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Myasthenia & Thymectomy

Thymus gland is a lymphoid organ.It isrelated to immune system.The human thymus situated in anterior &upper part of chest cavity, extending upto neck.It is bigger in infants & children ,becomes smaller later on. Thymus gland is related to Myaesthenia Gravis(serious weakness of muscle).Myaesthenia is managed medically but in some selected patients Thymectomy (Surgical excision of thymus gland)is performed.Thymectomy is also done for Thymoma(Thymic tumours). Thymectomy may be done by open surgery(By cutting the sternum or breast plate) by VATS or by RATS(Robotically assisted thoracoscopic surgery)

1) What is myasthenia gravis?

Ans: It is a chronic muscle weakness of voluntary muscles .Literally it means ‘Grave muscle weakness’.

2) What causes myasthenia gravis?

Ans:Myasthenia gravis is caused by a defect in the transmission of nerve impulses to muscles.

3) What are the symptoms of myasthenia gravis?

Ans:In most cases, the first symptom is weakness of the eye muscles. In others, difficulty in swallowing and slurred speech may be the first signs. The severity of muscle weakness involved in myasthenia gravis varies greatly among individuals, ranging from a localized form limited to eye muscles, to a severe form in which many muscles—sometimes including respiratory muscles—are affected.

4) How is myasthenia gravis treated?

There are several therapies available to help reduce and improve muscle weakness. Medications used to treat the disorder include anticholinesterase agents such as neostigmine and pyridostigmine, which help improve neuromuscular transmission and increase muscle strength. Immunosuppressive drugs may also be used. Thymectomy, the surgical removal of the thymus gland (which often is abnormal in individuals with myasthenia gravis), reduces symptoms in some individuals without thymoma and may cure some people. Thymectomy is recommended for individuals with thymoma.

5) What are the techniques of Thymectomy?

Ans: It may be open or Thoracoscopic (VATS) or Robotic(RATS).