Thyroidectomy

Doctor-examining-patient-prior-to-thyroidectomy
Illustration-of-thyroid-gland-removed-during-thyroidectomy

The thyroid gland, a butterfly-shaped organ situated in the neck, plays a pivotal role in regulating the body’s metabolism through the production of essential hormones. At times, due to various medical conditions or abnormalities in the gland, it may become necessary to remove all or part of it. This surgical procedure is known as a thyroidectomy.

Reasons for Thyroidectomy

Several medical conditions may necessitate a thyroidectomy:

  • Cancer: If a biopsy confirms the presence of thyroid cancer, the gland, or a portion of it, may be removed to halt the cancer’s progression.
  • Goiter: A non-cancerous enlargement of the thyroid, known as a goiter, can become problematic if it grows large enough to cause breathing or swallowing difficulties.
  • Overactive Thyroid (Hyperthyroidism): In cases where hyperthyroidism doesn’t respond to other treatments, a thyroidectomy may be recommended.
  • Cystic or Benign Nodules: While most thyroid nodules are harmless, some may grow large or produce excessive thyroid hormone, necessitating removal.
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Woman-touching-her-thyroid-before-thyroidectomy

The Three Types of Thyroidectomy

  • Total Thyroidectomy: The entire thyroid gland is removed. This is commonly done when cancer is present.
  • Hemithyroidectomy or Lobectomy: Only one of the two lobes of the thyroid gland is removed. This may be done for non-cancerous tumors or nodules.
  • Subtotal/Partial Thyroidectomy: A part of the thyroid is removed, leaving behind some thyroid tissue.

What to Expect During The Procedure

  • Preparation: Prior to surgery, imaging tests might be conducted to assess the thyroid’s size and position. Some patients may also be prescribed medications to stabilize thyroid hormone levels.
  • Anesthesia: A thyroidectomy is usually performed under general anesthesia, ensuring the patient is asleep and feels no pain during the procedure.
  • Incision: A small incision is made in the center of the neck to access the thyroid gland.
  • Gland Removal: Depending on the type of thyroidectomy, either all or part of the gland is delicately removed.
  • Closure: The incision is sutured, and the patient is moved to a recovery room.

Postoperative Care and Recovery

Recovery from a thyroidectomy can vary depending on the extent of the surgery and individual factors:

  • Hospital Stay: Patients typically stay in the hospital for a day or two for monitoring.
  • Pain Management: Some pain or discomfort around the incision site is expected, which can be managed with prescribed pain medications.
  • Voice and Calcium: Due to the proximity of the thyroid gland to voice box nerves and parathyroid glands, some patients might experience hoarseness or changes in voice, and fluctuating calcium levels post-surgery.
  • Hormone Replacement: If the entire thyroid gland is removed, patients will need lifelong thyroid hormone replacement therapy to maintain normal body functions.
  • Follow-up: Regular follow-ups are essential, especially to monitor thyroid hormone levels and ensure the incision is healing well.

Potential Risks and Complications

While thyroidectomy is a common and generally safe procedure, potential complications include:

  • Bleeding: Internal bleeding could occur post-surgery.
  • Infection: As with any surgery, there’s a risk of infection at the incision site.
  • Nerve Damage: The surgery might inadvertently harm nerves near the thyroid, potentially affecting voice quality.
  • Parathyroid Damage: These glands regulate calcium, and damage could lead to low calcium levels in the body.