |
1 |
|
|
|
2 |
|
|
tears easily but able to retract |
3 |
|
|
|
4 |
|
|
unable to hold with any glamp |
5 |
|
mobility of the gland |
elevates easily |
1 |
|
|
|
2 |
|
|
able to retract medially with effort |
3 |
|
|
|
4 |
|
|
fixed, unable to retract |
5 |
|
size of the thyroid gland |
normal |
1 |
|
|
slightly larger than normal |
2 |
|
|
above average |
3 |
|
|
|
4 |
|
|
large, goiter |
5 |
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 4
• maximum score: 20
• The higher the score the greater the difficulty in performing a thyroidectomy and the longer the operative times.
• Mok et al used a TDS >= 10 as indicating a difficult thyroidectomy based on impact on operating times.
Specialty: Endocrinology, Clinical Laboratory
