ABSTRACT
With a paradigm shift from subtotal to total thyroidectomy, the incidence of recurrent nodular goiters has reduced over the decades. However, when present, it poses a difficult and elusive challenge for endocrine surgeons. The causes of recurrence are largely speculative, with incomplete surgery being the most common cause. The role of thyroid stimulating hormone (TSH) suppression in preventing recurrence is still controversial. Recurrent laryngeal nerve and parathyroid function compromise are higher in redo thyroidectomies due to altered anatomy, fibrosis and scarring. Preoperative imaging and laryngoscopy hence are vital to plan re-exploration. Different approaches have been described in the literature for re-explorations to reduce morbidity of redo surgery. The following chapter deals with the pathogenesis, clinical presentation and operative strategies of patients presenting with recurrent benign nodular goiter.
