South West Surgical Club

to assess presentation diagnosis and morbidity. 63 goitres and 3 thyroglossal cysts were admitted under the author. The mean age at presentation was 43 years and 80% were female. 71% of the patients had a symptomless, solitary swelling, 16% a diffuse goitre and 13% thyrotoxicosis. The ultra-sound scan has been the most useful diagnostic tool. Fine needle aspiration cytology was used on all solitary swellings but it failed to confirm malignancy in the 7 thyroid carcinomata. Some points were stressed about surgical tecniques, in particular the necessity for care in tying the superior thyroid vessels and so avoid damage to the external laryngeal nerve. The author felt it important to identify the recurrent laryngeal nerve in all operations. There were no cases of nerve damage in this series, there was 1 minor wound infection. Solid thyroid lesions should be excised by ipsilaterial Total Lobectomy. Malignancy has to be confirmed histologically prior to proceeding to Total Thyroidectomy. This may be delayed until paraffin sections have been examined at 48hrs. Re-exloration of the neck on the contra lateral side was carried out with difficulty but there was 1 case of post operative hypoparathyroidism.