Saadi R, Brandt A, Kim Y, et al. - In patients with autoimmune thyroid diseases, researchers illustrated the differences in the degree of the technical difficulty of thyroidectomy. Charts of adult thyroidectomy patients have been reviewed. They individually compared patients with Hashimoto's Thyroiditis (HT) or Graves' Disease (GD) to a control group of patients with early stage malignancy or goiter. The authors discovered that the HT (n = 65) group was much more likely to have friable and fibrotic thyroids, longer operative times, and a 22-modifier. They observed that the GD (n = 169) group was much more likely to have friable, vascular, fibrotic, and heavy thyroids, longer operative times, increased length of stay and a 22-modifier. An institution's experience with a high-volume thyroid practice shows that patients with autoimmune thyroid disease have consistent thyroid quality changes and significantly increased operating times and surgical complexity.