Role of Total Thyroidectomy in Relieving Local Symptoms in Hashimoto's Thyroiditis

This study aims to evaluate the role and effectiveness of total thyroidectomy in relieving compressive and local symptoms (such as dysphagia, dyspnea, and anterior neck pain/discomfort) in patients with Hashimoto's thyroiditis who fail to improve with conservative medical management.

Inclusion Criteria: * Adults patients with confirmed Hashimoto's thyroiditis (elevated serum anti-thyroid peroxidase \\anti-thyroglobulin antibodies, characteristic ultrasound findings and/or positive fine needle aspiration cytology) * Biochemically euthyroid with normal thyroid function test. * Presence of persistent local symptoms (neck pain, throat discomfort,neck tightness,chocking) for more than 6 months * Patient fit and motivated to surgery. Exclusion Criteria: * Confirmed or high-suspicion thyroid malignancy (Bethesda V or IV on FNAC * Previous thyroid or neck surgery * Patient refusal to participate in the study * Severe comorbidities precluding general anesthesia * Active psychiatric illness