Background: Total thyroidectomy is increasingly used for treating bilateral benign thyroid diseases, but it requires ongoing levothyroxine replacement therapy to prevent hypothyroidism. Heterotopic thyroid auto transplantation was suggested to eliminate this need and preserve the body’s thyroxin synthesis. However, limited data exists on this topic. Previous studies on animals have shown successful auto transplantations, but limited clinical trials have used cryopreserved thyroid autografts, with insufficient number of studies and patients, and inconsistent study procedures.
Aim and objectives: The purpose is to assess the positioning of thyroid tissue in the thigh muscle following total thyroidectomy for benign simple nodular goiter, with the goal of avoiding the need for lifetime thyroid hormone replacement medication and preserving the autoregulatory mechanism of thyroid hormone production.
Methods: We performed a case series analysis on a group of 30 patients who were diagnosed with multinodular goiter and were being considered for complete thyroidectomy. The patients were randomly assigned to two groups: group A (consisting of 15 patients) who were administered 5 g of healthy non-nodular thyroid tissue, and group B (also consisting of 15 patients) who were administered 10 g of the same tissue. The viability and efficacy of heterotopic auto transplanted thyroid tissue were evaluated using hormonal analysis and ultrasound imaging of the thigh (the location of the transplanted thyroid graft) at 2, 6, and 12 months after the surgery.
Results: The study found no significant difference in radioactive iodine uptake between group A and group B, but significant differences in free T3, T4, TSH levels, and pulse after the 2nd, 6th, and 12th months. The processing and injection time range for auto transplanted thyroid tissue was 18-20 minutes, with no immediate or delayed problems.
Conclusion: Thyroid auto transplantation involves injecting a suspension of thyroid tissue, resulting in increased thyroid hormone levels. Larger implants absorb isotopes more, but not hormone levels. The process is safe, effective, and efficient, with superior outcomes in younger individuals. The process improves over time.