Dr. Kaylee Purpura, MD

Although biopsy is most often associated with cancer, it can also be used to check for other diseases, such as infections. A biopsy sample can be scraped, cut, collected with a needle, taken with a machine that punches out a tiny piece, or removed with the tiny tools in an endoscope.

In most cases, a biopsy is a simple outpatient procedure. Depending on the procedure, patients may need to stop taking certain medications beforehand, such as blood thinners. It is important for patients to tell doctors if they are pregnant, as certain biopsies require the use of x-rays to guide the needle to the right location. There is usually very little pain associated with a biopsy. Patients will have to wait a few days to hear the results.

Nasal endoscopy is the use of a thin, flexible tube (called a 'scope') that is inserted into the nostril to examine the structures of the nose. The scope contains a fiber optic light and a camera that allow a physician to see much more of the nasal passages, airways, and sinuses than is possible with a standard nasal exam.

A nasal endoscopy is typically performed by an otolaryngologist (or ENT) in their office. It may be performed for a variety of reasons, but some common ones include:

• Sinus infections
• Nasal polyps
• Frequent nosebleeds
• Persistent stuffiness
• Obstruction in the nose
• Suspected tumor in the nasal passages

In most cases, a medication containing a decongestant and anesthetic is sprayed into the nose before the scope is inserted. The doctor uses the scope to examine any problem areas. If necessary, most scopes allow for tiny tools to be inserted and used to removed tissue or take samples. Nasal endoscopy is a very safe and relatively easy procedure.

Both hypothyroidism and goiters are caused by an autoimmune reaction where the body produces antibodies that attack the thyroid cells for unknown reasons. The thyroid reacts by releasing too little or too much T3 and T4 thyroid hormones, impairing thyroid function and causing irregular metabolism. Goiters develop from the autoimmune reaction causing continued antibody damage to the thyroid over time. Thyroid goiters are large, swollen lumps that can be felt near the base of the neck. Obstructive goiters can cause pain, coughing, and abnormal breathing. Hypothyroidism may also be caused by iodine deficiency, as iodine is needed to produce thyroid hormones.

The exact cause of thyroid cancer and thyroid nodules or cysts is unknown. While thyroid cancer and thyroid nodules or cysts can occur in individuals with thyroid disorders, they are not associated with a malfunctioning thyroid.

Physicians may prescribe thyroid surgery if blood tests reveal patients' thyroid stimulating hormones (TSA) are outside of the acceptable range, indicating a malfunctioning thyroid. Thyroid biopsies (tissue samples) and tests for thyroid-attacking antibodies are also criteria for surgery.

An ENT or general surgeon performs thyroid surgery. While a patient is placed under anesthesia, the surgeon makes an incision at the center of the neck and removes the thyroid gland. Two alternative methods of thyroid surgery are transoral (incision through the mouth) and endoscopic, where a surgeon operates a video camera for live footage to help guide the removal process.

Thyroid surgery requires minimal aftercare. Most patients recover quickly and resume normal activities within a few days of surgery. However, thyroid surgery patients must take daily synthetic thyroid medication (levothyroxine) for life to replace their removed thyroid.