Procedure

Thyroidectomy- Ear Nose And Throat (ENT), Endocrinology, Gastroenterology, General Surgery

Thyroidectomy is a procedure that removes all or part of your thyroid gland. Your thyroid gland is a butterfly-shaped organ situated at the base of your neck. It produces hormones that control digestion, heart rate and metabolism. Thyroidectomy is utilized to treat thyroid problems, like cancers, enlargement of the thyroid (goiter) and overactive thyroid (hyperthyroidism).

Why is thyroidectomy required?

A thyroidectomy might be done for conditions, such as:

Thyroid cancer

Cancer is the most common reason behind thyroidectomy. If you have thyroid cancer, removing all or most of your thyroid gland will be a treatment alternative.

Noncancerous enlargement of the thyroid (goiter)

The removal of all or part of your thyroid gland is an alternative if you have a large goiter that is awkward or causes trouble breathing or gulping, or, if it is causing hyperthyroidism.

Overactive thyroid (hyperthyroidism)

Hyperthyroidism is a condition in which your thyroid gland creates excessively the hormone thyroxine. If you have issues with thyroid medications and if you don't like radioactive iodine treatment, thyroidectomy might be an alternative.

Which doctor to consult?

Consult an endocrinologist, because you will be needing their opinion if you will have  thyroid surgery. The person who does the surgery is an otolaryngologist/ENT surgeon or a general surgeon.

What to expect during thyroidectomy?

Before the procedure

Surgeons usually perform thyroidectomy under general anesthesia, so you won't be awake during the procedure. The anesthesiologist will give you an anesthetic medicine to inhale or will infuse medicine into a vein. A breathing tube will be placed in your trachea to help you breath during the procedure.

During the procedure

While you are sleeping, the surgeon will make a little incision at the middle of your neck or some incisions from the thyroid. All or part of the thyroid organ will then then be removed, depending on your condition.

In case you're having thyroidectomy because of thyroid cancer, the doctor may likewise check and remove lymph nodes around your thyroid. Thyroidectomy takes a few hours to complete.

There are three primary types of thyroidectomy:

Conventional thyroidectomy includes making an incision in the center of your neck to have access to your thyroid gland.

Endoscopic thyroidectomy uses smaller incisions in the neck. Surgical instruments and a little camera are placed through the incisions. The camera guides the surgeon throughout the procedure.

Robotic thyroidectomy is performed either through cuts in the chest and armpit or by an incision high in the neck. This method enables a thyroidectomy to be performed while not having to cut at the center of your neck.

Post-operative care

After the procedure, you will be moved to a recovery room where the medical team will monitor you. When you're conscious, you may be moved to a hospital room.

A drain may be placed under the incision in your neck. This drain may be removed the day after your surgical procedure.

After a thyroidectomy, you may have neck pain and a hoarse or weak voice. This is not due to damage to the nerve that controls your vocal cords. These side effects are temporary and may be because of irritation from the breathing tube that was placed into your windpipe or trachea during the procedure, or because of nerve irritation that is due to the procedure.

You may be able to eat and drink after the procedure. Depending on the kind of medical procedure you had, you might return home the day of your surgery or your doctor may suggest that you remain overnight in the hospital.

When you return home, you can do your regular activities. You can only do vigorous activities like heavy lifting or sports after 10 to 14 days. 

Complications

Thyroidectomy is a safe procedure. However, just like any procedure, thyroidectomy may also have complications, but they are rare.

Potential yet uncommon complications may include:

  • Bleeding
  • Infection
  • Airway obstruction that may be caused by bleeding
  • Hoarseness or weakness of voice
  • Hypoparathyroidism, that may cause low calcium levels and increased levels of phosphorus in the blood

To learn more about Thyroid Surgery, please check our blog on THYROID SURGERY (INCLUDING MINIMALLY INVASIVE APPROACHES).

References

  • Thyroidectomy - Mayo Clinic. Mayoclinic.org. https://www.mayoclinic.org/tests-procedures/thyroidectomy/about/pac-20385195. Published 2019. Accessed January 13, 2019.
  • Thyroidectomy: Overview, Preparation, Technique. Emedicine.medscape.com. https://emedicine.medscape.com/article/1891109-overview. Published 2019. Accessed January 13, 2019.

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