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The Increasing role of otolaryngology in the management of surgical thyroid disorders

Authors

  • Kyle J. Chambers MD,

    Corresponding author
    1. Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A
    2. Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, U.S.A
    • Send correspondence to Kyle J. Chambers, MD, Department of Otolaryngology, 243 Charles Street, Boston, MA 02114. E-mail: kyle_chambers@meei.harvard.edu

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  • Neil Bhattacharyya MD, FACS

    1. Division of Otolaryngology, Brigham and Women's Hospital, Boston, Massachusetts, U.S.A
    2. Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, U.S.A
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  • Recipient of the 2013 Third Place John J. Conley, MD, Resident Research Award, Eastern Section of the Combined Triological Society Meeting, January 24–26, 2013.

  • Neil Bhattacharyya is a consultant for IntersectENT, Inc., and Entellus, Inc. The authors have no other funding, financial relationships, or conflicts of interest to disclose.

Abstract

Objectives/Hypothesis

To determine trends in office visits and medical specialty seen for surgical diagnoses of the thyroid gland.

Study Design

A cross-sectional analysis of a national healthcare database.

Methods

From the National Ambulatory Medical Care Survey (NAMCS), all cases of surgical thyroid disorders (e.g., benign neoplasm of thyroid gland, malignant neoplasm of thyroid gland, multinodular goiter) were extracted for 2 calendar year cohorts: 1995 to 1999 and 2005 to 2009. In addition to demographic information, the medical specialty of the health care provider seen was extracted. Comparisons were conducted for the proportion of surgical thyroid cases seen between general surgeons and otolaryngologists for the respective cohorts.

Results

In the 1995 to 1999 cohort, there were a total of 107 ± 13 thousand outpatient visits annually to either general surgery or otolaryngology for surgical thyroid conditions. Among these, 62.7 ± 8.4 thousand visits (58.3 ± 5.6%) were seen by general surgery versus 44.8 ± 9.1 thousand (41.7 ± 5.6%) seen by otolaryngology. In comparison, in the 2005 to 2009 cohort, there were 218 ± 29 thousand visits annually for surgical thyroid conditions. Among these, 88.4 ± 17 thousand (40.5 ± 5.4%) were seen by general surgery versus 130 ± 21 thousand (59.5 ± 5.4%) seen by otolaryngology. The increase in proportion of surgical thyroid patients seen by otolaryngology in the second 5 year cohort was statistically significant (P = 0.032, chi-square).

Conclusions

There is a national trend in the United States toward otolaryngologists seeing an increasing majority proportion of increasingly prevalent surgical thyroid conditions. These data objectively confirm the perceived increasing role of otolaryngologists in the management of surgical thyroid disorders on a national level.

Level of Evidence

2a. Laryngoscope, 123:3239–3242, 2013

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